Matching policy on insurance. Is it legal?

[johnstanton1954]

I'm not sure if this is the best place to post this (apologies if not, this is my first post) but I'm being driven crazy by my insurance company and a claim that I have for a flood in my kitchen.

 

I made the claim back in the October (on my housedhold insurance) and they accepted the claim within days of me making it (I had a burst pipe in the wall). As part of the repairs to my Kitchen a number of old wall tiles and floor tiles have had to be removed (which has happened).

 

The problem is that the loss adjustors (I think they are called LAS) are saying that they will only replace the broken tiles (not all of them) and only with ones that are a 'close match'.

 

The problem is that the tiles are really old (i think they might be Victorian - they have old designs on them) and it's impossible to match them so they are insisting on putting in tiles that are a different colour.

 

I've tried talking to LAS but they say it's a Tesco decision and Tesco say it is an LAS decision so I spend hours on the phone going from one to the other. I've had a builder look at the damage and he has quoted around £1,500 to replace all the tiles, which I can't afford. It wouldn't be so bad if it was a handfull of tiles, but it's quite a lot and in different places around the kitchen.

 

I'm tempted to post reviews on various review sites but it will only make me feel better (it won't change anything). I'm not sure what else to do at this stage. I can't really afford to go to court but I don't want Tesco to get away with replacing old tiles in my kitchen with ones that look out of place.

 

Has anybody managed to persuade an insurance company that matching tiles need to match (and not look similar) or any advice on what to do next.

Edited May 2, 2013 by citizenB
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[42man]

You could possibly try the financial ombudsman although it may take a while....

[steampowered]

Why are Tesco involved? Surely this is up to the insurance company not Tesco?

 

I would start the ball rolling with a formal written complaint under their complaints policy - you are getting fobbed off on the phone.

[unclebulgaria67]

Why don't you give the FOS a call to discuss, as they would normally expect the Insurers to make a 50% contribution towards undamaged items in this situation, if ther were a significant number of tiles damaged. This is taken from the FOS site.

 

For many years, we have awarded compensation to customers who have referred complaints to us about "loss of match" where, for example, one part of a three-piece suite has been damaged and it has not been possible to obtain an exact replacement for the damaged item. Our typical award is 50% of the cost of replacing the undamaged items. We have applied this approach to buildings insurance as well as to contents insurance. However this approach is not always appropriate. For example, bathroom tiles give rise to similar disputes, but we are not usually sympathetic to demands for compensation when only a few of them need to be replaced. In these cases, we will assess the claim to see what effect the loss of match has on the remaining items. If there is no substantial loss, then we are unlikely to consider that any additional compensation should be paid. Conversely, where matching is intrinsic to the value of the objects, we will make an award for full replacement.

Once you have spoken to the FOS, then speak to the Tesco claims handlers about your situation and see if you can reach a compromise, so you don't feel the need to involve the FOS, which would time consuming to both parties and costly to the Insurers. Tesco Insurance handle the Insurance and claims on a delegated basis on behalf of underwriters.

[johnstanton1954]

To clarify about Tesco - my insurance is with Tesco. I wrote to them making an official complaint back in December and they promised that they would resolve the issue within 8 weeks. It's now been nearly 16. I've tried writing again but just get a standard letter back saying they are looking into things. I've called the Finanical Ombudsman and they said they have a backlog of complaints and it would be 12 weeks before they could look at my case. Is this right? I suppose I'll write anyway but I'll have to live without tiles for at least another 3 months before I do anything. I suppose I need to know if anybody has had success with fighting the 'matching policy' - if they have I think I will continue arguing my case but if not, then I might have to live with tiles that look nothing like the ones I had. What's frustrating is that I thought that the point of insurance was to restore things to how they were before damage.

[johnstanton1954]

I posted this before the last post. Useful advice. I'll try Tesco again.

[johnstanton1954]

An update on this. I've now been offered 50% of the value of the unmatched tiles which aren't damaged and 100% for the ones which are which is definite progress. However, if I pay for a builder to replace all the tiles I'll still be out of pocket on the claim (as it will cost more for me to replace all of the tiles than I'm being paid). Anybody got any views on whether this is the best I can do? Don't insurance companies have an obligation to return you to the same situation you were in before you had the damage? A

[johnstanton1954]

Sorry - one more question for anybody reading this - the money they are offering me is based on their own builder's quote which is lower than the quote I had from the builder I would need to use (one that I found myself). Am I allowed to get other quotes and use these as evidence that their quote is too low?

[unclebulgaria67]

You have got to the best position you can obtain i.e a 50% contribution towards undamaged tiles. Your contribution also of 50% towards undamaged items reflects that the tiles are brand new (betterment). While you don't think you have gained from having brand new tiles, the Insurer have now agreed to pay 50% for items that were not damaged by an insured peril.

 

If you want to use your own contractors, you would have pay the difference in cost. It is up to you to negotiate with your contractors to reduce their price to match as near to the Insurers contractors as they can.

[Alloyz1]

Another possible solution is to see if you can get ALL the work done including all the tiles, for the value of LAS scope of works? Then cash settle once you have their comittmernt to a 50% contribution.

[unclebulgaria67]

Another possible solution is to see if you can get ALL the work done including all the tiles, for the value of LAS scope of works? Then cash settle once you have their comittmernt to a 50% contribution.

 

You can probably purchase the tiles at a good discount, given the current state of the economy. If you search around, you will be surprised at what you may be able to negotiate.

[batty69]

An update on this. I've now been offered 50% of the value of the unmatched tiles which aren't damaged and 100% for the ones which are which is definite progress. However, if I pay for a builder to replace all the tiles I'll still be out of pocket on the claim (as it will cost more for me to replace all of the tiles than I'm being paid). Anybody got any views on whether this is the best I can do? Don't insurance companies have an obligation to return you to the same situation you were in before you had the damage? A

 

Yes it called indemnity.

 

to win this dispute, this is the principle you are going to have to prove.

 

I guess the key thing is how old and irreplaceable these tiles are?

 

The insurance company may argue that replacing all of the tiles constitutes betterment, but if you had an antique chest of draws worth £10k's there is no way the insurance company could argue betterment by giving a you brand new chest of drawers from ikea was betterment because it performed the same function but was brand new.

 

Likewise the insurance company is going to argue it only had duty to replace the damaged tiles, but if you can prove that suitable tiles are not available then it could be argued that the whole of tiling is irrepairable and thus needs replacing.

 

However this is all depends on how unique your tiling is ?

 

I'm not saying you have a case, but there is scope under the principle of indemnity to argue you have one if you can prove that the settlement offer will leave you in a worse position and that no betterment has been achieved.

[johnstanton1954]

Another possible solution is to see if you can get ALL the work done including all the tiles, for the value of LAS scope of works? Then cash settle once you have their comittmernt to a 50% contribution.

 

This is something I will explore with various builders. I think the problem is that the LAS scope of works is based on cheap building rates (I have spoken to the builder that LAS use and he thinks he will 'lose' money on my claim but as he makes money on most claims he has no choice but to accept it as he is contracted to complete all claims). LAS have removed a number of items from the statement of works that he submitted to LAS that he thinks will be required. Tesco are actively trying to push me to take a cash settlement for this reason (they went so far as to say they wouldn't talk to me any more and that they would be issuing a cheque but I've said I wouldn't cash it as I'm not accepting this at the moment). However, the LAS contractor might be exaggerating so I'll definitley ask a number of other builders to quote.

[johnstanton1954]

It's a good suggestion - thank you. I've been to a lot of tile places and reclamation yards - the problem is that they are very old and patterened and nobody has anything remotely like them.

[johnstanton1954]

This is very helpful. I think I'm beginning to see where I can move forward on this. I've put a lot of work into trying to find the tiles (have as LAS) so at this stage I can prove that unique and I might be able to prove that I'm not getting 'betterment'. I'll have this conversation with Tesco and see how I get on.

[johnstanton1954]

BTW, when I said "I'll have this conversation with Tesco", I'm hoping they will talk to me (although I would add that I've managed to get talking to a senior team leader in their Newcastle call centre and I have direct contact details and conversations are much more sensible than they were a month or so ago when I was always dealing with a different person and never had a number I could call back on).

[Alloyz1]

Ok

This is the CEO of Tesco direct email [email protected]

 

I'm sure a strongly worded email with LAS copied in will help... Copy in LAS.

 

Word of warning... You have agreed to a no match policy when agreeing to their t&c's and they have offered the FOS recommended resolution....

 

I would still go for a cash settlement including their 50% contribution....

 

Get your own quote from a builder and ask to cash settle on that, as you want to use him because you 'know how good his workmanship is'.....

 

And as for the contractor losing money??? Rubbish, I make 40% on cost of sales with LAS before overheads... So his overheads are to high or he is lying!!

 

A

[johnstanton1954]

All very helpful. Thank you. I'll let you know how I get on.

[johnstanton1954]

A final update on this. I've finally settled with Tesco. They have adjusted the statement of works to cover not just the damaged tiles but a row of tiles all around the damaged areas, which means that 3/4rs of the tile area is now covered. At this point, I've taken the cash settlement and have found a builder who can do the work a bit cheaper. I'll still be slightly out of pocket by the time I've purchased repacement victorian tiles but it's a much better situation than where things were at 6 weeks ago. I've also filed a complaint with the Ombudsman about the time it has taken for Tesco to resolve the claim.

[johnstanton1954]

Oh, and I would like to say 'thank you' for the advice.

[citizenB]

This thread is now in "General Legal Issues"

 

It is purely an administrative move.