Loss Adjuster issues on House Insurance claim

[andrew1]

A family member had a robbery where items of jewellery were stolen amongst other things.

 

The person is as straight as they come and that was reflected honestly on her claim - she hates insurance or benefits cheats with a passion so will not put anything which is not true on a claim form, but the loss adjuster is making her feel like a liar and a cheat as they are refusing to pay out on her claim anywhere near what the value of these items were worth and will not pay out on anything which either doesn't have a receipt or an original box.

 

Many items were handed down through the family in France as she is French. Many do not have receipts or the boxes they came in originally, but the insurance company, despite being provided with documents saying they were handed down or given as gifts and provided with pictures of some of the boxes which remained (some got stolen with the items) refuse to make any kind of payment against those.

 

Now I can understand they need to ensure bogus claims are not made, but as she is so straight she feels she is paying for the rogues deceiving the system.

 

I do not know which insurer it is yet, but she has spoken to the Ombudsman but we all know what a chocolate fireguard is don't we?

 

Can anyone tell me what the procedures are for situations like this where it is common practice that people keep things in one or two central jewellery boxes and disguard shop boxes, some people don't keep receipts of everything they buy, and many items of value both sentimental and valuable never have any kind of records when they are handed down through family or given as gifts.

 

What is the normal mode of dealing with this and insurance companies and what should she do to tackle this?

 

She has been offered a few hundred pounds for a claim in excess of 5k.

 

She's panicking....

 

Thanks

A1

[unclebulgaria67]

Can be tricky when you don't have receipts or evidence of having the items. Neither the FOS or courts are going to award a sum of money unless some evidence of ownership and value is provided. She should see if you can find pictures of her wearing the items.

[andrew1]

Can be tricky when you don't have receipts or evidence of having the items. Neither the FOS or courts are going to award a sum of money unless some evidence of ownership and value is provided. She should see if you can find pictures of her wearing the items.

 

Thanks, that's what we are doing, but there's thousands of photo's to go through.

 

What niggles her the most is that she is being treated worse than the criminal and it's been a severe experience enough just having had her flat burgled. She lives on her own in a rather crowded estate on the outskirts of town in the Midlands, she's petrified and this loss adjuster is just callas - no other word for it, making her feel dirty when she's always been a pillar of respectability.

 

I'm waiting for the policy to be sent over and I'll go through the small print because this is just turning what she thought was a safety net in a shark attack on her, this may lead to Unfair Terms or TCF, we'll see, but thanks Uncle.

 

A1

[Mwynci]

The FOS are generally sympathetic to cases like this, different to cases say where someone claims to have bought the item recently and can't provide anything.

 

It's not reasonable to have to keep boxes, receipts, photos. In cases of inherited items, how can you?

 

The adjuster would have to prove on balance (what's the phrase, unreasonable doubt ?) the claim was fraudulent to not pay this, they would need pretty good evidence to do this. It's clearly not the view held, otherwise no settlement would be offered.

 

It sounds like the adjuster just can't be bothered and is looking to settle out of the way, rather than get a detailed description and try to validate this correctly.

 

I generally don't work in an insurance environment anymore, but if I still was, there would be a stapler flying towards the head of the adjuster who's tried this one on if I found out about this.

 

Persevere with the complaint, don't let them try to bully.

[andrew1]

Thanks Mwynci, that is very reassuring. We'll proceed to talk to the FOS I think.

 

Much appreciated.

 

A1

[TSx]

Are they refusing to pay or are they saying they'll only pay a certain amount? You say a few hundred in your initial post - what is that based on and what is the £5k figure based on? Can you also name the insurer?

[f16]

I've been in this "position".

 

Got my warehouse "ram raided". In excess of £15,000 tools gone.

I had to produce ALL the receipts or the would not pay.

 

I paid my eldest daughter to "trawl" through years of receipts to try to "prove" the loss.

Some of the tools were older than 7 years and we had no "proof".

We ended up with £7,500. Half the loss !!!!!

My yearly premuim was in excess of £3,000.

 

That is when I decided to use ISA's instead of insurance. ........

That way you get ALL your money back !!!!!!

If you don't encounter a "problem"; Your "Quids" in.

[andrew1]

Are they refusing to pay or are they saying they'll only pay a certain amount? You say a few hundred in your initial post - what is that based on and what is the £5k figure based on? Can you also name the insurer?

 

Thanks folks, they are refusing to pay the whole sum and only paying out on a couple of their own selected choice items. All the unsupported items which have been handed down through the family or given as gifts are excluded and anything not in it's original box. The 5k is an 'under estimate' of value based upon comparable items in the market and the handed down items have been based upon what the values the family in France believed the items to be worth less a %. None of these valuations have been hyped up. I'd rather not say who the insurer is whilst the claim is in progress but it is, I now understand, underwritten by a large organisation as most of these policies are.

 

I have seriously thought about sticking my own insurance money into a savings account rather than paying them out each year, but many many years ago we had a cup of tea knocked off a bannister post on the landing (while I skipped into the loo en route to my study) and the carpet was ivory coloured. The tea never came out even though the insurers sent in professional cleaners of their own and in view of the type of policy and the carpet throughout the house, the insurers had the whole 5 bedroomed house recarpeted throughout - cost over 10k even back then (10-15 yrs ago) so unless I'd saved from day 1 it's hardly likely I'd be in pocket.

 

I must say the insurers in that instance were incredible, the carpet fitters were the issue trying to rip-off the insurers and I went to 13 different carpet fitters myself the insurers had recommended. I had 3 around to choose but the the ones I wanted were not on the approved list. The jack-the-lads who the loss adjusters chose gave prices, for exactly the same carpet make and underlay, varied so much I knew something was amiss so I chose the fitter myself from a highly reputable company locally and the insurers agreed to allow them to do it. It cost them less than through their own loss adjusters prices so it just goes to show what they're up to some of them.

 

Anyway, I think our next port of call is some rather strong letters to the insurance underwriter and the Ombudsman as my relative should not be being put through this kind of stress given the trauma she has already suffered, they're making it worse and that's not what having insurance is all about. Even if they do have to watch out for rogue claims and treat some with caution as I fully understand, some people are obviously not on the make and this is one of them.

 

Thanks

 

A1

[unclebulgaria67]

If you search through the FOS sites, you will see a number of different cases, where you can work out what the general rule is.

 

This appears to be that for general household items, the Insurers would not expect receipt or valuations, but for valuables such as jewellery they would expect the policyholder to have obtained valuations.

 

If these were items that were of sentimental value to them and possibly of significant monetary value, the policyholder should have obtained valuations. In the event of there being no valuation, there would need to be pictures of the policyholder wearing the items.

 

If there is no evidence of the policyholder having the items, the Insurers won't pay out and I don't think the FOS or courts would make the Insurers pay. It would be unreasonable to expect Insurers to just take the policyholder word for it. The jewellery taken may be costume jewellery of no significant value, but the Policyholder thought they were real diamonds.

[andrew1]

Yep, I can see the logic of that. Thanks

[dacouc]

Thanks folks, they are refusing to pay the whole sum and only paying out on a couple of their own selected choice items. All the unsupported items which have been handed down through the family or given as gifts are excluded and anything not in it's original box. The 5k is an 'under estimate' of value based upon comparable items in the market and the handed down items have been based upon what the values the family in France believed the items to be worth less a %. None of these valuations have been hyped up. I'd rather not say who the insurer is whilst the claim is in progress but it is, I now understand, underwritten by a large organisation as most of these policies are.

 

 

What is the percentage deduction you refer to for?

[caro]

I don't know if it might be worth appointing her own loss adjustor. Just something to consider as it was suggested to me when I had a major claim, but that wasn't for burglary so the evidence of loss was available.

[andrew1]

What is the percentage deduction you refer to for?

 

Just trying to be sensible I guess rather than over inflating the price - that's the way they are..

 

Caro, I can't see them doing that. I'm only on the side-lines trying to help, what they actually do is in their control.

 

But thanks

A1

[dacouc]

Just trying to be sensible I guess rather than over inflating the price - that's the way they are..

 

Caro, I can't see them doing that. I'm only on the side-lines trying to help, what they actually do is in their control.

 

But thanks

A1

 

It's up to the policyholder to substantiate their claim.

 

Uncle gives good advice to read the Ombudsman's guidelines / previous rulings on lack of receipts as this will help you. His a link http://www.google.co.uk/#q=ombudsman+receipts

 

The Ombudsman may accept photographs of the items or of her wearing the items.

 

For a valid claim the Insurer should settle the claim on the current new replacement value of the items

[andrew1]

Thanks dacouc..