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A couple of weeks ago, my wife noticed some water appearing from under the washing machine. When I moved the washing machine to take a look, I found that there was a small leak from the fitting to the water supply.

 

The washing maching is in the conservatory and is full enclosed in a fixed cupboard.

 

The washing machine sat on a wooden floor which has been very badly damaged and whilst moving the washing Machine & Dryer (which sat on top) my heel actually went through the floor. The odd thing is that there was no smell at all.

 

I am insured through Tesco who asked me to get quotes and the cheapest I got was for £2700 +vat. Tesco sent around a loss adjuster who came today. She has repudiated the claim saying the damage had occured over time and that it was my responsibilty to have checked my property regularly.

 

The flooring in question is mostly covered by large rugs as the kids play in there a lot and we store a lot of clutter. Parts of the floor have become discoloured but the vast majority was covered by rugs which means nothing was noticed.

 

She also said that the damaged has occured over at least 6 years which is rubbish as we had the machine repaired in Dec 2003 and there was absolutely no problem then.(I have the repairers receipt).

 

I have never dealt witha loss adjuster before but from her manner after the inspection, she seemed to be quite adamant that the claim would be rejected and refused to listen to anything I had to say.

 

Would it be unfair of me to assume she is targeted to have claims thrown out? Both the builders who came round seemed to appreciate how this could have happened.

 

I haven't heard from Tesco yet but I doubt they'll pay the claim against her report. What do I do? I would appreciate any help or advice you can offer.

 

Thanks

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get an independent loss adjuster to act on your behalf. o/h is a loss adjuster on commercial claims. he has just told me you can do this. :)

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Thanks for the reply kimmy01.

 

I've just spoken to 2 Independent loss adjusters on th phone and unfortunately, the case would be too small for them to get involved. Both of them were really helpful in giving me advice though.

 

Both said I should pursue the claim as they think I've got good grounds.

 

Anyone else had experience of taking on loss adjusters?

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Looks like a tenous declinature here. What you need to do is to write to the Loss Adjuster, cc Tesco's in, and say to them - as far as you are concerned this was a genuine and fortuitous loss. As soon as you discovered the incident you took all reasonable steps to a. identify the leak, and b. prevent any further loss.

 

I would also put at the bottom of the letter this: "If you still wish to maintain the declinature can you advise at the bottom that this is a "final notification letter for the purposes of the financial ombudsman""

 

This can bypass the Insurance Companies long complaints process.

 

Good Luck

Abbey - owed £3260 - Paid up.

 

Barclays owed £2500 - Paid up.

 

Halifax, Mint & Egg - next on the hit list

 

Dont click on the scales - I'm quite proud of my little red dot! - As the little red dot has gone - click away!!!!

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Thanks craigwalton, some very useful tips there that i will definitely be using.

 

Following my conversation with the Independent Loss Adjuster (ILA), I am waiting for the loss adjuster to write officially but I will be sending a formal letter of complaint and cc to the CEO of Tesco Ins. i will includethewording you suggest. i guess that'll let them know that I've taken advice elsewhere.

 

From what the Crap Loss Adjuster told me, I am responsible for not checking under carpet or behind the washing machine. The ILAs i spoke to thought it was unreasonable to expect me to have to do this. I intend to ask her how often I need to move my Fridge/Freezer, Dishwasher, Dresser, Bookcase etc to check for damage so as not to invalidate a potential future claim. There's nothing in the T&C of my Insurance booklet to that effect.

 

She also wasn't interested in how the furniture was arranged before i moved it all to allow her full access to inspect.

 

She also made a personal comment about how i should know better because of my job.

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The loss adjuster calledme this morning confirming that the claim had been "Repudiated". I tried to confirm with her what address i should write to for her and she said I shouldn't write to her at all and any correspondance should only go to Tesco.

 

That can't be right can it?

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The loss adjuster calledme this morning confirming that the claim had been "Repudiated". I tried to confirm with her what address i should write to for her and she said I shouldn't write to her at all and any correspondance should only go to Tesco.

 

That can't be right can it?

 

Actually I think this is right. I suspect that there is no contractual relationship between you and the loss adjuster. The loss adjuster is a third party appointed by your insurer for the purposes of vetting your claim and advising your insurer on the merits of the claim. The phone call sounds like a courtesy rather than official confirmation from your insurer of the status of your claim. If you are unhappy with the outcome of your claim, when formally advised by your insurer, it is the insurer you should complain to. They may then refer back to the (same or another) loss adjuster for a second opinion.

 

For what its worth, I think the loss adjuster's justification for rejecting the claim is very weak and can be easily challenged with a letter (clearly marked as a complaint) to your insurer stating:

 

(i) That the machine was repaired in Dec 2003, at which time it was moved and no leak or damage was evident.

(ii) That there was no reason to believe a problem existed as there were no tell tale signs (e.g. musty odour, condensation problems).

(iii) That there is no explicit requirement in the T&Cs of the insurance policy and it is not reasonable to expect a householder to move large white goods items (i.e. fridges, freezers, washing machines, etc) and lift carpets to inspect for problems when there is no reason to suspect that any problem exists. Indeed, such a course of action would be likely to result in an increase in claims for accidental damage caused during the process of moving said items.

(iv) That when the problem did come to light you took immediate steps to correct the leak and prevent further damage, thereby mitigating your loss.

(v) That if the insurer stands by its rejection of the claim you would be obliged if they can provide a deadlock letter so that you can pursue a complaint with the Financial Ombudsman Service.

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The la is correct. They have written to Tesco's with a final report. Their job is now concloded, and it is up to Tesco's whether to accept the reports findings or pay the claim.

Abbey - owed £3260 - Paid up.

 

Barclays owed £2500 - Paid up.

 

Halifax, Mint & Egg - next on the hit list

 

Dont click on the scales - I'm quite proud of my little red dot! - As the little red dot has gone - click away!!!!

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Thanks for all the helpful advice.

 

i have to keep reminding myself not to get angry and takethese things personally. The LA was just doing her job. It does seem strange that she said it was impossible for me not to notice the problem earlier as i obviously didn't.

 

I find it strange that having moved furniture and stuff around to allow unhindered inspection of the area etc, she wasn't interested in where the furniture and the rugs/mats I moved out of the way were originally, which completely covered the damaged area.

 

She is adamant that the damage is at least 6 yrs old even though i can prove it definitely didn't start before 15/12/03 when the appliance was last moved for a repair. Does that imply that I'm lying?

 

Still I will use all your tips and advice when dealing with the Ins Co.

 

Thanks again all.

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She is adamant that the damage is at least 6 yrs old

 

I would love to know how the LA came to this conclusion and how they substantiated it.

Cahoot - Rejection of offer sent 14/06/07

 

Barclaycard - S.A.R - (Subject Access Request) sent 22/03/07

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Well well well,a twist!!!

 

Sounds a little unfair to me (well it would I suppose)

 

I called Tesco today to find out what's happening. Apparently the claim is being turned down due to

any other gradually operating cause
. It's in the T&C booklet (36 pages) but NOT in the "keyfacts" leaflet.

 

Short answer is that because the leak/damaged started before I was insured with Tesco, it's not their problem.

 

The reason i think this is unfair is that every year as my renewal date comes up, I am bombarded with letters/emails/telephone calls claiming I could save ££££££££s by switching provider.

 

When I switched to Tesco, was I warned that I had better check under carpets and behind furniture/appliances? No.

 

Bearing in mind how aggresively marketed to about B&C Ins, I think that needs to be made clearer. It's never been mentioned to me before.

 

Am I snookered????

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It's in the T&C booklet (36 pages) but NOT in the "keyfacts" leaflet.

 

 

To play devils advocate and answer this point, the Policy Summary (Keyfacts) clearly states the following 2 pieces of information -

 

It does not show all of the benefits, exclusions or limits. Please refer to your policy booklet and policy schedule for full details of all terms, conditions and endorsements or excesses that may apply.

 

Summary of Exclusions and Limits

 

Please refer to your policy document for full details

Cahoot - Rejection of offer sent 14/06/07

 

Barclaycard - S.A.R - (Subject Access Request) sent 22/03/07

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To play devils advocate and answer this point, the Policy Summary (Keyfacts) clearly states the following 2 pieces of information -

Agreed point taken.

 

 

 

Am I unusual in not knowing about the effect of this clause when considering changing insurer?

 

If this is legal and commonplace then surely everyone who changes insurer should either have to move all furniture/appliances and lift carpet everywhere before doing so OR the new insurer needs to send our a surveyor before accept the property as a risk?

 

At the very least, their attention should be brought to it rather more than a 5 word statement tucked away in the T&Cs and not even mentioned on the keyfacts.

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Just to clarify these points -

 

A household insurance policy will only cover you for an incident which occurred during the term of the policy.

 

Exclusions which apply to the whole Policy

4. Existing Damage

 

Any loss or damage occurring before cover commences.

 

A household policy always excludes damage by 'gradually operating causes'.

Uninsurable Risks

 

5. any other gradually operating cause.

 

When you start a policy with an insurer you confirm on the proposal form (or statement of facts)that the property is in a good state of repair and will remain so for the duration of the policy.

 

All of these points are fundamental to a Household Insurance policy.

Cahoot - Rejection of offer sent 14/06/07

 

Barclaycard - S.A.R - (Subject Access Request) sent 22/03/07

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When you start a policy with an insurer you confirm on the proposal form (or statement of facts)that the property is in a good state of repair and will remain so for the duration of the policy.

 

When I agreed, I did so in the full belief that my home WAS in a good state of repair. The damagewas completely hidden.

 

In fact, i have called plumbers out for 5 different things since I moved here in 2001 as well as having the Gas heating serviced. Surely if iknew ofthe problem i would have fixed it earlier.

 

I'm not arguing with you xchris, just staing how unfair it is i imagine many people will also get caught with this. i doubt I'm the first.

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Thats ok i understand - just trying to be objective and provide the alternative view for you.

 

There is something i want to research/check on this but will have to wait until this evening when i have time as i cannot fully remember the details. Brain is not fully working at the moment. :)

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Cahoot - Rejection of offer sent 14/06/07

 

Barclaycard - S.A.R - (Subject Access Request) sent 22/03/07

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OK.

 

The FOS and Insurers agree that the date that you notice the damage is the date of incident, unless they can prove that the damage hapenned before you incepted with Tesco.

 

Try to argue this with them, but you advise that you had insurance before. This will be a bit of a ball ache, but you need to contact the Insurers for the last 6 years, advise them of the damage, register a claim with all of them, advise the Insurance Company you are registering the claim with of all the other Insurance Companies involve and say Tesco has declined the claim as the damage occurred prior to their inception. In this case I will be seeking a contribution from all of you on the dbasis of time on cover.

 

Long winded, but you will get your money back - good luck

Abbey - owed £3260 - Paid up.

 

Barclays owed £2500 - Paid up.

 

Halifax, Mint & Egg - next on the hit list

 

Dont click on the scales - I'm quite proud of my little red dot! - As the little red dot has gone - click away!!!!

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I've just remembered that I had a plumber around in Oct '04 to unblock the waste water pipe behind the washing machine. There was no damp or leak then so that makes a mockery of the 6 years the LA claimed verbally to me. I have a sales invoice to prove it.

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Craigwalton has suggested exactly what i was going to check for you so he has saved me a job. :)

Cahoot - Rejection of offer sent 14/06/07

 

Barclaycard - S.A.R - (Subject Access Request) sent 22/03/07

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  • 2 weeks later...

Hi guys

 

Some interesting developments.

Although I'd been verbally "Repudiated" by the LA for failure to maintain my property and verbally turned down by Tesco for pre-existing damage, I had still to receive official confirmation in writing. Therefore I sent a letter last week by recorded delivery as follows:

 

Further to my telephone conversation today with your representative S**** B*****, I have been told that my claim for damages has been refused because of “any other gradually reducing cause”. I was referred to this on page 35 of the “Your Policy” booklet.

This differs somewhat from the reason given to me by the Loss Adjuster from GAB Robins that you appointed (E******* T****). She “REPUDIATED” the claim verbally on the day of her visit and also on the phone 2 days later. The reason she gave amounted to my failing to maintain my property properly.

Please accept this letter in the mean time as a formal complaint and as confirmation that I will be appealing against the decision.

Obviously I would like written clarification as to which was the actual reason or reasons before I will go into detail as to why I am appealing/complaining.

 

I still hadn't had a reply a week later so I called yesterday morning to demand a letter. I spoke to a Tesco claims handler who said she would look at the claim and call me back.

 

At 7pm last night, she did call back. She said that although the damage probably did start to occur before my cover started with Tesco, she was satisfied that I didn't know about it and was allowing the claim.

 

I was speechless............

 

She's therefore instructing the LA to contact my builders to agree a price. I only truly believe it when it happens, I'm a sceptic, but it's looking rather promising.

 

Thank you all who took the time and effort to read and reply to my post. I will pop in when I can to see if I can offer assistance to anone else who has a problem in myfield of expertise.

 

CHEERS GUYS :D

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Hi guys

 

Some interesting developments.

Although I'd been verbally "Repudiated" by the LA for failure to maintain my property and verbally turned down by Tesco for pre-existing damage, I had still to receive official confirmation in writing. Therefore I sent a letter last week by recorded delivery as follows:

 

 

 

I still hadn't had a reply a week later so I called yesterday morning to demand a letter. I spoke to a Tesco claims handler who said she would look at the claim and call me back.

 

At 7pm last night, she did call back. She said that although the damage probably did start to occur before my cover started with Tesco, she was satisfied that I didn't know about it and was allowing the claim.

 

I was speechless............

 

She's therefore instructing the LA to contact my builders to agree a price. I only truly believe it when it happens, I'm a sceptic, but it's looking rather promising.

 

Thank you all who took the time and effort to read and reply to my post. I will pop in when I can to see if I can offer assistance to anone else who has a problem in myfield of expertise.

 

CHEERS GUYS :D

 

 

Hi

I will be having a loss adjuster on Monday (Insurance with Barclays) are you saying that the loss adjusters are there to try not to pay your claim??I will like to be prepared for them.

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