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Insurance claims advice

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  • 1 year later...

Hi Andy


I've just logged in to the forum after a lengthy period of absence, for one reason and another (family life and business diversification etc) as I'm faced with a potentially large bill if I don't prepare myself adequately for a meeting this Friday (30th June, 2017) with a 'Subsidence Consultant'.


I am a relative veteran as far as property investment goes, having got into the 'game' back in 1999, and built a portfolio soon after - to then sell off half of it for the economic abyss we face; but that's a story for another time.


Where I'm not experienced is in insurance claims, as to date I've only ever claimed once, and that was for something minor. But now I face something pretty major and I need to consider my options and how I might navigate the rough waters I face:


One of my properties is a Victorian house, and the front wall has bowed markedly tot he front of the house. It's a terrace house, and each side is fine as far as bowing goes; but in the centre it's bowing by about 4". Initially we thought it was the wall ties having given out.


Ordinarily these types of houses have the wall plates (and for those who aren't familiar, a wooden support that rests on top of the wall that takes the weight of the roof and therefore supports it) to the inner skin (wall). 


Also one the purlins (roof cross members) had split right through, to the rear of the pitched roof. Luckily this was directly over the central supporting wall, so we were able to jack the roof up (literally with a jack, a car jack) and fitted an adapted, old oak fence post. We thought nothing more of this.


Additionally, as the roof apex had dropped (which could be seen by simply standing opposite the house, on the other side of the road) we decided to also reinforce the timbers supporting the concrete-tiled roof; and so we fitted 2.4m 2" x 4" cross members, with double-sided galvanised dogtooth connectors, fixed with large bolts and 2.5-3mm thick, square washers to each end. We did this on every other truss/tile-supporting timber, across the whole width of the house. So 7 of these were installed in all. 


We were going to remove the out skin to the front wall, down to the windowsill level, which is where the bowing began; but after installing and paying for scaffolding, we were about to begin, and upon removing the first brick, we noticed that actually the wall plate was/is actually on the outside wall, not the inner skin. So the roof is actually bearing on the outer bowed wall. We had to immediately stop! The roof would collapse if we were to remove the said wall, obviously, and we were both shocked by this. It's going to be a MUCH bigger job now, and one for insurance!


I did have to instruct a watercourse/pipe leak some years back, as the rear of the house had evidence of mild subsidence, and an inspection revealed a broken pipe, which meant much water was leaking into the surrounding footing, resulting in softer ground support. But that was remedied and we rendered over the crack that first alerted us to it, which went from the top corner of one side of the house, down, across to the other side - though it wasn't a wide crack, thankfully.


So, having finally managed to get hold of the insurance company (having called several times but kept on hold for a long time, and then when I did speak to someone they said they'd e-mail me, but never did, so again to call etc.) their claims department have arranged for this assessor to do a site visit this coming Friday, as already stated.


FINALLY I now get to my question:

As it can only be a single event or cause, and classified under either 'perils' or 'subsidence', to be covered, I'm at a loss as to what I could in fact say or do so as not to scupper my chances of having insurance pay out on this.


I, stupidly in hindsight (from a shooting myself in the foot perspective), mentioned that I'd noticed 2 or 3 other houses along the same road had bowing house fronts, though nowhere near as bad as mine. This might indicate poor design or ongoing/gradual problems, in which case I WON'T be covered, according to the claims advisor. He said "it's wasn't looking good", when I mentioned that, but I'm damned if I'm going to just give up and have to shell out many thousands to rectify this, from my own pocket. This kind of scenario is the whole reason we have insurance, as far as I'm concerned.


What can I say, or what could I stress or focus on in order to steer the assessor to act in my favour? How could I present this in such a way as to tie in each element, or a couple of them, that could be related, so I qualify for financial assistance? 


You can't give an accurate assessment without seeing things for yourself, but even so, any words of advice would be greatly appreciated. Meanwhile I can, and will, forward the "Circumstances and Nature and Extent of Damage" to a loss adjuster friend of mine, who is also looking at this case - but as he'd no doubt recommend too, it's best to spread the net far and wide in order to possibly catch something worthwhile. As you've had 15 years in claims work, your angle may well reveal something my buddy's won't.


Thank you in advance, Andy, and sorry that this is such a long post, but I feel it needs to be to fully brief you, or we'd be exchanging yet more messages.


Ian :-)

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Hi Ian, thanks for the note. Sorry to hear about your issue with the house. 


My first point would be that I can't recommend any ways to present your claim so as to qualify for financial assistance. The decision the insurer makes must be made based on the facts presented by the professional assessment, so the assessor' report in this instance should provide the information on the cause of the issue and then the insurer can see if that cause is covered. Although, depending on the qualifications of the assessor, it may need a more detailed and specialist report. 


I would disregard the speculation from the claims advisor at this stage as it was just that, based on your description. You clearly know your stuff on the building's construction and that will be useful in understanding the technical details of the report and the decision made. Also great that you know a loss adjuster who can give an opinion too.


I would also disregard any suggestion of poor design. It's a Victorian terrace that is still standing and fully functional, I'd say it was pretty well designed. However, based on that design, the bowing MAY be caused by time and be simply wear and tear that was inevitable at some point (rather than damage caused by a peril), which is something that insurance isn't designed to cover. I appreciate that this would be disappointing, especially as it sounds like it will be costly to rectify.


It will all come down to the cause of the problem. My best advice would be to assist the assessor with any information you have and ensure all the details are included in the report. Let me know how it goes and what decision you get. There are options for disputes if you disagree with it but that will depend on the reasons given and the evidence provided. Happy to discuss though. 


kind regards


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First of all, many thanks for such a speedy reply, Andy. With a Friday, this week, deadline, it naturally gives me more time to think about my options etc.


Thank you too for your well-considered thoughts on this case. I wasn't of course suggesting anything underhand or otherwise being economical with the truth, but more so I stand better informed and to therefore hopefully know an angle that I could focus on more, in order to work things in my favour. After all isn't this why anyone would seek help and advice? LOL!


Meanwhile, I'm frantically trying to assemble as much would-be useful information to stand me in better stead, naturally. Even talking about it helps focus the mind, and hopefully steer one in the direction that best serves them. It's just the same the other way: The insurer will try NOT to pay out if it can. But the way I see it is that this condition has arisen through no fault of my own, so isn't a matter of negligence or similar, but simply an unfortunate situation; and having buildings insurance, one would hope that they are covered for such eventualities. I won't be very happy if I'm not covered, for some reason, and have to dig deep into my pockets, as I think most folk could empathise with.


But I will keep you informed and let you know the outcome. I'm not feeling very positive at the moment, to be frank.


Thanks again.

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I can understand where you're coming from and insurance is not a well trusted industry, for good reason in many cases. Insurers shouldn't ever try to avoid paying out where there is cover in place but I can't speak for them all and I'm aware that this has and does happen. 


In terms of fault and negligence let me at least clarify that a declinature wouldn't suggest either of those on your part, more that some things are not covered by insurance. In any case, that can be considered after the facts have been established. Good luck, hope the visit is productive. I look forward to hearing from you again, hopefully with good news. 



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Many thanks again, and just to say I'm looking at the routes I'd need to consider IF things don't go my way: Broker help; ombudsman (though I've found these to be pretty much useless in the past: toothless tigers, happy to appear helpful, but rarely helping individuals); CILA (Chartered Institute of Loss Adjusters) and even a named person, who was int he media a couple of years back, who is apparently very successful in helping to get insurance companies coughing up their dues, being both a chartered surveyor as well as offering help with claims too. But I shall only go this latter route if it looks likely that I'd stand a good chance of winning. I don't want to just throw good money after bad, employing someone, when in fact there is very little hope of working to a solution that works for me.


I will certainly let you know how it all goes - as it may help others too, in future; you never know!



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