Household Buildings Decision Reference 2022-0365

Case OutcomePartially upheld
Subject MatterHousehold Buildings
Reference2022-0365
Date14 November 2022
Finantial SectorInsurance
Conducts Complained OfClaim handling delays or issues,Dissatisfaction with customer service , Failure to consider vulnerability of customer, Failure to process instructions in a timely manner
Decision Ref:
2022-0365
Sector:
Insurance
Product / Service:
Household Buildings
Conduct(s) complained of:
Claim handling delays or issues
Dissatisfaction with customer service
Failure to process instructions in a timely manner
Failure to consider vulnerability of customer
Outcome:
Partially upheld
LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN
This complaint concerns a home insurance policy originally incepted in 2017 and renewed
periodically thereafter.
The Complainant’s Case
The complaint concerns a home insurance policy (the “Policy”), organised through a Broker
(the “Provider”) and underwritten by an insurance company (the “Underwriter”). The
Complainant has appointed two family members under a Power of Attorney (her son and
her daughter). The two family members, who are Attorney for their mother, outline the
nature of her complaint against the provider, a broker, as follows:
There was an unacceptable delay in settling simple water damage household claims
on our mother’s house. This caused both her and us much stress and distress and the
house continued to deteriorate from the water damage during
this period. Our mother is currently in a nursing home and her house is her only
asset. Loss of value in this asset, the additional cost of employing a loss adjuster
and the opportunity cost of not being able to rent it out had a direct impact on her
nursing home care going forward.”
- 2 -
/Cont’d…
The Complainant’s daughter, who is acting for her mother, is referred to below as the
“Complainant”.
The Complainant states that a leak occurred in the Property in July 2019. The Complainant
submits that information, which was given to the Provider, was not passed to the
Underwriter and that this caused delays and uncertainty over whether the Property was
covered at the time of the incidents. The Complainant states that, despite reporting the
claim ****31 in July 2019, the claim was not settled until February 2020.
The Complainant states in her submission, that the Provider was informed that the
Complainant’s mother had moved to a nursing home and that the property would be
unoccupied, except for a relative who would stay there occasionally. She states that this was
notified in advance of the incident which gave rise to the claim in July 2019.
The Complainant further notes that a revised household schedule was received from the
Underwriter, noting that it was “amended to permit her to let the home to one tenant.
The Complainant, in her letter dated 9 June 2020, submits that after the leak pursuant to
the claim *** 131 was reported to the Provider, and the property was inspected by the
Underwriter's appointed Loss Adjuster, the Provider advised her that the Property may not
have been on cover, at the time of the incident, and requested further information.
The Complainant submits that, despite providing the requested information, it wasn't until
10 September 2019 that they were advised the claim would be covered:
We continued to follow up with [the Provider] by phone. On 10 September [the
Provider] informed us that [Underwriter's Loss Adjustor] has been instructed by [the
Underwriter] to proceed with the claim, that [the Provider] requested [Underwriter's
Loss Adjustor] to reinspect the property.”
The Complainant says that the Underwriter's Loss Adjustor notified the Complainant, in a
letter dated 17 September 2019, that part of the damage had been caused from an earlier
leak and that would be dealt with as a separate claim (Claim Ref: ****94). The Complainant
says she was asked to submit details of the estimates for repair. The Complainant submits
that, at this point, she had decided to appoint a Loss Assessor. The Complainant submits
that their appointed Loss Assessor submitted the estimates for repairs on 23 October 2019
and had met, with the Underwriter's appointed Loss Adjustor at the property:
Our loss adjustor [Complainant 's Loss Assessor], provided [Underwriter's Loss
Adjustor] with his estimate of the repairs required to my mother’s house on 23
October 2019 and, at the request of [Underwriter's Loss Adjustor], met at the

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