Household Buildings Decision Reference 2023-0020

• Case Outcome: Rejected
• Subject Matter: Household Buildings
• Reference: 2023-0020
• Date: 31 January 2023
• Finantial Sector: Insurance
• Conducts Complained Of: Claim handling delays or issues,Dissatisfaction with customer service , Failure to consider vulnerability of customer, Failure to process instructions in a timely manner

Decision Ref:

2023-0020

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:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant held a Home Insurance Policy with the Provider, which she had purchased

through an Intermediary (hereinafter ‘the Broker’). The policy term in which this complaint

falls, is from 20 March 2019 to 18 January 2020. This complaint concerns the amount of

time it took for the Provider to assess and admit the Complainant’s home insurance claim

made in July 2019, and the customer service it provided throughout. The Complainant has

appointed a third party to deal with this complaint, referred to below as ‘the Complainant’s

Representative’.

The Complainant’s Case

The Complainant’s Representative says the Complainant moved into a nursing home in

March 2019 and, in her letter to this Office dated 18 November 2020, she submits that:

“At the time, [the Complainant’s son] rang [the Broker] … and informed them that

[the Complainant] had gone into a nursing home. When asked if the house was

empty, he responded that it wasn't as our brother, visiting from Germany, was

staying there at the time. [The Complainant’s son] explained that this was a

temporary situation, that he would be staying there periodically when in Ireland, but

that it was not a permanent arrangement as my brother resided in Germany and my

mother’s affairs were in a state of flux. The person he dealt with at [the Broker] said

that the house would then be classed as “tenanted” despite [our] insistence that my

brother was not paying rent, nor was it a permanent or full-time arrangement”.

- 2 -

/Cont’d…

The Complainant’s Representative notes that the Complainant then received an amended

Household Schedule from the Provider detailing that Clause HH126 now applied, permitting

her to let the property to a tenant.

The Complainant’s Representative says that on 9 July 2019, the Complainant’s son

discovered that the water storage tank in the attic of the Complainant’s property had leaked,

causing a large amount of water damage to ceilings, floors, carpets and walls in a number of

rooms throughout the house, and he notified the Complainant’s Broker of the loss.

The Complainant’s Broker notified the Provider of the claim on the following day, 10 July

2019.

The Complainant’s Representative sets out the Complainant’s complaint in her letter to this

Office dated 30 April 2020, as follows:

“A water leak occurred in [the Complainant’s] house in early July 2019 and the

manner in which the resulting claim was handled by [the Provider] is the subject of

our complaint …

Despite reporting the claim to [the Broker] in early July 2019 we did not receive the

final claims settlement cheque until February 2020”.

Similarly, in her letter to this Office dated 13 July 2021, the Complainant’s Representative

submits, among other things, that:

“The claim was first advised to [the Broker] on 8 (sic) July 2019. We received verbal

confirmation from [the Broker] that [the Provider] confirmed cover only on 10

September 2019 and then only received the settlement cheques in January / February

2020. This was a simple water leak claim, the only issue was occupancy, and we were

timely, forthcoming and straightforward in the information we provided in relation

to this”.

The Complainant’s Representative says that the Loss Adjuster first inspected the

Complainant’s property on 11 July 2019, and despite the Provider having being informed of

the occupancy arrangements in March 2019, issues regarding the occupancy of the property

delayed the claim, in that the Provider only instructed the Loss Adjuster to proceed with the

claim on 10 September 2019, two months after the claim notification.

The Complainant’s Representative says that it was not until the Loss Adjuster inspected the

property for a second time on 13 September 2019 that he advised them that a second claim

would need to be made, because some of the water damage in the kitchen had occurred

from an earlier leak at the property, and that this delayed matters further.