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Independent Loss Assessor

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Insurance unoccupancy issues

Insurance unoccupancy issues can lead to your claim being declined, what to do if you notice an unoccupancy issue, we analysis a decision made by the FSPO, the decision reference is 2021-0143 and you can log onto their website for full details. The complainant attended the providers office at the end of 2016 to ensure […]

Rejection of Claim due to non-disclosure

FSPO – Decision Ref: 2019-0145 – Rejection of Claim due to non-disclosure Background The complaint relates to the Insurers declinature of a claim and a cancellation of a household insurance policy held by the Complainant due to non-disclosure. The Complainants Case The Complainant is unhappy that her house insurance policy was cancelled ab initio due […]

Declined Water Leak Claim

Declined water leak claim due to an Insurance company wont pay the claim to repair water damage because the circumstances weren’t covered by the policy – Case Study –   Background The Complainant found water coming up through the floor and contacted an emergency plumber, the plumber couldn’t find any sign of a leaking pipe, […]

Storm / Flood Claim Declined

Storm / Flood Claim Declined by Insurance Company Due to Late Notification. FSPO – Decision Ref: 2019-0112 Background The complaint relates to the Insurers declinature of the storm / flood claim made by the Complainant for his rented property under his buildings cover only insurance policy for damage as a result of Storm/Flood. The Complainants […]

FSPO – Decision Ref: 2019-0107 – Under Insurance

Background The complaint relates to the Complainant’s claim under his home insurance policy arising from damage caused by chimney fire and was subject to the average condition which resulted in under insurance. The Complainants Case The Complainant made a claim on his policy following a chimney fire. The Complainant states that the claim was approved, […]

Business Interruption Claims – Covid-19

It comes as no surprise that insurers are declining business interruption claims in their droves, some policies clearly cover a notifiable disease or indeed Covid-19. To us, it would seem that there is a major capital issue within insurance companies at present, and it would appear that they are not upholding the requirements of the […]

Claim for the floor collapsing

A customer was not reasonably aware of a water leak or damage to prevent a claim for the floor collapsing an FOS case study presents. Background The Complainant had a water leak from his washing machine but was not aware of the water leak happening. The water leak caused damage to the Complainants kitchen walls, […]

Slow water leak damage

Slow water leak damage not covered under all risks policy an FOS Case Study reported. Background The Complainant noticed a stain had appeared on her lounge ceiling resulting from a slow water leak. The Complainant called a plumber to come out and take a look at the slow water leak damage. The plumber found that […]

The truth about fraudulent claims

Insurance Company’s were requested to answer questions in relation to insurance fraud to determine the Bona Fide of their allegations regarding fraudulent claims. This is a transcript of the video Pierce Doherty: Can I just pick up on that point in relation to fraud? You make the claim that 20% are fraudulent claims. How […]

Insurance claim for betterment

Insurer rejects an insurance claim for betterment – but expert opinion said it would be needed – Financial Ombudsman Service – Case Study Background The Complainant noticed that there was a crack in his garage, so he notified the Insurer of this. The Insurer agreed to cover the claim for subsidence damage. Both the Insurers and […]

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