Claim Decision Ref: 2022-0003
The following summary is provided by us and the full details of the case can be found on www.fspo.ie
A complainant left their residence for approximately seven months under advisement from the loss adjusters in September 2010 due to damage caused following an escape of oil. The complainant noticed damage caused to the front porch and landing due to a water leak, and noticed storm damage affecting the roof. An inspection was carried out by a loss adjuster, yet they only registered a singular claim, unrelated to the storm damage and that claim was settled in December 2012 for the amount of €3956.79.
The complainant refutes that he repeatedly notified his provider through his broker that there were two areas of damage, and was unaware that two separate claims should have been made. The Loss Adjusters inspected the two locations three times, and were made fully aware by the complainant of two claims at those inspections. The complainant notes that the claim which was filed was for the smaller area of damage in the porch, and notes that the damage caused to the hallway by the storm was not filed. The complainant believes that a claim to the order of €35,000 should be paid in full due to the damage caused to the hallway.
The provider notes that the claim caused by the oil damage was settled in September 2010, and accommodation costs for six months were included in this claim. The complainant was under insured at this time, and did not appear to properly maintain the roof of the property, as was found after inspection from the loss adjuster. This in part, lead to the rejection of the claim on 18 December 2012. Due to a number of policy breaches this claim was denied. The provider categorically rejects that a second claim was made. The provider states that it was due to the improper maintenance of the roof, and a number of other factors, that the second claim was denied.
The complainant began repairs on the roof without informing the broker, and did not take all reasonable steps to prevent loss or damage to the roof; Two things which go against the household insurance policy provided. Insurance may become invalid following failure to comply with either of these occurrences. The complainant proved to be difficult to organise a `meeting time with, and the meeting time needed to be changed three times. The complainant also could not provide any proof that a storm occurred or on what dates the storm may have occurred.
Access to the interior of the property was denied by the complainant and so the extent of damage on the inside could not be fully assessed. The provider provided sufficient evidence, including photos, to demonstrate that gradual wear and tear had occurred, and storm damage alone didn’t cause the damages. In section 1, “Buildings”, of the household insurance policy, page 12 notes “we will not pay for loss or damage caused by the ingress of water due to gradual deterioration. This complaint was rejected due to the reasons outlined.
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