Tullamore 057-8638136
Navan 046-9017211
Carlow 059-9108077
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Donegal 074-9715024
Tullamore 057-8638136
Navan 046-9017211
Carlow 059-9108077
Cork 021-6017148
Dublin 01-5135162
Cavan 049-4894036
Naas 045-499175
Limerick 061-579023
Dundalk 042-9424138
Monaghan 047-40110
Sligo 071-9314271
Donegal 074-9715024

Claim Rejection – water leak


FSPO – Decision Ref: 2018-0064

Background

The Complainant made a claim under their home insurance policy for damage caused to the home due to a water leak from a kitchen sink feed pipe.

The Insurance company issued a settlement offer to the complainant for the sum of €3,961.16 for the water leak. The Insurance company didn’t receive a response and issued a reminder letter on 26 September 2011 which advised that the Complainant had 14 days to respond otherwise the file will be closed and the complainant did not respond.

The complainant accepted the offer after 3 years and stated he had signed the acceptance form and returned it 3 years ago however the Insurance company had no record of this acceptance. A new acceptance form was sent to the Complainant which was signed an returned to insurer. A cheque of €2,368.98 as a portion of the claim and settlement letter was issued to Complainant. The Cheque wasn’t cashed and the Insurance company increased its settlement offer to €4,761. The Complainant was not happy and stated that the insurer has failed to pay the full amount of the loss suffered from the water leak.

 

The Complainant’s Case

The Complainant wrote to the Insurance company claiming an additional €2,580 for loss of rental income as a result of the water leak. The Insurance company requested a copy of the lease agreement, name of the property agent and the reason for the late request. The complainant sent the rent book and requested for this to be included in his claim.

The Complainant raised an issue with the settlement offer in terms of failure to pay for additional loss of rent and the Insurance company home repairer not being able to undertake the work. The Complainant stated that he had paid his own contractor €7,934 to complete the works as a result of the water leak.

The Complainant states a letter from insurer agent (repairer) states that the home repairer would complete the work. The complaint states that the delay in settling this claim was due to the repairer not showing up to do the required work and the Complainant sent numerous reminders to the repairer and eventually had to a hire a different contractor to do the work.

The Complainant sent a letter to the Insurance company stating that he sent numerous letters to Insurer’s requesting for an update on the claim and had heard nothing back.

The Complainant wants the Insurer to accept his claim for €19,677.07 which included €9,671.82 for building repair work, €5.25 for registered post and €10,000 compensation for all the delays, neglect and breach of contract.

 

The Insurer’s Case

The Insurance company state it wrote to the complainant pointing out that he had accepted the settlement offer. The letter also requested tenants contact details, how long it took the contractor to complete the work, the invoice from contractor and VAT number, a complete copy of rent book as the one previously sent was incomplete and an explanation as to why the loss of rent issue arose 3 years after the date of loss.

In relation to the settlement offer the insurer reviewed the settlement figures taking into consideration the contractors quotation and then offered a revised settlement offer of €4,761 net of policy excess of €1,000 for the damage caused by the water leak.

In relation to the home repairer issue the insurer states that in order for the home repairer to undertake the works the repairer would complete a scope of works required and submit this to the loss adjuster for approval, which would then be submitted to the complainant as an option to settle the claim. The insurer states that this didn’t happen and the repairer confirms this.

In terms of loss of rent issue the insurer states that the Complainant claimed for this 3 years after the date of loss. The insurer requested relevant documentation and information to support this. The Insurer states that the Complainant provided a rent book which was incomplete. The Insurer also states it was willing loss of rent aspect of the claim, once it received required and completed information.

 

Decision

The FSPO are satisfied that the submissions and evidence were sufficient to enable a Legal Binding Decision to be made in this complaint without the necessity for holding an Oral Hearing.

A Preliminary Decision was issued to the parties. The parties were advised that certain limited submission could be made within a period of 15 working days, and if no submissions are made from either or both of the parties, a Legally Binding Decision would be issued to the parties, on the same terms as the Preliminary Decision, in order to conclude the matter.

There was a delay of three years where the Complainant appears not to have contacted the Insurer. The Complainant states he sent numerous letters to Insurer and requested for an update but was not able to provide evidence of these letters. The insurer was entitled to have closed the file. This is not a situation where The Complainant had health issues and was unwell or that there were other issues that would delay from progressing the claim.

In relation to the Home Repair specialist the complainant submitted a quote from his own contractor insinuating that the Complainant intended to use his own contractor. A cash settlement was agreed therefore a cash settlement wouldn’t have been made if the Home Repair specialist was being engaged. The Complainant never confirmed that he was using the home repairer specialist and evidence suggests that the Complainant didn’t engage the Home Repair specialist. The Complainant provided a quote from his own contractor and the contractor confirms that works commenced and when it was finished. The FSPO does not accept the confusion about the Home Repair specialist caused the delay. Accordingly, on the basis of the evidence available, the FSPO does not accept that Insurer’s are responsible for these delays.

In relation to the loss of rent Insurer is entitled to seek information and documentation to support the claim which includes full rent books with completed information and proof of tenancy rather than an incomplete photocopy as supplied. The FSPO points out if the loss of rent claim had been made in 2011 and not 3 years later the proof of tenancy would have been much easier to establish and these delays were not the Insurer’s fault.

The Insurer made an offer of €6,051 including loss of rental income to the complaint which the FSPO consider to be a very reasonable settlement.

The FSPO state on the basis of the evidence they do not believe that the Insurer acted wrongfully. Rather dealt with this at all times in a reasonable fashion. On the basis that Insurer made the settlement offer available, and remains open to him to accept. The FSPO does not believe that it is necessary or appropriate to uphold this complaint.