‘Read the Fine Print’ as Insurers Stick to their Guns on Claims

Most insurers do a good job at detailing the main points of policies to prospective customers. But the devil is often in the detail. It can be a little difficult sometimes to know precisely what you are or are not insured for. Policies often come with loads of fine print – this writer has fond memories a few years back of having to print out over 20 colour pages of policy details for a continental day trip car insurance travel policy!

Legalese

The Plain English Campaign has been trying for decades to get companies to avoid jargon and obscure legalese in such policies, but law is law and if it requires companies to write in the language of 300 years ago for it to be ‘legal’, then so be it. Insurers are businesses after all, and they have to protect themselves from fraudulent claims with legal remedy, whilst at the same time treating customers fairly .

A Recent House Insurance Dispute

A recent case in a national newspaper underlines the problems and what you can do to sort them out. A pensioner with house insurance had her garage roof blown off on a very windy day. She went to her house insurance company with a builder’s estimate for repairs. Not terribly expensive as it happened, well under £1000. You’d think that would be clear cut and the cheque for the claim amount, minus the excess, would be in the post a few days later.

But no. The claim was rejected because the wind speed was only 45 mph that day and the policy only pays out when the wind is over 47mph – that was this insurers definition of a storm, and it is that kind of storm she was covered for.

Definitions of a Storm

Now, the wind was obviously strong enough to blow the roof off this lady’s garage, but not strong enough in this case for the insurer. Her daughter then had to spend time and effort chasing up the claim. She pointed out there was nothing specific in the policy about windspeed. The company then rightly relented and agreed to pay the claim. But apparently the 47mph rule is the cause of a lot of disputes about wind damage. The Met Office official wind speed data, which the insurers use, may not be locally accurate enough for the property you are claiming for, so this could be brought up in a claim dispute. But it’s a reminder that you need to read the small print carefully.

Appealing Rejected Claims

The financial ombudsman noted a 20% increase in complaints about insurance claims in the year up to March 2013. It seems that in tough times,the insurance companies are keeping to the letter of their policies very closely, and are digging their heels in when there are grounds for refusing to pay a claim. The consumer group Which? recently noted that more than 10% of home insurance claims were fully, or partly, rejected. However, the financial ombudsman is upholding appeals of nearly half of failed claims on building insurance at the moment. So it really could be worthwhile getting in touch with them them if you think you have a good case.

How to Help Your Claim

Evidence may also be an issue. It’s very useful to you to provide information in the form of photos and to have kept receipts for recently bought goods in case of a burglary. If a tree falls on your house, get the camera out and take several pictures of it immediately after it happens. Some people and companies keep a cheap digital camera in the car at all times in case they or their staff have an accident. Very useful for insurer and the insured.

When dealing with the insurance company, it does, of course, do your case no harm if you can stay polite and friendly, however frazzled and frustrated you actually feel. It can sometimes get a bit confusing too. A good tip is to get a folder and put in copies of all paperwork with the company you are dealing with, and keep sheets where you can make notes of phone calls along with the time and date and the person you spoke with. Any other evidence should also be kept there,such as copies of photos, estimates, bills and receipts.

The Loss Adjuster Visits

Loss Adjusters are only doing their job, and whilst it can be a little intimidating having someone looking around your house and asking for information about damaged property or missing goods, they are just trying to satisfy their employers that your claim is bona fide. But they don’t always need to visit. Another feature of the hard times at the moment may well be an increase of fraud in connection with insurance policies. Insurers feel they have an obligation to protect their shareholders and customer’s money very carefully.

In the end, most house insurance simply does what it says on the tin. It provides peace of mind about the property you live in, and helps you out when problems happen.