Insurance company never advised information was missing from claim, cover now lapsed

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gh0676

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Hello,
I do not want to give too specific information as I am still currently in dispute with an insurance company in relation to a claim. I would appreciate if somebody could provide any assistance before I respond to the insurance company/

A couple of years ago we submitted a claim with an insurance company due to structural damage in our house. An external report had to be submitted by a third party to provide evidence of damage on our behalf, with specified protocols to be followed.

One of the protocols specified by the insurance company was not included in our third part report.

It has now come to light that the expert whom assessed our claim on behalf of the insurance company pointed out to the insurance company that specific information was missing from our submission.

The insurance company never relayed this information back to us or to our third party expert whom provided the report. They relayed a summary of their experts analysis based on the evidence provided but failed to inform us that he couldn't make a complete recommendation as certain information was missing.

Our cover has recently lapsed and the insurance company have advised, that we did not follow their suggested protocol a few years ago when we originally submitted our claim and the claim is now rejected as our cover has lapsed.


Should the insurance company have advised us of the specific missing information when we originally submitted the claim?

Can they justifying withhold this information after it was pointed out by their expert ?
 
How many years ago did this happen, were you insured then? If you were, even if the policy has now lapsed they are liable. The fact you are now not insured is not relevant.

But there are time limits to make claims.

I find it odd that your claim is lasting years? Why did your policy lapse?
 
Bronte said:
How many years ago did this happen, were you insured then? If you were, even if the policy has now lapsed they are liable. The fact you are now not insured is not relevant.

But there are time limits to make claims.

I find it odd that your claim is lasting years? Why did your policy lapse?
Click to expand...

The insurance was the '10 year structual insurance' so we weren't continuing to insure the property after the event occured, This 10 year structual insurance came with all built new houses. When we noticed structural damage a couple of years ago we submitted a claim.
Only when the insurance expired this year , it came to light from the insurance company, that our original submission of evidence was missing some required information.


Should they not have been obliged to point out to us at this time, that key information was missing?. Therir expert pointed out his concerns to the insurance company in his correspondence to them and advised that the claim could only be assesed in relation to the information provided. They decided to not provide the information to their expert even though this information was available to them in other reports and also they did not notify us, therby giving us an opportunity to remedy our submission.
 
In insurance it is up to the claimant to substantiate any loss. Not sure home bond is the same. But seeing as you engaged a professional to work on your behalf shouldn't you be taking this up with him?
 
At the time of our original claim submission we were provided with a summary of their independent experts findings and advised of further steps to fulfill before they would re-consider our claim.

Their summary, however, omitted the part about their experts concerns and the fact that certain information was not provided.
If we had got the full report summary at the time , we could have addressed the issue.

The concerns expressed by their expert in relation to some incomplete information were only notified much later, after our cover had expired and we were appealing their decision, leaving us no opportunity to provide the information. The insurance company had the information available to them in another one of our exper's reports and failed to address the concern of their expert and provide this information to him.

Surely ,if the insurance company were providing us summary of their independent expert's analysis, should all of these points from their experts not been presented to us.
Can they legitimaley withold information from us and only provide us with points that suit their cause in their summary?
 
Both parties are at fault IMHO.

You paid a guy to do a job upon which he knew you relied. You can sue him. The insurance company ordinarily would have been able to sue if they relied on the report - but you say they didn't, so my guess is they're taking the easy-option of not paying you, rather than trying to sue the guy who compiled the report.

*Caveat- I'm not a legal guy*
 
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