Dealing with Insurance Claim Denials: What You Need to Know 🚔
House floods due to burst pipe, and surprise reasons given by insurance company for refusal to payout; DEAN DUNHAM offers suggestions on possible actions to take.
Got a house flood disaster and your insurance claim got rejected? Here's the deal - they're blaming it on those furry critters chewing through a pipe! But what can you do, mate? Let's dive in and explore your rights as a homeowner.
First things first, don't just accept their reasoning! They're saying it's your fault for not maintaining proper pest control, but you know the truth. Here's what you gotta do:
- Ask for Evidence: Demand that they show you where in their terms and conditions rodent-related issues are excluded.
- Get Specific: Ask for a detailed explanation as to why your claim is being denied. This will help you figure out if there's any wiggle room to overcome their reason for denying the claim.
For instance, if they claim the rejection is due to a failure to take pest control measures, you can counter this by presenting evidence of a pest control contract, or receipts of buying pest control products.
If your provider can't find a specific clause about rodent issues or if it's not an absolute exclusion, file a complaint! Complain to the Financial Ombudsman Service at financial-ombudsman.org.uk.
Now, if you've been swindled by a fraudster and your bank's refusing to reimburse, don't despair just yet! You've been a victim of an Authorised Push Payment scam (AKA bank transfer scam), and the rules have changed since October 7, 2024.
Before that date, your case fell under the Contingent Reimbursement Model Code (CRM Code), and most banks were supposed to reimburse victims unless there was an exception. One of these exceptions was where a customer paid attention to warnings issued by their bank and ignored them.
If your bank is claiming negligence due to ignored warnings, demand proof! They have to show that these warnings were prominent and likely to be seen by customers. If they can't provide a satisfying answer, you might have a case! Complain to the Financial Ombudsman Service if you think the warnings were inadequate.
Dean Dunham's got your back 🤝
Have a legal question? Let Dean handle it for you! Email [email protected] with your question or problem.
Remember, Dean's not legally obligated to help you, but he'll give it his best shot!
Read more of Dean's consumer rights expert columns here.
- It's crucial to reconsider the insurance company's claim denial, particularly if they're blaming flooding on rodents.
- If the insurance provider claims the denial is due to a lack of pest control, gather evidence such as pest control contracts or receipts to counter their argument.
- If the insurance company can't find a specific exclusion for rodent-related issues or if it's not an absolute exclusion, consider filing a complaint with the Financial Ombudsman Service.
- In the case of an Authorized Push Payment (APP) scam, where the bank refuses to reimburse, review the warnings issued by the bank and demand proof if they claim negligence. If the warnings were inadequate, consider filing a complaint with the Financial Ombudsman Service.
