Insurer not paying

positivenote

HI all,
My wife's car recently had some technical issues and the cost quoted was approx 650 euro. She brought it to our local mechanic and he said that her insurance (a years extended warranty that we paid extra for when buying the car from a dealer about 7 months ago) covered it. She provided him with all the appropriate details having verified with the insurer that the work was covered by the policy. He completed the work and gave us an invoice and returned the car when the work was done. We have sent off the invoice and the details of the cost and work carried out and now the insurer wont pay out saying that work was carried out prior to being authorised by them. They did verify over the phone that the work was covered by the policy, we provided all said details to the mechanic and was under the impression that he would be paid by the insurer.
Any advice here would be appreciated
Thanks

thebiglad

This is down to the fine details

They are not saying the work undertaken is not covered but instead that they did not approve the work being undertaken.

Did you formally submit a claim to them or call to 'ask' would the issue be covered under the warranty.

What are the terms and conditions of the warranty - is there a requirement that they are permitted to inspect the vehicle or submit to a mechanic of their choice?

I would be submitting a formal complaint to the Insurer and asking for copies of the telephone calls between yourself and their agent so that you can be sure exactly what was said and how.

Within their policy will be a complaints procedure and then an escalation procedure - probably the Financial Ombudsman, necessary to lodge and receive response to your complaint initially though.

positivenote

thebiglad wrote: »

This is down to the fine details

They are not saying the work undertaken is not covered but instead that they did not approve the work being undertaken.

Did you formally submit a claim to them or call to 'ask' would the issue be covered under the warranty.

What are the terms and conditions of the warranty - is there a requirement that they are permitted to inspect the vehicle or submit to a mechanic of their choice?

I would be submitting a formal complaint to the Insurer and asking for copies of the telephone calls between yourself and their agent so that you can be sure exactly what was said and how.

Within their policy will be a complaints procedure and then an escalation procedure - probably the Financial Ombudsman, necessary to lodge and receive response to your complaint initially though.

Thanks for the response. My wife is very upset about this and we will struggle financially to pay the mechanic for the work. They have sent the audio recordings of two phone calls my wife made... the first to enquiry if the mechanical fault was covered, which they said it was and that our own mechanic could carry out the work, and the second from my wife at the mechanics garage confirming that the work could be carried out by him. At no point in either conversation does the insurer say that a claim needs to me made prior to work being carried out. In my, and my wife’s opinion, this second phone call being made from the mechanics garage,as stated in the phone conversation, would indicate that she was confirming this was okay to have done and then forward the claim to the insurer as requested. Surely a claim is a request that ‘follows’ work done.??
This is really unfair as there were numerous times that clarification could have been made by the insurer that no work is to be done prior to a claim being made and authorised? This could take days/weeks to receive...
any further advice would be appreciated as the only reason we got/paid for the extended warranty was to cover potential costs like this...

thebiglad

Based on what you say you are in a good position if you have not already done so then document all of this to the insurer by way an official complaint - hopefully the Insurer's own complaints process will resolve in your favour.

If not then take it to the Financial Services Ombudsman, they tend to be fairly consumer friendly and so the benefit of the doubt or any ambiguity will go in your favour.

Unfortunately may not be a swift process but make it clear to the insurer in your complaint that you are in for the long haul and will be ultimately referring to Ombudsman if they do not support you.