Losing confidence in Loss Assessor re house insurance claim?

Dubwat · 27-04-2023 02:19PM #1

About 7 weeks ago, we had a leak in the upstairs bathroom which caused damage to the ground floor ceiling. The emergency plumber (sent by insurance company) recommended a particular loss assessor who we hired. The value of the claim is probably around the €10k mark. Since we know next to nothing about insurance claims, he was as good a choice as sticking a pin in the phone book (remember them!).

After a month passed with no news except for a CC: letter from the insurance company's loss adjuster to ours, I started phoning our guy once a week asking for news in a friendly tone. The first time, he was on holidays and, for the second & third phone calls, he said he would chase up and get back to me. Which he hasn't obviously. He said he has passed the relevant info to the insurance companies loss adjuster so the ball is in their court?

So I'm not sure what to do next and looking for advice. There's a hole in my ceiling so I'm reminded of it everyday! Our guy only gets paid if the claim is successful so it would be counterproductive if he was holding things up? I could start being a bit more assertive with our guy but if the logjam is on the insurance side, that won't achieve much. If I start phoning the insurance company, what's the point in having our own loss assessor?

So looking for advice, please? What's the average time to settle a water leak house insurance claim? And what to do to speed things up?

TIA

coylemj · 27-04-2023 02:52PM

If I start phoning the insurance company, what's the point in having our own loss assessor?

Couldn't you ring them anyway, to ask if there is a holdup on the part of your loss assesor i.e. are they waiting on a submission fom him? As things stand, you don't know what's holdng things up. Won't cost anything to ask your insurer where you are in the claims process.

On a different note - what was the cause of the leak and are you sure your policy will cover the damage? Most home policies do not cover something which is caused by gradual deterioration, it needs to have been caused by a specific event.

Dubwat · 27-04-2023 03:59PM

Thanks. I will phone the insurance next week then.

Yeah, I didn't want to go overlong on my OP but the leak could possibly be argued either way so that's one of the reasons we went with the loss assessor. We (the emergency plumber, the L.A. and I) are arguing that a specific joint failed underneath the bath so there is no way we could have seen it happening. Was it a sudden failure or "wear and tear" that caused the damage? The insurance company L.A. didn't offer any opinion when he was in my house. I don't know anything about plumbing or insurance so that's why we chose someone who would argue on our behalf. But you'd imagine the insurance company would be quicker to say 'no' than 'yes' & write a cheque?

coylemj · 27-04-2023 05:03PM

Was it a sudden failure or "wear and tear"

They are not necessarily different things. If the clutch in your car packs in, is it a sudden failure or "wear and tear". It's both.

Dubwat · 27-04-2023 05:25PM

Ah, ok. You can see why I'd need help with the claim, lol. Hopefully, my phone call to the insurance company next week will clarify things.

SEPT 23 1989 · 27-04-2023 05:29PM

Threaten to go legal if it’s not sorted quickly

Eggs For Dinner · 28-04-2023 07:19AM

The insurance company won't (shouldn't) discuss the matter with you, given that you have appointed a loss assessor to act on your behalf. This is for your own benefit as you could inadvertently say or do something which would prejudice your situation. You could replace your assessor if you feel they aren't acting to a high standard. Claims where there is a dispute over sudden and unforeseen/wear and tear/ gradually operating cause, are the most difficult to find a satisfactory outcome, so I wouldn't attempt it alone

JenD87 · 31-07-2023 09:37PM

Does anyone know how long it takes from when the insurance send out the settlement letter to actually getting the payment? I got the letter over a month ago and sent it straight back signed etc.

Eggs For Dinner · 01-08-2023 07:28AM

https://www.boards.ie/discussion/comment/120923436#Comment_120923436

It usually takes 5-10 working days. Something is not working in your situation, so Id be making a call

Jim2007 · 01-08-2023 07:44AM

https://www.boards.ie/discussion/comment/120923436#Comment_120923436

Every company has it's own procedures for making distributions, so it's very hard to give an accurate estimate for something like this. But in most cases I would assume that a company runs their payment system at least once a month, so if I'm expecting a payment and have not heard anything for a month I follow up on it, just to make sure that it has not fallen between the cracks. So I'd suggest you follow up this and do it by phone, not email.

Eggs For Dinner · 02-08-2023 07:00AM

The Consumer Protection Code (Item 7.18) states that the insurer must discharge an accepted claim within 10 working days. If you appointed a solicitor or loss assessor, are you sure payment has not been made to them?

Gilly43 · 23-09-2023 06:16AM

Speed to settle depends on a few things.

As with anything there’s good/bad loss assessors (PLAs) and the same applies to loss adjusters. Loss adjuster workload can also impact turnaround. The same applies to assessors.

For a loss adjuster, speed to turnaround can be impacted on how quickly the claim is submitted by the loss assessor (can sometimes take as much as 4-6 weeks to actually receive a claim). There can be a requirement for a previous insurance claim’s history if only relatively recently on cover with your insurer & this can slow things.

Also, things can slow down if the loss assessor is absolutely taking the piss on the scope/cost - they sometimes dig their heels in on ridiculous stuff. 100% overstatement of cost isn’t uncommon.

A straightforward €10K escape of water claim should only take 10/15 minutes to cost once all required background info received

A call to Insurers will probably result in a grenade from them up the adjuster and prompt a response.

Hope it gets sorted 👍🏻

Builderwoman! · 21-01-2025 10:11AM

So sorry to butt in but what is covered in an ‘unknown’ water leak. It will have to be investigated upstairs en-suite may be leaking into downstairs loo. Or it could be underfloor in d/s toilet. Do we pay for investigations and then claim on insurance or report it first? Thanks so much. Clueless on insurance claims.

coylemj · 21-01-2025 01:55PM

If you can't pin it down to a specific event, you may have to foot the bill yourself. House insurance typically excludes damage caused by something which happens gradually over time e.g. a pipe or joint slowly corroding and eventually springing a leak.

To answer your question, I'd talk to your insurance company, ask them if they will help to identify the cause. I suspect they will tell you to call in a professional and have it investigated at your expense. Consider your situation from their perspective - if they offer to assist, when do they shout 'stop' if the plumber you call in can't find the leak and/or it will require tiles and floorboards in the en suite to be lifted?

Eggs For Dinner · 21-01-2025 07:23PM

Most comprehensive household policies have an extension for Trace and Access. Basically, it covers the cost to try and identify where the cause of a leak is from fixed domestic fittings. Whether further repairs are covered will depend on what they find. A typical amount of cover for Trace and Access is circa €5k

Losing confidence in Loss Assessor re house insurance claim?

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