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How to have a claim denied

After a particularly sharp frost you notice that some tiles in your bathroom close to the wash hand basin are coming loose and the plaster behind them is quite wet. You call in a plumber, who removes the wash hand basin, hacks an area of tiles off, removes the plaster behind them, finds a burst pipe and repairs it. He then re-plasters as necessary, and then comes back a few days later when the plaster is dried to replace the damaged tiles and refit the basin. You get a horrendous bill for this of course; but you're insured against burst pipes anyway, aren't you? So, you send the bill off to the insurance company who refused point-blank to pay more than a small proportion of it. What has gone wrong?

Repairing a burst pipe is one thing. Getting at that pipe in order to repair it and then making good disturbed surfaces is a different matter altogether. This is why many home insurance policies; but not all; include what is called 'trace and access' cover, which is insurance for the cost of finding the actual cause of a problem and repairing any damage caused by work which has to be done in order to get at the source of it.

That was your first mistake; buying the cheapest policy available without checking on what was covered, and more importantly what was not.

Your second mistake was to call in a plumber before you had contacted your insurance company. This is normally acceptable in an emergency situation when you need to act quickly in order to minimise damage but this was not the case in this instance. Your insurance company is fully entitled to question why the plumber felt it necessary to remove the wash hand basin in the first place, and they may feel that his bill was excessive. Many insurers have a panel of local plumbers that they trust to deal with problems like this and had you contacted them they would have sent one of them around to you. By bringing someone in yourself without informing them beforehand you could be in breach of the terms of the policy.

You may of course complain to the Insurance Ombudsman but don't be too surprised if your claim was denied.

This is one problem with buying home insurance over the Internet; a very high proportion of buyers simply look at the price of the policy but never read about the benefits, or the terms and conditions. It is very important that you check policy documents carefully; they are always easily available on properly run price comparison sites; and make sure that you are familiar not only with just what cover it is that you are buying, but also the procedure you should go through before making a claim. A little time spent doing this could save you a lot of heartache in the future.

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