Declined water leak claim due to an Insurance company wont pay the claim to repair water damage because the circumstances weren’t covered by the policy – Case Study – https://www.financial-ombudsman.org.uk/

Background

The Complainant found water coming up through the floor and contacted an emergency plumber, the plumber couldn’t find any sign of a leaking pipe, but did confirm that water was coming up through the floor and into the walls. The plumbers view was that this was probably happening because a rise in the water table.

The Complainant contacted the Insurer to make a claim for flood damage, as this was included in his home insurance policy. The Insurer appointed a loss adjuster to investigate the damage. Following the inspection the Insurer declined the Complainants claim. It stated that the damage wasn’t covered by the policy, because their loss adjuster couldn’t find any evidence of a leaking pipe and there hadn’t been enough rainfall for there to have been a flood, therefore the Insurer is of the view that no insured peril occurred and subsequently there was a declined water leak claim or flood claim.

The Complainant complained that this was unfair and request the Insurer to accept the claim and pay for the repairs water leak claims.

Decision

The evidence supported that there had been a gradual build-up of water. Therefore the FOS though that this did constitute a flood. It didn’t need to occur because of heavy rain or another ‘force of nature’. The FOS stated although the damage was gradual, there was nothing to suggest that the Complainant could have been aware of it until the water had come into the property. As the damage in the property looked recent, FOS believed that the Complainant made his Insurer aware of the problem as soon as he reasonably became aware of the problem.

The FOS upheld the complaint and requested the Insurer to pay the claim the declined water leak claim.