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JimLawyer
JimLawyer, Solicitor
Category: Law
Satisfied Customers: 7148
Experience:  Senior Associate Solicitor
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My insurance company are not willing to pay for my claim

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Hi, my insurance company are not willing to pay for my claim
Assistant: Where are you? It matters because laws vary by location.
Customer: Essex
Assistant: What steps have you taken so far?
Customer: I have emailed them with all the evidence and the loss adjuster who was dealing with my claim was sacked in the middle of my claim and when I sent all the invoices after the work was completed which was the loss adjuster was dealing with, they said they have no records of the claim and would not pay
Assistant: Anything else you want the Lawyer to know before I connect you?
Customer: There were 2 claims at the same time and they only have records of 1 claim

Hello, this is Jim and I am a dual-qualified lawyer (UK and Republic of Ireland) and happy to help you today.

Which insurer is it who has refused the claim?.


 

Customer: replied 15 days ago.
The insurance is one call and I have received the letter from their complaints department where i logged the complaint because they were asking for all the information because the previous loss adjuster was sacked due to fraudulentbehavior and he had covered his tracks
Customer: replied 15 days ago.
Do i have to pay another £44.00 for a phone call?

It looks like you clicked the call button - apologies I can’t take a call at the moment. If no one calls you then you will not be charged for it - an "authorisation" has been made for payment, that's all. However, the call request is open to all experts - if you want to cancel the call then please send an email to [email protected]

Turning to the question, the issue is at their end and you were right to complain.

You are covered under the Consumer Rights Act 2015 here which means you have a right to expect a service (from the insurer) carried out with reasonable care and skill.

If the complaint does not resolve the matter ask them for a "deadlock letter", which is a letter giving their final response.

Once you have the deadlock letter the next step would be to escalate this to the Ombudsman - they will investigate and liaise with the insurer which would hopefully result in a reinstatement of cover under the policy/an acceptance of your claim. They can order the insurer to make a financial award for inconvenience if they have acted badly (which they have in my view).

You can make the complaint here : https://www.financial-ombudsman.org.uk/consumers/how-to-complain

Based on the circumstances, assuming the insurer does not uphold your complaint, I am sure the Ombudsman will do. I say this because their adjuster which was dismissed from employment binds the insurer to any agreement - under vicarious liability.

I hope this helps - if you can please accept the answer and give me a 5 star rating (there should be a button at the top of your screen to do this), I can answer follow up Q&A's at no extra charge and Just Answer will credit me for helping you today.

Many thanks,

Jim

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