Insurance house claim

[Tongs of Destiny]

Does anyone know if you get an insurance claim on your house do you have to actually use their builder or can they just give you the money and you do what you want to do.

I have floor tiles that suddenly popped in an apartment so the floor needs to be redone. Would insurance companies be happy with just giving the money, and you do what you want and use who you want, or do you have to now accept their builder and they sort out everything?

 

[As1974a]

Have they already approved the claim. Usually they will do either. if they pay you out for your to repair they don't take any responsibility.

However Given that nature of your incident i would think they would send out their own assessor first to check the reason for the tile lifting and whether it is an claimable incident.

Only once approved then you ca discuss to pay you or not.

 

[Hemi300c]

Does anyone know if you get an insurance claim on your house do you have to actually use their builder or can they just give you the money and you do what you want to do.

I have floor tiles that suddenly popped in an apartment so the floor needs to be redone. Would insurance companies be happy with just giving the money, and you do what you want and use who you want, or do you have to now accept their builder and they sort out everything?

An insurer usually requires a quote with the claim form and a damage report (cause).

Depends on the Insurer but i mostly find they accept your preferred repairer if the costing is within the pricing scale. They then, if the costing is acceptable, send a agreement of loss which will release them from any further liability.

Often if an assessor is appointed the assessor might have a contractor that they use for different losses. This is beneficial if something happens to the repair down the road.

PS some insurers might decline your claim due to incorrect building spec as there should have been measures taken. But this all depends on your insurer you with and their wording because they might even say cold/freezing is not an insured peril.

Hope you get sorted.

 

[Tongs of Destiny]

An insurer usually requires a quote with the claim form and a damage report (cause).

Depends on the Insurer but i mostly find they accept your preferred repairer if the costing is within the pricing scale. They then, if the costing is acceptable, send a agreement of loss which will release them from any further liability.

Often if an assessor is appointed the assessor might have a contractor that they use for different losses. This is beneficial if something happens to the repair down the road.

PS some insurers might decline your claim due to incorrect building spec as there should have been measures taken. But this all depends on your insurer you with and their wording because they might even say cold/freezing is not an insured peril.

Hope you get sorted.

Thanks for all the info.

I've had the assessor come over and have a look as well as their chosen floor person. I just thought their floor person was a bit, well... hopeless. Just waiting to see what the outcome is so was wondering "if" they approve the fix then the insurer would just give me the cash and then I can choose whoever I want to fix the floor. Not really sure how it all works.

 

[Tomtomtom]

Any idea what caused the tiles to pop?

 

[Hemi300c]

Thanks for all the info.

I've had the assessor come over and have a look as well as their chosen floor person. I just thought their floor person was a bit, well... hopeless. Just waiting to see what the outcome is so was wondering "if" they approve the fix then the insurer would just give me the cash and then I can choose whoever I want to fix the floor. Not really sure how it all works.

If they use their repairer they settle with them. If yours yours you'll get a agreement of loss and once signed and returned they will pay you. (this is basically std but can differ)

 

[Tongs of Destiny]

Any idea what caused the tiles to pop?

A few different factors, can either be a damn substrate or an incorrect tile adhesive used (poor quality)

 

[Mista_Mobsta]

A few different factors, can either be a damn substrate or an incorrect tile adhesive used (poor quality)

Tiles in my lapa started lifting - logged a claim with the insurer and they subsequently sent their own assessor who took all but 5mins to look around the lapa and then state they will write a full report.

Couple of days later, insurer calls and says they won't proceed with the claim due to "bad workmanship". This despite us having full approved building plans etc as part of the claim. They still claim the workmanship doesn't align with the plans and therefore, we can get stuffed.

Good luck!

PS: should mention the lapa is >25years old and tiles started lifting last year

 

[Neuk_]

Tiles in my lapa started lifting - logged a claim with the insurer and they subsequently sent their own assessor who took all but 5mins to look around the lapa and then state they will write a full report.

Couple of days later, insurer calls and says they won't proceed with the claim due to "bad workmanship". This despite us having full approved building plans etc as part of the claim. They still claim the workmanship doesn't align with the plans and therefore, we can get stuffed.

Good luck!

PS: should mention the lapa is >25years old and tiles started lifting last year

This is the type of nonsense that irritates me about the insurance industry and why we got an assessor in while changing underwriters to provide valuations of our house and contents. They'll do little to no due diligence but happily take your money every month and then do some due diligence at claim time before denying the claim. In my opinion, if they are happy to take your money to provide insurance, they shouldn't be able to deny a claim based on something like poor workmanship that was done long before they agreed to provide insurance and take your money.

 

[satanboy]

Does anyone know if you get an insurance claim on your house do you have to actually use their builder or can they just give you the money and you do what you want to do.

I have floor tiles that suddenly popped in an apartment so the floor needs to be redone. Would insurance companies be happy with just giving the money, and you do what you want and use who you want, or do you have to now accept their builder and they sort out everything?

They may send an assessor, but two or three quotes and photos are usually sufficient.
Once the claim is authorised, you can use any builder you want.

 

[Mista_Mobsta]

This is the type of nonsense that irritates me about the insurance industry and why we got an assessor in while changing underwriters to provide valuations of our house and contents. They'll do little to no due diligence but happily take your money every month and then do some due diligence at claim time before denying the claim. In my opinion, if they are happy to take your money to provide insurance, they shouldn't be able to deny a claim based on something like poor workmanship that was done long before they agreed to provide insurance and take your money.

Exactly my ire - can't even use my broker as the building insurance isn't done via them. The interesting thing is that the insurer acknowledges that we are covered for "slippage" etc and won't entertain my own, independent mind you, assessment.

 

[Tomtomtom]

A few different factors, can either be a damn substrate or an incorrect tile adhesive used (poor quality)

they shouldn't be able to deny a claim based on something like poor workmanship that was done long before they agreed to provide insurance and take your money.

PS: should mention the lapa is >25years old and tiles started lifting last year

Okay but to play devil's advocate, if insurers had to cover normal wear and tear and stuff breaking down after 25 years, they would not be able to provide a product at a reasonable price. They would be doing the medical aid savings account thing where you'd be partially paying upfront for your own maintenance. Actually come to think of it they already do this for geysers specifically, but that's a special case.

If the damp was from a sudden failure like a burst pipe or flood then that's insurable, but if it's due to blocked gutters and bad drainage over the years then it's probably not.

 

[Mista_Mobsta]

Okay but to play devil's advocate, if insurers had to cover normal wear and tear and stuff breaking down after 25 years, they would not be able to provide a product at a reasonable price. They would be doing the medical aid savings account thing where you'd be partially paying upfront for your own maintenance. Actually come to think of it they already do this for geysers specifically, but that's a special case.

If the damp was from a sudden failure like a burst pipe or flood then that's insurable, but if it's due to blocked gutters and bad drainage over the years then it's probably not.

Yep I 100% understand the logic behind the wear-and-tear but my policy specifically states that my house & approved outbuildings are covered against slippage and I believe that the underlying cause is not faulty workmanship or wear and tear.

 

[Neuk_]

Okay but to play devil's advocate, if insurers had to cover normal wear and tear and stuff breaking down after 25 years, they would not be able to provide a product at a reasonable price. They would be doing the medical aid savings account thing where you'd be partially paying upfront for your own maintenance. Actually come to think of it they already do this for geysers specifically, but that's a special case.

If the damp was from a sudden failure like a burst pipe or flood then that's insurable, but if it's due to blocked gutters and bad drainage over the years then it's probably not.

Normal wear and tear is very different from poor workmanship or lack of maintenance in my opinion but that opens another kettle of fish about proving poor workmanship or lack of maintenance. Perhaps a better example of insurers perfectly happy to take money to provide cover but then denying cover at claim time after only doing any due diligence at claim time is a story I have told about my father.

He bought a cheap CitiGolf for my middle brother after he wrote off another CitiGolf. The new cheap CitiGolf was used for around 4 years by my brother when it got stolen in Durban somewhere. My father had paid the insurance premium each and every month so was surprised when his claim was denied after reporting the car stolen. The reason provided, it was a previously stolen and recovered car with 'false' VIN numbers, so my father could never have 'legally' owned the car and thus not insure it.

The underwriter then asked if my father was happy with the outcome as they wanted to close the claim and he told them that in no uncertain terms, would they be allowed to take around 4 years worth of his money and THEN tell him he could never be the legal owner of the car and thus not legally insure it. He managed to get them to pay back all of his premiums on the car which I think is only fair since they did sweet **** all until he put a claim in, taking four years worth of premiums.

 

[Katelknaap]

Tile "tenting" is quite a common occurrence and is most often related to contraction and expansion and the accompanying stresses that build up over time. The risk of it occurring can be minimized if the SANS regulations iro tile installations are followed and expansion joints are provided in the installation.

It often occurs after/during a sudden cold snap. Had it happen in my upstairs granny flat, sounded like gunshots when those tiles released. Most likely not a valid claim, but depends on what exactly your Buildings cover includes and excludes.

 

[airborne]

Yep I 100% understand the logic behind the wear-and-tear but my policy specifically states that my house & approved outbuildings are covered against slippage and I believe that the underlying cause is not faulty workmanship or wear and tear.

How would you be able to prove it’s slippage?

 

[Mista_Mobsta]

How would you be able to prove it’s slippage?

Had a structural engineer (Pr.) come out and do an independent assessment that I sent through to oppose the insurers version and they didn't accept anything else than their own assessors version.

 

[Mista_Mobsta]

It seems people have had success using the ombudsman in cases like these.

Yep that is the next step

 

[Forum Reader]

Normal wear and tear is very different from poor workmanship or lack of maintenance in my opinion but that opens another kettle of fish about proving poor workmanship or lack of maintenance. Perhaps a better example of insurers perfectly happy to take money to provide cover but then denying cover at claim time after only doing any due diligence at claim time is a story I have told about my father.

He bought a cheap CitiGolf for my middle brother after he wrote off another CitiGolf. The new cheap CitiGolf was used for around 4 years by my brother when it got stolen in Durban somewhere. My father had paid the insurance premium each and every month so was surprised when his claim was denied after reporting the car stolen. The reason provided, it was a previously stolen and recovered car with 'false' VIN numbers, so my father could never have 'legally' owned the car and thus not insure it.

The underwriter then asked if my father was happy with the outcome as they wanted to close the claim and he told them that in no uncertain terms, would they be allowed to take around 4 years worth of his money and THEN tell him he could never be the legal owner of the car and thus not legally insure it. He managed to get them to pay back all of his premiums on the car which I think is only fair since they did sweet **** all until he put a claim in, taking four years worth of premiums.

This is standard practice to return all premiums in the case of full loss where the item was never actually insured. So with vehicles it's easy to just return all premiums.

It gets more tricky when there is partial damage. Like when you insure your entire house but only the tiles are a problem.

 

[SauRoNZA]

Simple answer is just ask your insurance.

They usually want someone on their side to give the original quotation to make sure it’s realistic.

But once the claim has got that value attached there is nothing that stops you from asking them to pay you out directly and do your own thing.

Problem would then be should you have a subsequent claim down the road they’ll likely tell you to get stuff because they removed themselves from liability.