Hilary Grayson, SAVA – How to handle insurance claims

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Part of National Energy Services

Avoiding Insurance

Claims

Hilary Grayson

Head of Surveying Services – SAVA

Offering the next generation of surveyors a way forward

 How insurers view a claim

 The SAVA process

 Some recent claims and lessons to be learnt

 Basic rules of inspection

Why does this matter?

How the Insurers view a claim

 They don’t rush to settle a claim

 Call for all evidence

 Work with the claims team at NES to pull together all of the evidence

 Review all the evidence ‘ What would happen if the claim goes to court?

 Rule applied – could the claim be successfully defended?

What if you get a complaint

• You should have your own clear complaints process

• In the first instance this involves you trying to resolve the complaint

• In the event that you cannot do so, then escalate to SAVA

• But you must tell us as soon as you can if you think the complaint might involve a claim

If a complaint is escalated

• We handle the discussions with the claims investigators appointed by the insurer

• We will look to see what documents you have lodged but usually have to call for more

• You send us all your photos and site notes etc. and any comment you want to make on the claim

Complaint can go 1 of 2 ways:-

No grounds for the complaint

Complainant may have a point!

May be a misunderstanding

The surveyor did not report properly – got it wrong!

May be that the complaint can be defended

The surveyor cannot defend his judgement!

Case Study 1 - reporting services

• The insured carried out a Home Condition Survey

• On visual inspection the electrics looked OK

• Modern consumer unit

• Earth bonding visible

• But on moving in electrics found to be faulty

(albeit the faults would have been hidden at the time of the inspection)

• Claimant had the property re-wired ( we presume at considerable cost as there would be ancillary re-decoration).

Case study 1 continued:-

• Insurers advised the claim would be settled on a DMV basis.

• Investigation was swift because the surveyor admitted that they made a mistake!

• No test certificate was available – should have been CR3

Change to the Product Rules

“When applying Condition Ratings to any of the

“services that kill” if no recent test certificate is present issued in accordance with the guidance from the relevant competent persons scheme, then a Condition Rating 3 should be applied on the basis that further investigation is needed”

Case Study 2 – leaking roof

“redecorated previous damage to roof”

Case studies – Japanese Knotweed

• A very unfortunate case

• Circumstances as explained to me by investigators

– Area had knotweed

– Buyers had specifically asked the surveyor to look out for knotweed

– Year after purchase knotweed was found in the garden

o Claim was lodged and internal investigations started o Claimants very quickly took legal advice o While the claims investigators and the Complaints team at NES were still looking at the claim the

Claimants lodged the claim with the Court o Insurers had to appoint solicitors – time frame ramped up

• Difficult position

– Lawyers advised insufficient evidence to successfully defend the claim

– Insurers did not want to risk more expenditure

– Claimants had put in a relatively low claim – on the face of it NOT Diminution in Value but Cost of

Remedy

– Risk – being liable for more cost

• Agreed – settle out of court with no admission of liability on surveyor

When carrying out the inspection the surveyor must have consideration to any risks to the property that could originate from outside the boundaries of the subject property. Surveyors must be able to identify Japanese

Knotweed at all times of year and must report to their client that they have identified Japanese Knotweed when :-

• It is within the boundary of the subject property irrespective of how far it is from any buildings or structures

• It is visible on any neighbouring properties within 7m of the boundary of the subject property.

• For the avoidance of doubt a neighbouring property can be any property within 7 meters of the boundary of the subject property and is not restricted to the immediately adjacent property.

• When recording the presence or other wise of

Knotweed the site notes and photographs should together evidence:-

– Locations from which the surveyor did a visual inspection of any neighbouring property [note; neighbouring property should only by inspected from within the subject property or from publicly accessible land]

– Any limitations that prevented a visual inspection (eg high fences, thick shrubs and planting preventing access to the property boundary, etc.)

– Any plants that could be mistaken for

Knotweed Wording need to be reviewed and then the correct place identified.

Any questions?

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