# When Is A Claim Not A Claim?



## caulkhead (Jul 25, 2007)

I decided to look on CompareTheMeerkat for Buildings & Contents Insurance. Found Admirals Platinum policy to offer better coverage at about half the cost of our current Tesco's policy so went for it. When it came to pay I got a message telling me to phone Admiral as payment couldn't be completed online.

Long story short! Customer Service advisor asked me if I had any "claims" (note the inverted commas) in the last 5 years? I said no as I had already indicated when filling in the online form. Advisor says that all info is shared between insurance companies and asks me again! I repeat, no I haven't made a claim in the last 5 years. He then tells me that it would appear that I have made 2 claims, 1 in Oct 2013 and 1 in March 2014 both with a ZERO settlement ! I tell him again that I have not made any claims and would welcome any evidence to the contrary. He then phones Tesco's, while I am on hold, and eventually comes back to say that in Oct 2013 an enquiry was made relating to water ingress through my roof but that it wasn't progressed by me! In March 2014 an enquiry was made relating to the loss of an iPhone while on holiday. This again wasn't progressed by me. In neither case was a claim form submitted nor a claims reference issued BUT as far as the Insurance world is concerned, I have made 2 claims in the last 5 years hence the quote that I received was increased by £40! 

Any thoughts?


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## Pudsey_Bear (Sep 25, 2008)

Yes, In February this year while we up in Scotland, someone ran into the back of our car left outside the house, this person reported it to their insurer, Esure, who as it happens was ours at the time, a few weeks ago I had to re-insure the van, I went via Asda for quotes, best one was approached and I actually mentioned we'd had this incident and the premium shot up by around £200, so I told them to stuff it, and rang Esure as we had not made any claim in reality, I informed them that I was recording the call to ensure they only told me facts, and they said it was not a claim, and that I did not have to mention it when going for a quote, so I rang the next quote on the Asda list, and didn't bother mentioning the claim, hopefully if it all goes tits up and the reckon I have falsified my details, the recording will get me out of trouble, and if not I may have a case against Esure for bad advice.


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## erneboy (Feb 8, 2007)

I believe that when you ring them with a query they log the details on a claim form as (or immediately after) it's discussed and save it on their system in case you do claim. Then even if you don't proceed there's an entry against your name which looks like a claim. They wouldn't delete the entry as it might lead to a claim at a later date, possibly in some cases even years later .

As you point out, in the end it wasn't a claim, even if they thought it might have been or might become one. What they did, from their point of view, was the right thing to do. It also protected you since you have a duty to inform them in a timely manner and if you don't comply you could have a genuine claim rejected. 

Perhaps you could ask for a letter confirming that in the event you didn't pursue a claim and that no money was paid out which might satisfy the new insurer.

You need to be very careful what you tell any insurer. When just asking their advice it is necessary to preface your remarks by telling that at that moment you are not attempting to make a claim, otherwise it will be recorded on a claim form which to them becomes a claim pending.


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## caulkhead (Jul 25, 2007)

You are spot on with your analysis of the situation Alan. I followed the advice in my Policy booklet and rang Tesco's to inform them of a possible claim. I now know that I should have told them that i simply required their advice and that I was not, at that stage, making a claim. I should also have informed them later on that I was not going to be making a claim. Unfortunately, Admiral take the view that those two incidents, regardless of the fact that Tesco's have confirmed that no claim was made in either case, are enough to make me an increased risk and therefore increased their quote by £40.

I'm not entirely sure what the moral of the story is!


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## erneboy (Feb 8, 2007)

The moral may be that the less you confuse junior functionaries working for insurers, always providing there is no obligation to tell them about whatever it is, the simpler life will be.

Just as an example the kind of query we sometimes get on here. A person buys a policy for their motorhome and intends doing a lengthy trip in the EU. All the EU countries are covered but the policy does not give a maximum length of trip. 

Can you read that policy as not having a restriction on the length of stay or should you contact them and ask?

The answer is that if the underwriters wanted to restrict the length of trip they'd have specified it in the conditions of the policy. But the reality is that if you ring your broker or agent the functionary you speak to may have no idea and may tell you the first thing that comes into their head, and may even write to you confirming what they've said, thus arguably, making it a condition of your policy. Your chances of speaking to the underwriter are more or less nil, but all policy wordings are very carefully constructed before being used. So, in the above example, you can be sure that the policy does not limit the length of trips. But if you ask a junior functionary (sometime once or even several times removed from the underwriters because they work for an agent or broker), who's almost certainly going to be your only point of contact, that may not be the answer you get. You'd have been better off not asking and you had no need to ask since the policy is already perfectly clear. There's no condition placing a restriction therefore there can be no restriction.

I should declare my hand here and say that Mrs. Eb was a regional manager for one of the UK's biggest, and oldest insurers. I've heard all these questions and the answers many times before. It's perfectly logical. If it's illegal or excluded under the terms or conditions of the policy you can't do it, whatever it is, otherwise you're covered.


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## patp (Apr 30, 2007)

When we moved out of our house and into our fifth wheeler, so that the builders could renovate the house, I rang our insurer, Marks and Spencer, to notify them. When I told the junior functionary that it could be many months she went off to consult with a manager. On returning to the phone she advised me that she was serving me with a "Section xyz" notice of withdrawal of cover! This gave me a set period of time to find cover from elsewhere. Shocked was an understatement! I phoned round but failed to find another insurer to cover the, now empty, house. I explained that the builder had his own insurance and that all I required was for the contents to be covered while stored in our portacabin. We were, at all times. living on site. I explained that NFU would have covered us if we had and existing policy with them but would not issue a new policy on an empty house. No joy.
By now I was getting angry and phoned Marks and Spencer to give them a piece of my mind and threaten to report them to the Insurance Ombudsman. The junior functionary on this occasion decided to consult the underwriter. Lo and behold the underwriters tell the junior functionary that they are about to change the wording of the policy to cover situations such as ours and that we would be covered. Phew! 


Whether any claim would have been successful I have no idea. Luckily we had not need to test it.


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## Pudsey_Bear (Sep 25, 2008)

Do you find that in these days that they send you a PDF it is much better as you can actually search for certain words and phrases much easier than scanning by eye a printed docimunt if you're not one that reads such things very often, having said that how legal is a PDF anyway?


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## erneboy (Feb 8, 2007)

Insurance Documents transmitted by electronic means have been legal since 30th April 2010.

https://www.theaa.com/insurance/news/electronic-car-insurance-certificates-update.html


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## Mrplodd (Mar 4, 2008)

When it comes to ANY form of insurance it is essential that YOU read (and satisfy yourself that) you fully _nderstand_ all of the conditions and exclusions that are listed in the POLICY document (not the insurance certificate) your insurer provides you with. Read what it ACTUALLY says, not what you think it says!! Sorry if that sounds patronising but it's a very common mistake people make "Oh I THOUGHT it said......" is a very common phrase in respect of insurance.

It's a minefield and you don't have the mine detector!

Andy


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## erneboy (Feb 8, 2007)

Your certificate will detail any exclusions or exceptions applying to you. The policy document may be more general and may detail options for which you may not be covered.

You need to read them in conjunction with one another because the certificate may vary the general policy conditions.

Limited mileage, towing trailers, who can drive and many more possibilities.


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