Leaking Roof Insurance Claim

Lcasualbrowser on 29/05/2015 - 10:42

Hello everyone - any advice on the following issue would be greatly appreciated.

Two weeks ago after a heavy rain, my roof started leaking and water started seeping through the ceiling. Rang Westpac Insurance and 2 days later they sent an assessor. Assessor came, saw the damage, took measurements of what needs to be repaired and said a roof repairer would be sent to go on the roof. A week later after hearing nothing from them and fearing that the damage would get bigger if nothing is done before another heavy rainfall, I rang them and was told that the claim has been rejected because Westpac Insurance does not cover this claim as this is maintenance issue.

11 months ago, we switched insurance from AAMI to Westpac Insurance after being convinced that by Westpac staff that Westpac would look after us better as Westpac (with whom we have our home loan) has an interest in our home as it is mortgaged to them. That was silly of us to switch.

3 months ago we switch our home loan to Bank Of Melbourne which was offering better rates. Now coming back to the claim - the roof and ceiling were repaired 2 years ago by AAMI but in a different spot. How can they say that it was a maintenance issue when it had not leaked for 2 years? How are we expected to go on the roof and maintain it? Any advice on what to do next would be very much appreciated as taking on a goliath like Westpac is not surely advisable for a commoner! I think that this is just a bullying tactic by Westpac.

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Comments

  • Randxyz123 on 29/05/2015 - 11:03

    Are there tall trees around your house?

    One thing I do know at this time of the year gutters do get blocked by leaves leaving the water with no where to go. If you don't feel like climbing on the roof then you need to pay someone to do it. This might be why they rejected your claim.

  • lemc6125 on 29/05/2015 - 11:14
    +2

    Regardless of your history with the homeloan etc, you should go through the PDS and look at the wording of your insurance policy. My (very limited) understanding of home insurance is that if the damage is caused by an event like a storm, then repairs are generally covered but if the issue is seen to be a maintenance one, then it's not. This is my experience with my insurance company but don't take it as gospel as each can be different.

    Your first step is to become familiar with your PDS about what is covered and what is not. Each time you speak with a Westpac representative, ask then which section of the PDS they are referring to when they give you information. The PDS details exactly what you signed up to and it is what Westpac references when they process your claim.

    If you believe they are not adhering to the PDS and the agreement you have, then you can contact the relevant ombudsman in your state.

  • casualbrowser on 29/05/2015 - 11:25

    thank you lemc6125 for your kind advice - will for sure check the PDS tonight - thank you all

  • strikerzebra on 29/05/2015 - 11:50
    +2

    I used to work in home and contents insurance and I do know for a fact that no claims will be paid due to lack of maintenance, one think I would query with the claism team is what was the maintenace issue as it seems they haven't specified.

  • YTW on 29/05/2015 - 12:56

    It comes down to whether it was leaking because of damage caused by the storm (ie. tiles blown off in wind, tree branch crashing through your roof) or if it was just getting old so needed some maintenance (and you didn't realise it until heavy rain).

    We had a very similar thing happen to us in the last month, it was quite unnerving to realise just how much ISN'T covered by home insurance. It's there for accidents, not maintenance on a crappy old roof (or a crappy newish roof in our case). We've just had to come to the conclusion that we need to get up and inspect the roof more frequently as it is of an age/condition where it needs very regular inspections/repairs.

  • Sharp on 29/05/2015 - 13:07

    Roof leak claims are problematic. if you don't have anything broken (tree fell on the roof tiles etc) insurance companies don't want to pay roof leaks. Because they tie it up to lack of maintenance and normal wear and tear. It's the same with all insurance companies. We had the same issue with NRMA.

    So sorry but I don't like your chances.

  • casualbrowser on 29/05/2015 - 14:24

    Thank you YTW, Strikerzebra and Sharp. Thank you all. I now have a more general idea on where I stand. Like one of you guys mentioned, they did not mention what the maintenance issue was.

  • Hellfire on 29/05/2015 - 15:47

    Ask them for a written response to why your claim was rejected.

    Raise a dispute with their internal disputes team. They sometimes pay out when the normal channel fails.

    Raise a complaint with the Financial Ombudsman. They may find in your favour.

    If all this fails then you probably don't have a valid claim and your only option is a lawyer.

  • casualbrowser on 01/06/2015 - 16:50

    thank you all very much for your advice - am now more much prepared when I start the dispute process - thank you

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