Damage to Wall after Storm - Claim Rejected

Hi,

We had a severe storm which caused our brick wall to be damaged.

Our insurance company rejected the claim.

They did send out a building inspector that was supposed to inspect the damage.

He walked around for a few minutes without actually physically inspecting the wall. Only a visual inspection.

He sent a report to the insurance company and claimed that the wall had a pre-existing condition, the damage was caused by root movements.

Whatever the cause is, I would have thought that they would need to do a proper inspection and not submit a report based on assumptions.

Please, no silly comments etc.

I would appreciate all support and tips.

May the Ozbargain force be with you :-)

Comments

  • +13

    He walked around for a few minutes without actually physically inspecting the wall. Only a visual inspection.

    What would a physical inspection consist of? A kick? A caress?

    • A question John Kimble.

      If you had an insurance and had a damage to your property (brick wall).

      The repair cost would be app. $5000.

      The insurance company would send out an an assessor that simply walked around for 3 minutes looking at the damage but did not actually inspect the brick wall.

      I would have accepted the rejected claim if he would have spent 5 minutes digging up some soil to check if his assumption was true or not. How hard is that…

      If we allow insurance claims to be assessed by assumptions and not inspections, then we are in deep trouble.

      It is easy to make silly (I did not say stupid) comments when you will not have to pay for the repair.

      • +2

        It was a genuine question. I didn't know what a physical inspection involved.

        Why didn't you ask them to do a physical inspection when he was there?

        • +3

          "Why didn't you ask them to do a physical inspection when he was there?"

          In hindsight, I should have done that.

          But my insurance company (been with them for 27 years) are always very good and I did not want to interfere with the inspection.

          • @vegemite2008: These people do these things in and out every day. Just like a car assessor can quote $Xxx to replace a panel without touching/pulling at it.

            He will have seen the trees nearby, maybe even the roots pushing underneath the wall and said "that's what has weakened the wall that made it susceptible to damage. If the tree had been taken care of it wouldn't have damage"

      • +1

        We've had site visits/investigations when i was in geotech that would take ~10 minutes to condemn a $300,000 house. Pretty much just walking around, no physical inspection necessary if it's an obvious case, just a couple of photos and case closed.

        Without photo's it's anyone's guess

  • +24

    Inspector: "Yeah this wall looks pretty rooted."
    Insurer: "Root damage you say? Claim denied!"

  • Put a photo, and I’ll do a free visual inspection for you.

    • +2

      He's already had a visual inspection, he wants a physical inspection.

      • +5

        Time to glove up

        • So many comments, so many ways to be sin binned. Just think about variations on “rooted” and “gloved up”.

  • +5

    Request a internal review & assessment. If that fails to yield result then contact AFCA who might be able to assist.

    • I did, they want me to pay for a building inspector.

      I thought that was part of the insurance policy to have a proper inspection.

      • +3

        Guess say to the insurance company that you'll pay for the inspector but if the issue is verified not to be pre-existing then the insurance co will have to reimburse you for the builder inspector fee.

      • +1

        If you pay for an independent 3rd party to inspect the wall and the insurance companies finds in your favour, will they reimburse that fee?

        Unfortunately, insurance companies don't give a fig how long you've been a customer. The longer you are with them, the more they charge you.

    • +10

      Background - lifetime in the industry
      These days most insurers do not use 'qualified' inspectors/assessors
      Just an internal person who comes out to authenticate that you actually have damage and the claim is genuine
      Expert advice is rare and usually only called on to aid them to deny your claim
      Suggestion - get a builder/bricklayer to come and give you a free quote for repair
      Ask their opinion as to the cause of the damage
      Based on the zero info but the balance of probabilities the tree roots undermined the wall and the storm water just finished it off
      If your builder says different then it is worth getting an independent building consultant review
      Pay for it yourself and if your claim is accepted you can claim the cost
      Typically the insurers won't fight too hard over a $5K claim if you have evidence

      • Mate, thank you.

        I will get a free quote.

        Excellent advice.

  • What sort of inspection are you expecting?

    We obviously don't know the details of the situation, but it might be possible that it is quite obvious to a professional building inspector that roots have moved into the wall and materially disturbed it. Yes, the storm is probably what "pushed it over the edge" by softening the ground around it, etc., but if it is clear there are roots in the wall's foundations or what have you, then that is the cause.

    • You would accept this assertion, no questions asked, from an insurance company? Yeah, it’s not like they’ve been caught out denying legitimate claims before. Me, I’d want some pretty good proof as to why they consider root damage is the main cause of the failure. Unless they are on, very, solid ground they might just roll over and pay you out.

      • The details provided by OP are scant. I would adopt the process I've outlined below if I was convinced that the inspection was in error.

        • I agree with the process you’ve detailed below but I do like the idea of getting builders in to look at repairing the wall and get their view as well. My issue was just with this comment. Unless I had really good proof I wouldn’t accept the first “no” from an insurance company. :)

  • +2

    "but if it is clear there are roots in the wall's foundations"

    That's the issue. We don't know if there are roots in the wall's foundation because he did not inspect it.

    Or, maybe he has x-ray vision….

    • Well then that's what you go back to them with.

    • +2

      Presumably that's what's in the inspection report.

      You should request a copy of the report.

      Pending what it says, you should speak to the insurer about challenging the report on the basis of the comprehensiveness of the inspection and/or the findings.

      Presumably they will say that you can arrange your own inspection and they will reconsider.

      You can do that and if the new inspector finds in your favour, then provide the report to the insurer and see what they have to say. They may agree with that and pay the claim, or they may stick with their original denial.

      You can then raise a formal complaint through the insurer's internal dispute resolution mechanism.

      If you don't find satisfaction there, you can raise a complaint through AFCA.

      If you don't find satisfaction there, you can lawyer up and launch civil proceedings on the matter.

      After all of that, you will know where you stand.

    • Can you see any root under/ around the now collapsed wall?

  • What damage did the storm do to a brick wall?

  • +4

    I suggest you start by having a good look yourself. Is there a tree nearby that could’ve provided the root damage? Do you have any recent photos of the wall that shows if it has any deformation. Where the wall has fallen down is there any visible signs of root damage.

    If there is a large tree, nearby, the inspector may have decided there was root damage. If you don’t think it was root damage what do you think caused the wall to collapse?

    Did the inspector actually take some photos?

    My suggestion is you go back to them and ask for any relevant photos, that he took, and the indicators as to why he called it root damage. You always have the option of going to the insurance ombudsman if you aren’t satisfied. They can’t just fob you off without providing you with the reasoning, and proof, that is was root damage.

  • +6

    Ok, going to put my civil engineer hat on for a second.

    Walls don't generally get storm damaged, especially brick walls. Fences i understand, but they're succeptible to wind loading.

    Brick walls generally fail due to either damaged foundations due to roots, concrete cancer, poor workmanship or if its 50+ years old just plain weathering.
    If it was flooded and this eroded the foundation then you might have a case but without pictures we'd never be able to tell is there a big tree nearby? is the abutting wall in similar condition?

    Too many variables imho

  • +1

    Which insurance company, and which assessor company? It makes a big difference.

    Is it Westpac & MK3?

  • picture or it didn't happen.

    • +5

      Patience, they are just trying to photoshop a massive tree out of it. :p

    • MS Paint will do.

  • Could you post some photos?

    • or even better, an MS Paint image

  • +4

    Had this scenario happen, there was construction on a bordering property and they damaged the drainage near a shared wall which caused damage to it. Had an inspector to come out and inspect it and they gave some nonsense about "loamy soil" or "root damage" in a property that had none of these things for 20 years. Basically just told them their report was wrong and they sent out the boss who came and said that the damage was definitely caused by water. It can't hurt to ask your insurance to inspect again.

  • +1

    Insurance companies deny plenty of claims on the basis you will walk away and they save $$$$. Always challenge any claim denial if you feel you have a legitimate claim.

    • At least you have kept your sense of humour

    • God damn mongorians

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