Ealing, London W5 (2023–2024) — insurance claim resolution

What was the client and the project?

Our Client was the owner of a three-bedroom first-floor flat in Ealing, who sought our assistance in resolving their insurance claim.

The claim resulted from a leak originating from a neighbour’s bathroom, with water pouring into their property causing extensive damage and associated mould growth leaving the flat uninhabitable.

What was the challenge?

The loss adjuster’s remedial works cost assessment was undervalued in the Client’s opinion, resulting in a potential significant loss as result of an event that was no fault of their own. Following lengthy dialogue between Client and loss adjuster and a resultant relationship deterioration, the Client employed LMA to act on their behalf in resolving the claim.

The situation was made all the worse for the fact that the insurer’s own drying-out specialist had, themselves, caused a second water damage insurance claim event caused by their malfunctioning dehumidifiers.

Our challenge was to resolve the differences between the claim to the satisfaction of the claimant.

What were the financial or operational risks?

The insurers’ drying-out specialist significantly delayed their works, compounded by the fact that they themselves had caused a second leak resulting in extensive damage to the bespoke kitchen installation. Consequently, the property remained uninhabitable for over a year. This ultimately led to the client’s continued loss of rental income and the incurrence of council tax premiums.

When the flat was finally dry our Client employed their own remedial contractor. The insurance company advanced the Client monies on account to progress with the repair works. Unfortunately, the remedial contractor abandoned the works, having underpriced the works, leaving the Client with further problems. It needed a further two contractors to complete the works.

What action did LMA take?

LMA, having firstly introduced ourselves to the loss-adjuster and struck up a rapport which immediately assisted the process, agreed to provide the necessary cost particulars in an acceptable in a bid to obtain mutual co-operation.

Following this, LMA:

  • Set out the sequence of events in a Scott Schedule format.
  • Cross-referenced the heads of claim against the insurance policy terms and conditions.
  • Reviewed the loss adjuster’s cost assessment build up.
  • Flagged missing costs items and undermeasured works for comparative assessments.
  • Ultimately provided an auditable trail of cost expenditure for the agreement of the claim.

What was the measurable outcome?

A further payment was made to cover the identified shortfalls, ultimately resulting in the settlement of our Client’s claims.

This project demonstrates LMA’s ability to:

  • Apply a considered, calm and factual approach.
  • Work in a collaborative manner with both parties.
  • Analyse where the differences pertain and challenge where applicable.
  • Put forward the necessary evidence to support entitlement.
  • Mediate without the need for third party resolution.
  • Achieve a mutually acceptable resolution.