Insurance company making claim difficult

[NormanH]

Following idun's

general thread about insurance a couple of weeks ago, I now have a

specific example of how the companies make things difficult for their

clients when it come to claims.

I have an insurance

which covers plumbing and leaks, including the cost of the water lost

up to 1000€ (in principle) . Many people don't realise that much

of this is not covered by ordinary house insurance, which will

probably only cover water damage, not the repairs to the system.

Well, during my 4 month

absence earlier in the year there was a major leak in part of the

house that I don't go into. I didn't know, as it turns out to have

been a problem with the cistern on the toilet, so the water just ran

away into the drains without leaving a trace.

The lodgers hadn't

turned off the water when they left without paying...

To cut a long story

short I received a water bill of 2500€, of which I had paid 900€

in my usual monthly payments over the year. They also told me that

they had put up my monthly payments to 342€ !!!

Obviously I contacted

both the water board (Lyonnaise des Eaux) and the Insurance

company, and that's when things started to get complicated.

I called out the

insurance company to send a plumber: he arrived 2 days later at 5:30

on a Friday afternoon, took one look and said there were 2 problems,

but he was only allowed to put one right under the terms of my

insurance, and being very friendly said he would do the more

expensive.

He nipped out to his

van, and replaced the mechanism in the toilet, saying that there was

also a little leak in the tap in the washbasin, but “any plumber

could put that right, just open the telephone directory and call the

first name you like”

I have since done that

and it cost me 450€ to replace the whole sink column. I reckon he

knew that but didn't want to be bothered to go and get parts on a

Friday afternoon when he could just change the mechanism with parts

from his van, which he left blocking the road for the hour it took

him to do the job.

He signed the job off,

and luckily I had the presence of mind to ask him to sign the meter

reading as it was when he did the job .

When he went I saw that

the meter was still ticking over busily, and it wasn't until the

second plumber, whom I was paying came that the root of the problem

was found.

I called the Insurance

company to ask HOW to claim for the lost water. Nowhere on the

contract was this shown.

The woman said she

would send a claim form with a list of documents required, but 10

days later I still had nothing, so I called again.

A couple of days later

the form arrived from the first call saying that everything

had to be in within 15 days of the leak, so I had 24 hours to get it

all back to them.

The problem was that

they wanted a copy of the bill signed by the water board as having

been paid in full, which I hadn't got.

They also wanted 3

years paid up bills, and the bon from the plumber they had sent.

My scanner went into

overdrive and I prepared most of that, arguing that the “échancier”

of 342€ a month counted as evidence of the fact that the bill was

being paid..

They also demanded that

I choose between a possible 'dégrèvement' from

Lyonnaise des Eaux, and making a claim on this insurance.

Of course at this point

I hadn't had any offer of a 'dégrèvement, and

still don't know if one will be offered

In

any case it seems remarkable to be asked to choose between an

insurance policy I have paid for, and the possible generosity of the

water board, so I just didn't tick the choice on the form.

To get it to them in

time I turned it all into a .pdf file, having to reduce the quality

of some of the scanned images to get within the Poste's limit, and

sent it online as a lettre recommendée

using

that useful but expensive service, so just managed to get it within

the deadline.

In parallel I wrote to

the water board

I explained the

situation about my absence due to ill health (fully documented with

bulletins de situation from the Hospital) gave them a copy of

my Avis d'imposition for the last two years, showing that I couldn't

easily pay the 342€ a month they were demanding for 2012 and asked

for a

'dégrèvement”

see above .

I

also asked them to check the metre to be sure it was accurate (at

that point I hadn't had the visit from the plumber) and promised that

I would have any leaks repaired.

I

also pointed out that it wasn't sensible to base the estimate for

next year on an artificially high consumption, elevated by the leak.

I

also sent that online as a lettre recommendée.

Today

I have had replies.

Lyonnaise des Eaux

completely ignored my request for a dégrèvement and sent a letter

saying if I want my metre checking it will cost me 60€

The insurer (Domeo

contract Max) have played the usual card of 'pièces manquantes'

asking for the receipt to show

that I have paid the whole 1600€ left from the 2500€, plus a

statement from Lyonnaise des Eaux

of how much, if any dégrèvement they

are offering

I

too would like to know, so to try to stop going round in circles I

will have to go miles into the offices of Lyonnaise des

Eaux and threaten them with the

Médiation de l'Eau, although I doubt it will make them tremble.

Meanwhile,

despite my express demand they have taken the first instalment from

my account …

Has

anybody any idea if it is legal for an insurance to insist on all

this?

And

what should I do about Lyonnaise des Eaux?

Faire oppositon at the bank and wait for them to squeal so as to

force them to negotiate?

I

don't take anything back of the encouraging message I posted a while

back for those freshly diagnosed with cancer, but I could have wished

a less futile use of the extra time granted to me .

[Frecossais]

Norman, I'm sorry I can't offer any suggestions or help with your insurance/water problem. Is there no such thing as an Ombudsman in France? 

[AnOther]

Don't know if this might help:

http://www.60millions-mag.com/actualites/archives/un_plafond_en_cas_de_fuite_d_eau

[NormanH]

Thanks AN....it's always useful to have something to quote at them...

[Théière]

[quote user="NormanH"]

there was also a little leak in the tap in the washbasin, but “any plumber could put that right, just open the telephone directory and call the first name you like”

I have since done that and it cost me 450€ to replace the whole sink column. I reckon he knew that but didn't want to be bothered to go and get parts on a Friday afternoon

[/quote]

Can't offer any help on the insurance technicalities but how does a small leak in the tap ( conventional tap requires a new washer or 1/4 turn tap requires a new cartouche) become €450 sink column? In some cases cartouches cannot be found so a new tap may be needed but €450?

I changed one 2 weeks ago inc callout was only £60.......

[NormanH]

Probably because I am a mug.

The Insurance Company's plumber had said that it was only a small leak from the mitigageur, saying that he would do the 'more expensive' job.

When I called the second plumber he found that the whole column needed changing as the model was obsolete.

Remember I can't get upstairs to see these things for myself.

This second plumber has also replaced two whole WCs, one for me to have a high level one, and one in the second flat.

The price of the first was 450€  the price of the second 300€.

Do these seem fair prices?

[Chancer]

French plumbers!

There was an exposé on the TV the other night, well for any of us that are used to proper consumer programs who actually champion the consumer it was typically very lightweight, it followed the usual format, expert plumber from a trade association creating the faults, hidden camera, woman of the house calls out plumber to leak......................

The faults were no silicon sealing between the end of a brand new gres ceram sink/drainer and he pulled out the WC cistern fill pipe ever so slightly from the seal.

Of course all the plumbers wanted to change the sink and the WC and their devi's were up to €2K for each item, what peed me off is the expert saying a reasonable price would be what Norman paid and that they could have just pushed back the WC pipe which should only cost €150 [:-))]

Frankly the whole plumbing and electrical sector stink in France with the manufacturers, merchants and trade associations all doing their bit to ensure the consumer pays massively over the odds for materials, my €29 couronne of gaine that the grossiste wanted €290 for and an electrician would have billed out at €450 being a good example.

A good first step in the right direction would be the removal of the need for factures to be broken down between labour and materials.

[Théière]

Norman I don't think you are a mug, I just get angry when someone takes the **** when someone who has quite enough on their plate healthwise is an easy target. As I said cartouches do change frequently so become obsolete requiring a tap change, I frequently hear parts are un available and sometimes it's just laziness, I lost a little job the other day because I needed a part that had to be ordered. The result is they got in a guy who replaced the whole thing and made a tidy profit but was quick (well you would be) so the customer (impatient) lost out but didn't seem bothered and of course me who had already ordered the part. Lesson learnt I will probably charge for a replacement tap next time in order to make some income.

The second prices seem reasonable 300€ (n0t knowing exactly what was involved from the other end of my pc)

[NormanH]

Well I have made some progress, thanks to AN's link, and the fire engendered in my loins by the other posts..

I have now been able to base my demand on the 'texte' in the law mentioned in the link, and it looks as if I may get part paid by the water board and another bit paid by the Insurance.

To get that far was another mountain however.

I went to see the Lyonnaise des Eaux in their office...or so I thought.

I checked on the website before going, (I have a screenshot of my account details and the address from the 27th December) and trundled off with several breaks on the way a couple of kilometres across town pushing my rollator .

When I got there the place was abandoned, with a scrawled piece of cardboard announcing that they had moved to 'The Polygone' (A large new shopping centre too far away for me to get to)

Most of the facilities seem to be moving there so it was inevitable perhaps, but they could have changed the contact details on their website all the same.

The trip wasn't completely wasted, because I was able to take advantage to change my Mutuelle (another Saga I won't bore you with now), but I returned exhausted and demoralised.

Today a friend and I went to this Polygone , and to find the mystery entrance to the offices of the water board was like something out of a 'Quest' film, involving lifts, asking three different people for directions, and finally coming to a door with three buttons with no labels.

Pressing them all we finally saw that there was a LED which flashed various names of offices in succession.

When finally Lyonnaise des Eaux  came up we had three seconds to press before the name changed.

We managed to get it on the third attempt, and a voice announced that the door would be unlocked

Once inside we had to take another lift two floors higher, and pass another secure door to find ourselves in the office, confronted by a large and rather ferocious lady, who rather deflated when I started producing EVIDENCE..

For example " you wrote to us on the 13th December"

"No Madame it was the 2nd" (dates are important to keep within their deadlines)

"It was the 13th. I have it on my computer"

"No Madame, it was the 2nd. I have the Accuse de reception from the registered letter"

"Oh!  Well it was the 13th. when it was put on out computer"

"Well doesn't that show how inefficient you are?"

and about 40 mins more in this vein...

Anyway it was a face to face with a semi-human being, so perhaps some progress is being made.

All the same I sent the same documents again this evening by registered  mail to have proof that I have given them ...

[idun]

[quote user="Chancer"]

French plumbers!

There was an exposé on the TV the other night, well for any of us that are used to proper consumer programs who actually champion the consumer it was typically very lightweight, it followed the usual format, expert plumber from a trade association creating the faults, hidden camera, woman of the house calls out plumber to leak......................

The faults were no silicon sealing between the end of a brand new gres ceram sink/drainer and he pulled out the WC cistern fill pipe ever so slightly from the seal.

Of course all the plumbers wanted to change the sink and the WC and their devi's were up to €2K for each item, what peed me off is the expert saying a reasonable price would be what Norman paid and that they could have just pushed back the WC pipe which should only cost €150 [:-))]

Frankly the whole plumbing and electrical sector stink in France with the manufacturers, merchants and trade associations all doing their bit to ensure the consumer pays massively over the odds for materials, my €29 couronne of gaine that the grossiste wanted €290 for and an electrician would have billed out at €450 being a good example.

A good first step in the right direction would be the removal of the need for factures to be broken down between labour and materials.

[/quote]

 

There used to be an hilarious tv series calles La Famille Bargeots, le papa was a plumber with a rolls royce, if I remember properly. So nothing changes nez pah.

 

NormanH, I am still having problems, but good luck sorting yours out.

[AnOther]

Glad to have been able to help in some small way [;-)]

[woolybanana]

I am sure they will give in to your wishes Norman, once you have got you teeth into them.[:D]

[5-element]

[quote user="woolybanana"]I am sure they will give in to your wishes Norman, once you have got you teeth into them.[:D][/quote]

 

...and so it should be, that they give in. I am filled with foreboding at the thought of ever having to face that sort of ordeal, as I don't have your backbone Norman. But more power to you, you are carrying the flag for others. You obviously have the stamina, the wits and sufficient indignation to keep on and on until they do what they should have in the first place.  Absolutely appalling, from several quarters. Go Norman, go, you will get them all in the end!

[Patf]

Norman you deserve to get a good result with all your persistence!

[GeordieTony]

This doesn't deal directly with your issue but another example of how devious and uncooperative insurers can be:

We had been back at home for two weeks after spending some time at our house in Limousin. This was in 2007. We were trying to get back into some sort of routine when the phone rang.It was our English neighbours to tell us that we had “a big problem”. Apparently we had a burst pipe inside the house.

Obviously we needed to go back straight away to see what had happened. Briefly, the main water supply pipe in our living room had fractured. Fortunately this was just upstream of the meter, which meant it was the responsibility of the commune. However, that also had a downside.

Water had been spraying around the living room at high pressure for about three days and there was at least one metre of water in the cellar. Furniture, carpets, books etc were soaked and ruined and, of course, the paintwork. Also the flooding, as our surveyor confirmed, had caused a crack through one of the interior walls.As soon as we returned home we submitted a claim to our insurance company. This was accompanied by photographs showing the extent of the damage. We also provided a copy of the report of our surveyor.

After some time the insurance company (AGF) sent an “expert” to inspect the damage and recommend the settlement. After this visit he only reported on the furnishings etc and hadn’t looked at all at the very extensive redecoration and repair that was needed. We pointed this out to the insurers, who said they would get the “expert” to look again.

There was then another visit, at which we were present together with the “expert”, his assistant, the mayor, another representative from the commune, and our French neighbour. The mayor was there because the insurers were also making a claim against the commune. This, although it was nothing to do with us (our contract after all was with the insurers) was used by them as an excuse not to settle the claim.

After this visit there was complete silence for a few months. After several phone calls and emails to the insurers we were told that the “expert” considered €450 was appropriate (about one tenth of the claim). This was never put in writing. Not surprisingly we said this was not satisfactory and we also complained on numerous occasions about the lack of response and the time it was all taking.

We were eventually able to arrange a further visit at which we met someone from the insurance company who, we were given to understand, would be able to finally sort things out. How wrong that turned out to be, although the person concerned did agree that our claim was entirely reasonable. After the customary several months with no feedback despite numerous phone calls we were told that there was to be yet another visit by a new “expert”. This duly took place in June 2009, and again we were present. By this time our expectations were very low and so far as the insurers were concerned, it was business (or lack of it) as usual. At around this time AGF were taken over by Allianz, which muddied the waters still further.

After the usual long wait we were eventually told that a new person at the insurance company was taking a new look at the whole case. By this time were too cynical to believe that anything would actually happen, and of course nothing did. Having come to the conclusion that the insurers were simply not interested in settling our claim we wrote to the Médiateur de la Fédération Français des Sociétés d’Assurances. It almost goes without saying that his response was that outside his field of competence!

We are still waiting and, because we were so fed up with the state of the house, we decided that we really had to get something done so, at our own expense, we had all the repairs and redecoration carried out.

A few months ago we decided to employ French speaking solicitors to see whether some pressure from them would persuade Allianz to make some sort of offer. Sadly all they did, after the usual periods of complete silence, was to pass our solicitor on to people at offices elsewhere in the country and provide no satisfactory response. The end result has been that it would probably now cost us more in legal fees than we would hope to recover from the insurers. We are going to make one more attempt on our own behalf but without any great optimism.

So far as we are concerned, this all reflects very badly on the French insurance industry. We appreciate that trying to find excuses not to settle claims is not unique to France but we cannot understand how they can get away with simply ignoring claims on the basis that they will go away because they become too costly and time consuming to pursue.

Needless to say we have been through the ridiculous bureaucratic French process of sacking the insurers and only time will tell whether our new company is any better or this is simply the norm in France.

If anyone has any similar experience to share we would b e pleased to hear about it.

[idun]

I am so sorry to hear about his GT.

450€ in France, getting a decorator to work for that, as if you could, ten times that might seem realistic, and then there'd be the actually goods in your house that were destroyed. It would have cost them a pretty penny and it should have cost them a pretty penny.

 

[mogs]

On a slightly different tack to that of Norman, I would like to ask if anyone has ever had to deal with an insurance company following a house fire and total loss of everything?

If you have you will know what I am talking about, but if you haven't I am sure you can imagine the difficulties we have encountered with trying to get our house rebuilt.

I hope you get your insurance company/water company sorted Norman without much more stress, which is not good for ones health.

[NormanH]

Thanks mogs...it is still ongoing!

It seems that these things are not easy in France [:(]

[idun]

Sorry to hear that yours is still ongoing NH, hope it gets sorted soon.

 

[idun]

Mogs is that what happened to you? If so I would be interested to know what problems you encountered with the insurers.

[mogs]

Yes Idun, in 2010 we lost everything.

Initially the insurance company were brilliant, quickly helping us out with contacting authorities, banks, CPAM etc to replace carte vitale, bank cards etc.etc. They also dished out an emergency fund to enable us to find somewhere to rent and pay the necessary fees, and to buy clothes and replace chairs, beds and so on.

It took 3 months for them to finish working on our file, we (perhaps stupidly) allowed the insurance company "Experts" to award us the fund for rebuilding and replacing contents. We were happy with what they offered.

This is when the problems started : they misled us by telling us that when we had reached a certain figure of factures for the rebuild they would issue us with the 2nd payment. The expert speaks excellent English so there was no problem with breakdown in communication.

We reached that certain figure some time ago to then find out that they only pay us for building materials/builder AFTER they have the factures. So we are left with a half finished house and have to buy out of our own money to then produce a facture which we send off. But, they won't pay small amounts like 5,000 they will only issue payment when we have a larger sum like 15,000 plus. We've currently been waiting 4 weeks for another payment from them, meanwhile our builder is getting fed up of waiting to be paid (understandably) and so the saga continues.

There has been many more issues with the insurance company, but too many to explain here but I certainly would not recommend these "experts" who are employed by the insurance company and yet get paid from our payments.

[idun]

I am so sorry you are being messed about in this way, this really should not be yet another ordeal. I think you have been through enough.

[GeordieTony]

Thanks for that idun, we'll keep trying!

[idun]

As I said on another thread, I have little faith in insurance companies in general. It's good to hear when they do as they should, but we pay and we expect and they should pay up without distressing any of us further........ do they think we enjoy these crises, we don't and there is no way any of us would even think about our insurance company other than at renewal time, unless we need them.

I am partially sorted out now and this thread has been the deciding factor that I will write to the one that has not been of any use at all.