JOHN LEWIS REFUSED CLAIM VIA COTSWOLD GROUP

[Politico]

Even though my wife was assaulted in our own home and items of value were stolen, the insurance company are refusing the claim because they have it on record that we did not declare 2 accidental damage claims when the initial policy was taken out. (These claims were not missed deliberately, and purely missed off because I forgot I had made the claims)

 

Their reasoning is that had we declared the claims then they would have not allowed the policy to take place. The problem I have is that they employed The Cotswold Group to investigate the case, knowing already that they were going to reject the claim anyway. 

 

The Cotswold Group came to our house, made my wife relive the entire story again and cause her immense stress and anguish by doing so. If John Lewis insurance knew the claim was going to be rejected then why did they cause ourselves more anguish and pain reliving the story, as they could have just rejected the claim anyway at the outset.

 

The accidental damage claims were genuinely forgot as they were several years ago, and these were not missed off because we wanted to not let the insurance company know. We declared a claim for loss away from the home, as this was a claim which we remembered as it was for over 4000.00. It does therefore not make sense to make a policy, declare a loss claim and then also not declare two other minor accidental damage claims as if I had remembered the other claims then I would have declared these. 

 

Is there anything I can do, John Lewis are cancelling the policy, refunding our premiums and I have said I will raise the case as a complaint as I feel that we have been let down. The accidental damage claims would not invalidate the policy, though RSA underwriters are saying they would have not allowed us the policy had they knew we had 2 AD claims and a loss away from the home claim. They even tried saying we had not declared 3 AD claims, but we only knew of 2 which were advised to us by John Lewis, but Cotswold Group said it’s 3. 

 

We we are hoping they change the decision, but I am wondering if I take this to the FOS is there a chance they will overrule the insurers and accept the claim.

 

many thanks.

[unclebulgaria67]

All the Insurers have to evidence is that they would not have offered you Insurance had they known about the other undisclosed claims. 

 

If they can evidence this, the Insurance is void from inception and the Insurers may not offer any refund of the premium paid, if they can justify retaining it, as they have incurred costs.

 

The question is how to do you get them to evidence that no Insurance was available with all of the claims declared ?  This is where the FOS can help, as they will request a copy of the Insurers underwriting guidelines and other documents to support them not offering Insurance with all claims disclosed.

 

So yes get a final response from Insurers, go to the FOS and see what happens. You could make a GDPR subject access request for all of your data, just in case this reveals anything helpful.

 

 

[Politico]

They are paying the premiums back, but not accept the claim and want to cancel it from inception. I will get them to see if they will send me underwriters guidelines, if not will get FOS to get them for me. Thanks. 

[honeybee13]

It sounds as if you may have come up on the CUE database for these claims. I expect unclebulgaria will know if you can query what they know about you, it might be worth checking.

 

https://www.mib.org.uk/managing-insurance-data/mib-managed-services/cue-miaftr/

 

HB

[Politico]

Thanks I’m waiting to hear from RSA in regards to this, as their exec team is looking into for me. I don’t hold out much hope, but I’m hoping they will allow us the claim. As genuine mistake and not deliberate is what they advised me today from the Cotswold Group. That’s why they are paying the premiums back.

 

ill try and do a SAR and see what appears on their and unclebulgaria can you let me know.

 

thanks