Can we sue our insurance company for neglect, distress and loss? more details>?

Question

in 2004 a main sewer backed up and our home was surrounded by 10 inches of sewer water, dampcourse breached etc and severe damp/ moisture problems within house, we lost everything, our insurance complany would not admit liability claiming the problems were due to 'furniture being too close to the walls' and 'warm air hitting a cold wall'. We have a 7 year old daughter who was 5 at the time of the incident (10.08.04) temporarily rehoused 16.12.05, we slept on contaminated beds wrapped in sheets & muslin and lived in & breathed in damp for 16 months . I suffered from OCD which worsened & haven't had treatment as my fears/ actions were 'justified' and released back to my gp & I suffered 3 chest infections, 2 pleurisy, 2 kidney infections, an ear infection and skin problems, and since developed We received payment for some of our belongings and also 'goodwill' payments towards essential property repairs, we still don't have a kitchen, we ran out of funds after paying £22k for repair work

Answer 1

This sounds horrendous. I'm assuming you are in the UK.

If the insurance company won't pay up, this is known as 'avoiding the policy'. There are many reasons for this: not an insured loss; material non-disclosure; failure to notify etc. etc.

I assume the insurance company told you on what basis you are not being paid.
As a preliminary step, you can't sue them for any failure arising out of the policy until you have proved that the policy appleis to your particular circumstances and you have suffered an insured loss. there are three ways this can happen:
1, The insurer can admit it;
2. You can get the insurance ombudsman bureau to intervene/investigate (www.theiob.org.uk) - this is free.
3. As an alternative or in addition to (2) above, you can sue for breach of contract.

You clearly cannot even contemplate 3 without proper legal advice and representation. If you can get a favourable ruling from the IOB, you should have no trouble getting a solicitor to take it on a no win/no fee.
If you get an unfavourable ruling, you may have substantially more problems.

However, whilst you may have a claim for monetary damages and interest as a result of breach of contract; you will not be able to obtain damages for neglect, distress or personal injury.

I hope this helps - even if it may not be as positive as you might hope for.

Answer 2

She cannot sue the insurance company at this time, the insurance company has done nothing for which to be sued. She can only sue you. If you don't think the dog bit her don't give her your insurance information and don't put a claim in yourself. She will then have to sue you and at that time you let the insurance company know. The insurance company will get any police and medical reports and do an investigation. If they find probable cause that the dog did bite her they may settle out of court, but only up to your policy liability limits. Most homeowners' policy limits are $300,000. Since she's on Medicaid the insurance company will only pay for her medical bills directly to Medicaid if Medicaid is named in the lawsuit or if Medicaid requests. Since she doesn't have a job she cannot claim any loss wages. She may get pain and suffering but only if the judge can be swayed to award it to her. If the judgement is over your policy limits you will then be responsible. If the dog did bite her the insurance company will cancel your policy unless you get rid of the dog. If the dog is of a certain breed, such as a pit bull or doberman, the insurance company probably has an exclusion in the policy and they won't pay anything and will cancel on the spot. They can, and probably will, raise your rates.

Answer 3

You would need to definitively prove that the insurers did not pay out for something they were liable for. This will be an incredibly difficult task - they did not admit responsibility in the first place, and have subsequently stood by their position - they have issued you with some goodwill payments, so I suspect they will have looked into it in a good deal of detail and decided that even though they are NOT liable, they wished to assist in some way. It's gonna be nigh impossible to sue - the only way you will get any action taken without paying a fortune (legal aid WON'T be available for this action) would be to find a no win no fee lawyer who MAY get an out of court settlement in return for a large slice of the winnings. However, i feel the fact that the insurers have issued goodwill payments to you will make them p1ssed off you have subsequently decided to sue and will take you up to court (at which point you may find your no win no fee lawyer looking to, if you will excuse the pun 'bale out - those guys hate doing actual court work, and if they can't get a settlement they drop the case).

Answer 4

You need a good lawyer who specialises in this sort of thing.
Do not take the Insurance company on byyourselftheyknow all the tricks and a few more. I'm notsure we have the full story buton theface of ityouhave dealt with someone who's enthusiasm has outstripped their nouse.You may get legal aid if in UKask about it

Answer 5

sounds like you need a lawyer... thats just wrong...

Answer 6

Urgh! That is not a helpful answer but.... URGH!