case
studies – insurance disputes involving
personal possessions
35/1
customer unable to recover full amount of claim under contents
insurance policy – value of damaged property exceeded
the policy limit – whether firm right to reject customer’s
claim for the balance under his purchase protection policy
Mr
K accidentally dropped and damaged his new camera one afternoon
when he was taking pictures of his family at a local carnival.
The camera was worth about £4,000 and Mr K put in
a claim under his household contents policy. He had paid
an additional premium on this policy to obtain cover for
his personal possessions while they were outside the home.
Mr
K’s contents insurer accepted the claim. However,
it only paid him £1,500, as this was the policy limit.
Mr K then tried to obtain the balance from his purchase
protection insurer (firm C). Firm C rejected the claim on
the grounds that its policy contained the following exclusion:
‘This policy does not cover… loss or damage
insured under any other policy or which would have been
insured under another policy but for the application of
a policy excess.’ Mr K then complained to us.
complaint upheld
The clause in this particular policy was similar to that
found in many types of policy. We consider the purpose of
such clauses is to prevent policyholders making a ‘double
recovery’ (claiming for the full amount of the
same claim – from two different insurers). We did
not consider the clause to be inherently unfair or unreasonable,
provided the firm applied it appropriately, so as not to
exclude genuine losses that were otherwise uninsured.
Mr
K had recovered only part of his actual loss from
the contents insurer. We therefore considered that it was
fair and reasonable for him to ask firm C to cover the balance
– and for it to do so, subject to the policy excess
and limit.
..........................
35/2
whether electricity generator came under policy’s
definition of ‘personal possessions’
When Mr J’s electricity generator was stolen from
a local stable, where it was being kept temporarily while
in use, he made a claim under his household policy.
The
firm rejected the claim. It said the generator was not covered
when it was outside the home. The only ‘personal possessions’
that the policy covered outside the home were ‘Items
which you… would wear or carry around for personal
use, adornment or convenience …’. Mr J then
complained to us.
complaint rejected
We felt that the firm’s policy definition was worded
sufficiently clearly to exclude Mr J’s claim. The
firm intended only to cover certain sorts of items –
those that were portable. It could not reasonably be said
that a bulky electricity generator was an item that you
would carry around for ‘personal use or convenience’.
We therefore rejected the claim.
..........................
35/3
customer’s claim for stolen computer – whether
firm correct to say computer did not fall within policy
description of ‘personal belongings’
Miss G took her personal computer with her when she went
to stay with a friend for a few weeks. The computer was
a standard desk-top model, not a laptop. There was a break-in
at the friend’s house shortly after Miss G arrived
and the computer was stolen.
Miss G put in a claim under the ‘personal possessions’
section of her household policy but the firm turned it down.
It said that her computer did not fall within the policy
definition of ‘personal belongings’
which listed ‘Clothing and Personal Effects (including
clothing, jewellery, watches, furs, binoculars, musical,
photographic and sports equipment)’. Miss G then
complained to us.
complaint upheld
We decided that if the firm intended only to cover personal
belongings that were designed to be portable, or that were
customarily carried about the person, then it should have
said so in plain language.
We pointed out that the policy definition included musical
instruments. Some musical instruments, such as pianos, are
not usually considered ‘portable’.
However, the policy did not make any distinction between
‘portable’ and ‘non-portable’
instruments. So non-portable items could fall within the
policy definition of ‘personal belongings’.
The computer was a possession that was personally owned
by Miss G. Since the policy did not specifically exclude
computers, we decided the fair and reasonable solution was
for the firm to pay the claim.
..........................
35/4
customer’s furniture destroyed in fire at ‘storage
facility’ – whether firm correct in rejecting
claim on grounds that items were stored in a ‘furniture
depository’
Mrs A put her furniture into storage while she was having
renovations carried out after moving home. Unfortunately,
all her furniture was destroyed when the storage facility
burnt down. The owners of the facility held no insurance
and had been declared bankrupt, so Mrs A put in a claim
under her household insurance policy for £50,000.
Her policy covered her against loss or damage for ‘personal
possessions temporarily away from the home’.
However, there was an exclusion that said items were not
covered while they were stored in a ‘furniture
depository’. The firm cited this exclusion to
turn down Mrs A’s claim.
Mrs
A argued that the storage facility was not a ‘furniture
depository’, but the firm still refused to pay
the claim. However, it did offer her a goodwill payment
of £5,000.
complaint rejected
We decided that a ‘storage facility’
fell within the ambit of the phrase ‘furniture depository’.
It was a place where furniture was deposited. We did not
agree with Mrs A that because items other than furniture
could be stored there, it could not be defined as a ‘furniture
depository’. We concluded that the firm was not
liable to meet the claim and that its goodwill payment had
been very fair.
..........................
35/5
bag stolen from parked car when left covered with a coat
on front seat – whether firm right to dismiss complaint
on grounds that bag had not been ‘concealed’
Mr D and his wife left their car in the car park while they
were visiting a stately home one afternoon. They returned
to the car later in the day to find that a thief had broken
into it and stolen Mrs D’s handbag. She had left the
bag on the front seat, covered with a coat.
Mr D made a claim under the personal possessions section
of his household insurance policy. However, the firm said
it would not meet the claim because the handbag had not
been left in ‘a locked and concealed boot, concealed
luggage compartment or closed glove compartment’,
in accordance with the terms of the policy.
complaint
rejected
The policy exclusion had been very clearly stated and it
was evident that the bag had not been left in a ‘secure
concealed compartment’. The handbag could easily
have been left in the boot. Even though the bag had been
covered with a coat, it would have been obvious to an opportunistic
thief that the coat could be hiding something worth stealing.
We decided the firm acted reasonably in turning down this
claim and we rejected the complaint.
..........................
35/6
firm turns down claim for sunglasses stolen from car –
whether sunglasses had been ‘effectively concealed
from view’
When Mrs M returned to her parked car after a brief shopping
trip, she found that a thief had broken into her car. The
designer sunglasses that she had left in the pocket of the
door nearest the driver’s seat had gone.
Mrs M put in a claim under the personal possessions section
of her household policy but the firm turned it down. It
said this was because the sunglasses had not been left in
‘a concealed luggage compartment or closed glove
compartment’. Mrs M then complained to us.
complaint upheld
We considered that, strictly speaking, Mrs M’s claim
fell foul of the exclusion clause. However, we felt the
firm’s decision was less than fair and reasonable
because the sunglasses had effectively been concealed from
view. They would not have been visible to a passing thief
and the door pocket was, in many ways, similar to a glove
compartment. This thief just happened to strike lucky when
he broke into the car. We therefore decided that the firm
should pay the claim.
..........................
|