Freda’s boiler broke but her insurer disagreed it was an emergency

Freda, who is 87 and lives alone, contacted her home emergency insurer when her boiler stopped working – leaving her without hot water or heating. 

The insurer sent an engineer to investigate. They found that the problem was caused by a frozen external overflow pipe. The engineer advised Freda to throw hot water out of her window onto the pipe to thaw it. 

Freda told the engineer she couldn’t do this because of her arthritis. The engineer said they couldn’t help because the claim wasn’t covered under her policy and suggested she should get someone else to help.
  
Freda had to wait a couple of days before she found someone who could help, which left her without heating or hot water.  

Freda complained to her insurer about the poor service she’d had from the engineer. 

It said the policy defined an emergency as “sudden and unexpected” and that the damage to the pipe wasn’t sudden or unexpected because the pipe wasn’t insulated.

Unhappy with the insurer’s response, Freda contacted us for help. 

We looked at the terms of Freda’s home emergency insurance policy. We acknowledged the definition of emergency, but disagreed with the insurer. 

We thought that the boiler stopping working was an emergency, because it was sudden and unexpected for Freda. We didn’t think it was reasonable to expect her to know that the frozen pipe had caused the problem, as this hadn’t happened before. 

We also looked at Freda’s individual circumstances. We noted that the fix was simple for someone to do on their own, but that Freda was elderly and lived alone. We felt it would have been reasonable for the engineer to fix the problem. 

We were satisfied that the insurer was wrong to reject the claim. We also felt that leaving Freda to sort the problem herself was poor customer service. We upheld Freda’s complaint and told the insurer to pay her compensation for the distress and inconvenience this had caused.