View Full Version : Claim for leathers and helmet on home contents insurance?
Following my recent off, I've just tried claiming on my Direct Line home contents insurance, stating that I had fallen off my bike and damaged the items.
They accepted the jackets claim, on the basis that I could "wear it anywhere, not just on the bike", but denied my helmet claim, as it says in the policy docs exlusions list:
"motorised vehicles, caravans, trailers, watercraft, hovercraft, or aircraft (other than hand propelled or models) and their accessories (while attached)"
They class it as a vehicle accessory. I tried to say I could equally wear my helmet whilst off the bike, and that its not a vehicle accessory, on the basis that it does not attach to the bike by any means, and its an item of safety clothing.
They still refused. They will refer my complaint to the "customer relations team" but they may take some weeks to get back to me. :(
Has anyone succesfully claimed from Direct Line for this?
Any advice?
DJFridge
20-06-11, 06:29 PM
I can't help feeling you're on a hiding to nothing with this one. Even though you definitely could, there aren't really any non-bike circumstances where you actually would wear the helmet, if only because you tend to look a bit of a tool walking round the shops with your helmet on! They will just say "Safety clothing for what exactly?"
Good effort though!
Other folk have managed it though!! They did say if I'd dropped it down the stairs I would be covered. I may wait a month or two and drop it down the stairs ;)
WeegieBlue
20-06-11, 08:03 PM
I work for Direct Line just now. The clothes are covered under personal possessions away from the home. Helmets aren't covered I don't think, however if you have accidental damage it may be covered under that.
I'll call the claims team tomorrow and find out for sure, and if it can be covered I'll get back to you and sort it out for you.
MisterTommyH
20-06-11, 08:11 PM
Hmm, how is the helmet attached to the bike?
Can you get round it by arguing that it wasn't attached at the time because you were 10 feet from the bike by the time it hit the floor? It is very specifically worded.
speedplay
20-06-11, 08:31 PM
Hmm, how is the helmet attached to the bike?
Via the rider....;)
MisterTommyH
20-06-11, 08:35 PM
Yeah, but if he'd had an 'off' there wouldn't have been an attachment.........
Bit tenuous?
WeegieBlue
20-06-11, 09:12 PM
Yeah, but if he'd had an 'off' there wouldn't have been an attachment.........
Bit tenuous?
The joys of insurance. They get round it by saying if it isn't explicitly covered in the booklet, it's not covered. You could argue that if it doesn't say it's NOT covered then it is, but unfortunately the law and the Financial Ombudsman Service are on the side of the insurer here.
yorkie_chris
20-06-11, 09:21 PM
however if you have accidental damage it may be covered under that.
I never knew many people fall off on purpose
DJFridge
20-06-11, 11:23 PM
I never knew many people fall off on purpose
You'd be amazed what people will claim to get an insurance payout!
If they care to read their own policy they will find the "exclusion" they are referring to is not actually relevant.
It's part of a definition applicable to Section 2: Contents and has no bearing on this claim which I presume is being made under Section 3: Personal Possessions.
They might have another reason not to pay out but they haven't found it yet.
Big red X. Must try harder. :D
Yes, its the personal possessions cover. I've got the full boonah cover for direct line. Its a tad annoying I have to admit!
I can see their reasons for saying its a vehicle accessory, but their reasoning is vague. I could wear it anywhere else and it would be covered, but on my bike it's not? Huh? I did try to tell the lady at the time i wasnt on the bike at the time of the damage, and that I was rolling down the road at the time, but she seemed to have had a sense-of-humour-ectomy.
Cheers for your help Weegie!
I win these all the time - they've left a bit of room in their wording for you to work on.
So we know it IS covered under the contents section (i.e. in the home).
Where does it say it's NOT covered in the personal possessions section?
Have a look at your policy. "Contents" and "Personal Possessions" are both defined terms in the policy. The wording they have given you is the "Contents" definition. Section 3 does not mention Contents.
According to the policy wording I've got here, Personal Possessions are items that are "worn or normally carried" as defined by Direct Line, so how does this exclude your helmet? (other insurers word this as "normally worn or carried" and exclude vehicle accessories "on or in a vehicle" which is much clearer). It's not actually just semantics - the policy has to be precise in its meaning.
Even if the wording they have quoted you was relevant (and I could happily argue that it isn't), no reasonable person would say your helmet was attached to the vehicle - the word means what it means, not what they want it to mean.
Unless you have a different policy wording to the one published online, then you've got a case IMO.
Other insurers policies are much clearer than this one. If the wording is vague then it has to be interpreted in your favour - that has always been the principle and the Ombudsman is very clear on that.
WeegieBlue
21-06-11, 09:21 AM
OK, I've checked and this is from our internal site:
"Crash helmets are deemed to be motor accessories and any claims under a household policy for the loss of or damage to a crash helmet are to be repudiated on the basis that they are motor accessories and thus excluded. This is in accordance with the FOS view on the situation."
However, if your policy wording says they are only excluded when attached to the vehicle, the helmet will be covered.
When did you take out your policy? I'll check the T&C's here and if it is covered I can speak to claims for you and get them to pay out :D
"Crash helmets are deemed to be motor accessories ..... This is in accordance with the FOS view on the situation."
It's worth mentioning that's almost certainly the case. Where a household policy has a clear exclusion of motor accessories, then you're snookered.
The issue here is the actual policy wording.
WeegieBlue
21-06-11, 09:32 AM
I've just checked the latest standard Direct Line policy wording and it says these aren't covered:
"motorised vehicles, caravans, trailers, watercraft, hovercraft or aircraft (other than hand propelled or models) and their accessories
(while attached)"
WeegieBlue
21-06-11, 09:36 AM
Right, just spoke to claims and the helmet is covered. They will ask how old the helmet was and how much it cost, and will make a deduction for wear and tear, however it is definitely covered.
Nelson, if you can get back to me today before 5pm I'll get this sorted for you.
They will ask how old the helmet was and how much it cost, and will make a deduction for wear and tear
The basis of the policy is reinstatement. Cover is only reduced to indemnity for clothing.
We've already established that the helmet is not treated as clothing, but is a vehicle accessory. The basis of settlement is therefore reinstatement - i.e. full cost of the same or comparable helmet.
They can make a deduction for the jacket but, as it's a robust item of clothing, the wear and tear allowance should be minimal unless it was already very old.
WeegieBlue
21-06-11, 10:36 AM
The basis of the policy is reinstatement. Cover is only reduced to indemnity for clothing.
We've already established that the helmet is not treated as clothing, but is a vehicle accessory. The basis of settlement is therefore reinstatement - i.e. full cost of the same or comparable helmet.
They can make a deduction for the jacket but, as it's a robust item of clothing, the wear and tear allowance should be minimal unless it was already very old.
The basis of the policy in not reinstatement and the policy booklet confirms deductions will be made for clothing, and for the condition of any item that is not repaired or replaced.
"2 We will reduce any claim payment for:
a) clothing; or
b) any item or part which is not replaced or repaired;
to take account of wear and tear or improvement in their condition."
As this will be betterment, they make a deduction based on age and condition. It's likely they will refer the loss to a supplier who will provide a replacement helmet to the policyholder. If the OP wants cash in lieu, it will be based on the value of the item pre-crash, including wear and tear.
WeegieBlue
21-06-11, 10:39 AM
And another quick point. If the there is a third party involved the home insurer will pursue the TP for recovery and if one is made, the OP won't lose his 10% NCD from Direct Line. Also, if there is another policy in force which specifically covers the helmet and leathers, Direct Line will refer the OP to that policy first, and the insurer on that policy may approach Direct Line for a contribution.
The basis of the policy in not reinstatement
I'm sorry, but it is.
The policy has been issued on a reinstatement basis - commonly referred to as "new for old". That's why they needed to include the following wording for clothing and cash settlements, which are settled on an Indemnity (current value) basis;
and the policy booklet confirms deductions will be made for clothing, and for the condition of any item that is not repaired or replaced.
"2 We will reduce any claim payment for:
a) clothing; or
b) any item or part which is not replaced or repaired;
to take account of wear and tear or improvement in their condition."
As this will be betterment, they make a deduction based on age and condition. It's likely they will refer the loss to a supplier who will provide a replacement helmet to the policyholder. If the OP wants cash in lieu, it will be based on the value of the item pre-crash, including wear and tear
I assume he wants to replace the helmet though. If he didn't then, yes, the settlement would be reduced but that's a moot point as he needs a new lid.
Whether they reimburse the cash for him buying his own or get a supplier to provide it is immaterial - the policy allows them to do either (under the policy's Reinstatement Clause funnily enough). My point is there should be no deduction for wear and tear.
Betterment will only apply in this case if he chooses to buy a more expensive lid - then he would need to pay the difference himself.
WeegieBlue
21-06-11, 11:11 AM
To be fair, I think they'll just replace his lid as it's cheaper for the insurer to use suppliers they have deals with, so wear and tear deductions won't come into it.
If he wants cash, they will make a deduction. The policy says they will. If the OP isn't happy he'll have to make a complaint but there will definitely be a deduction made at this end.
You're right - they probably will replace. It's usually cheaper and cuts down fraud a bit (fraudsters want cash, not goods).
However, if they don't use their own supplier to replace then the cash settlement should be for the full value of the lid (assuming the OP wants a new lid).
I just want the OP to understand, that if he wants a replacement lid, he should be getting it - one way or the other.
I have actually already replaced the helmet already with an Arai as I couldnt wait for all this! I need to use the bike. I'd be perfectly happy with a replacement jacket though :-)
Send them the receipt for the Aria. You're entitled to claim the new value of your old lid against it, so check online prices for your old one and claim that amount. Send the page prints from the online shop as evidence.
They might come back and say they could have got it cheaper. If so, they'll pay you that amount.
WeegieBlue
21-06-11, 12:45 PM
Tam, I know what your saying here, but what he wants and what the insurance company wants are very different matters. The biggest thing here is that he's claiming on a home insurance policy, not a motor policy, so the claim conditions are a bit different, and it's not as simple as old for new, especially when the policy booklet states that claims won't be paid out like this.
This might be a good time to mention that, 10 years ago, I was actually writing insurance policies. :)
No offence to you WB, but it matters not one jot what the insurance company wants, they need to treat their customers fairly - uberrima fides.
If you hadn't been good enough to sort this out for the OP he'd have been waiting ages and may well have given up. There's no reason for him to be out of pocket just because his insurers can't understand their own policy.
For any one item of
personal possessions or part of a set that is lost or damaged
we will decide to either:
a) pay the cost of replacing the item or part as new; or
b) replace the item or part as new; or
c) pay the cost of repairing the item or part; or
d) make a cash payment which will not be more than the amount
it would have cost us to replace or repair the item using our
own suppliers.
Those are the options available to them to settle - taken from the Direct Line policy. In this case, it's option d).
The above clause gives the insurer the choice of how to settle the claim but they blew that option when they incorrectly told him he wasn't covered. He had no choice but to reinstate the property himself.
There would only be a wear and tear deduction if;
a) it's clothing - Direct Line say it isn't
b) the property wasn't reinstated - he's already done that.
He's therefore entitled to the new value of his old lid (or equivalent), without any deduction for its age. Anything less than that is outwith the terms of the contract.
I have to deal with this nonsense from insurance companies constantly and it really boils my p!sh. While they're banging on about "cutting out the middleman" they're shafting their direct customers who don't know any better. They're not even doing it because they're sneaky (as everyone assumes). It's usually just a lack of knowledge.
Apologies if I come across as a little terse. ;)
WeegieBlue
21-06-11, 02:27 PM
Haha! No probs Tam - nice to have a bit of an intellectual chat with someone who knows his peas and carrots!
I spoke to claims and our technical referral unit today. The decision has been made now and can only be overturned by the Customer Relations Team, which I work for. Unfortunately, I'm Glasgow and this case is with Leeds. The poor OP now has to wait weeks/months for this to be looked at. Hopefully he'll get the right decision on this.
Wha??? I thought it was done!
So because it's been declined, even though they now know that was a mistake, they're still going to take their sweet time to resolve it anyway? That's mince.
Nelson. How's your shouty voice? The squeaky hinge gets the oil pal.
WeegieBlue
21-06-11, 02:52 PM
They don't know it was a mistake. The claims department have interpreted the in-house wording in a particular way and aren't looking to change that now. CRT can overrule but Nelson needs to wait in line for them to do that. I spoke to him earlier and said if he hasn't had a response by mid-August he can go to FOS.
Rubbish eh?
Jeebus.
Big companies, man. Totally unsuitable for interaction with human beings.
So they're likely to take the full 8 weeks? No way would I accept that shiz.
startrek.steve
21-06-11, 03:23 PM
My Home insurance paid up for £400 leathers, new helmet, boots and gloves.
WeegieBlue
21-06-11, 03:24 PM
Yup. I'm here as a contractor dealing with a backlog of cases. Some are recent, like March. Others are not, like November!
don't mean to offend but...
this is why insurance premiums are going threw the roof. you fall of your bike and expect your HOUSE insurance to pay out for items that were damaged in the accident. there are add ons to MC policy's that cover this. if you were to tight to take the extras when you took out your MC policy then i think its a case of tough luck.
i do apologise for being rude but its a pet hate of mine.
yorkie_chris
21-06-11, 04:44 PM
Isn't the personal kit cover an add on to house insurance that you pay for?
Yes, its a costly add-on to the house insurance. I've been pretty good to be honest, paying about £100 in insurance premiums every month for years. This is my first claim, so they're still quids in from me.
I would have claimed for ones off my bike insurance, however, I didn't claim off the bike insurance as I fixed it myself. Most companies would only pay out for leathers, if there was a registered claim for the bike. I aint gonna do that in a hurry!
i feel your pain m8 i really do as i have been paying insurances since i started driving etc.etc 25+ years and have claimed only once for a theft (bike 1.5 years ago). my insurance should be peanuts for the no claims i have on the car but no, it goes up every year because of the recent spate of insurance claims as people don't want to spend their hard earned cash but would much rather con the insurance company out of theirs. so in turn it effects people like me. why should i be paying for other people possessions.
If I didn't know you better, I would read that last post as you accusing me of trying to con my insurance!! If I was, you'd be damned sure id be claiming for my boots, jeans and gloves as these were also damaged, albeit still useable.
I don't see the point in shelling out my hard earned money every month for something that I'm frightened to use. If I don't use it when I can, I might as well not bother paying for it in the first place!
If you want premiums to go down, look at the uninsured drivers out there, the personal injury accident scams, and the waste that goes on for solicitors and hire cars snd bikes, temporary accomodation, etc etc. I dont think claiming £450 worth of kit for something that I've paid for to be covered is that much to ask!!
If you want to be really cynical, Churchill and Direct Line (both owned by RBS) made a healthy profit of £67 million in the first three months of this year alone. Given that 83% of RBS is now owned by us, the humble taxpayer, I can deduce that I'm just paying extra tax every month, and we all know that taxes gets us sweet **** all in the end, so a new jacket is a Brucie bonus!!
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