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Insurance Claims:

Structural Movement / Subsidence / Structural Cracking:

Most house insurance policies cover damage due to an escape of water, and again most will cover subsidence. An escape of water, e.g. from drains, is very often a cause of structural movement and cracking in the walls of buildings. Dangers to your property for which you are insured are known as Insured Perils, and once an Insured Peril has operated you can invoke the coverage of your policy. Below are the usual steps taken when initiating and resolving an Insurance Claim for structural damage due to an escape of water.

  • Structural Movement is identified in the structure, generally by noticing cracks in the walls of the house or building.
  • A suitably qualified Engineer is engaged to assess the structure and identify the cause of the movement.
  • If it is established that an insured peril has operated, the insurance company are notified of same either by the building owner or the Enginerr acting on their behalf.
  • The insurance company will generally appoint a Loss Adjuster to handle the claim on their behalf and to ensure that a fair and equitable settlement is reached.
  • The Engineer, acting on behalf of the building owner, will meet with the Loss Adjuster on site to explain how the insured peril has operated and show the Loss Adjuster what damage has been caused.
  • In the case of Damage Due To An Escape Of Water the Engineer will furnish the Loss Adjuster with a Drains Test Result showing where the leaks are occuring, and will have a trial hole excavated at the foundation close to the leak to prove the softening of the soil.
  • Once the Loss Adjuster has accepted that an insured peril has operated, both the Engineer and the Loss Adjuster will agree on a scope of remedial works required to make good all damage caused and carry out the necessary reinstatement and redcoration works.
  • The Engineer will then engage a firm of suitably experienced contractors to provide a quoatation for the proposed scope of works.
  • This quotation will then be forwarded to the Loss Adjuster for his consideration.
  • The Engineer, acting on behalf of the building owner, will then enter into negotiations with the Loss Adjuster to agree upon an equitable settlement that is in accordance with the terms of the insurance policy.
  • When a settlement figure has been agreed the insurance company will forward an initial cheque for approximately 80% of the agreed sum to the policy holder. And once the work is completed to the Engineers satisgaction and suitable invoices are to hand for the work carried out the final payment will be forwarded to the policy holder.
  • Once the settlement has been agreed the property owner will appoint a contractor or contractors of thier choice to carry out the specified works for an agreed sum.
  • When the works have been completed to the satisfaction of the Supervising Engineer, all relevant invoices are forwarde to the Loss Adjuster to vouch that the work has been carried out and costs incurred.
  • The Loss Adjuster will then generally notify the insurance company of this and request that the retained monies be released.
  • Once these retained monies are recieved by the policy holder, all outstanding accounts can be settled.

Structural movement generally occurs in a structure when the ground bearing the structure yields, under the load of the structure, and compresses to such an extent that the structure settles at the point of failure.

This settlement at the foundation line gives rise to tensile stresses in the masonry of the structure, which generally cause diagonal cracking in the walls of the building. These diagonal cracks generally occur at weak points such as window and door opes. The simple diagram at the top of the page shows a typical crack pattern that may occur as a result of subsidence.

Very often the cause of the ground yielding is erosion of the soil due to movement of water, often due to defective sewers or water mains leaking water. This erosion decreases the bearing capacity of the soil, with the result that the house sinks slightly into the weakened subsoil. This type of erosion is particularly common in the greater Cork area due mainly to the make up of the soil and the Limestone bedrock in the area. The water which has escaped from the drains will not only erode the soil by washing away fines, but will also erode the Limestone bedrock. To arrest this structural movement it is generally necessary to underpin the house. The type of underpinning required will depend on the type of soil present and the existing foundations, and should only be specified by a suitably qualified engineer.

A simple hydrostatic test carried out on the sewers will determine if they are leaking. Digging a trial hole exposing the soil at the foundation line will facilitate an assesment of the soil to determine whether it has softened or not. If it is established that there is an escape of water and that the subsoil has softened, then it is likely that the cost to repair the damage caused by the escape of water will be covered under the relevant house insurance policy.

If you are concerned that your house or other structure is either Subsiding or Settling feel free to contact our office, or requesting a call back by clicking here and filling out the form. Our contact details can be found by following this link: Contact Us


Claims Processing (Extracted From The Consumer Protection Code)

7.6
A regulated entity must endeavour to verify the validity of a claim received from a claimant prior to making a decision on its outcome.

7.7
A regulated entity must have in place a written procedure for the effective and proper handling of claims. At a minimum, the procedure must provide that:

  1. where an accident has occurred and a personal injury has been suffered, a copy of the Personal Injuries Assessment Board Claimant Information Leaflet is issued to the claimant as soon as the regulated entity is notified of the claim;
  2. where the potential claimant has been involved in a motor accident with an uninsured or unidentified vehicle or with a foreign registered vehicle, the regulated entity must advise the potential claimant to contact the Motor Insurance Bureau of Ireland (MIBI);
  3. where a claim form is required to be completed, it is issued to the claimant within five business days of receiving notice of a claim;
  4. the regulated entity must offer to assist in the process of making a claim, including, where relevant, alerting the claimant to policy terms and conditions that may be of benefit to the claimant;
  5. a record must be maintained of all conversations with the claimant in relation to the claim; and
  6. the regulated entity must, while the claim is ongoing, provide the claimant with updates of any developments affecting the outcome of the claim within ten business days of the development. When additional documentation or clarification is required from the claimant, the claimant must be advised of this as soon as required and, if necessary, issued with a reminder on paper or on another durable medium.

7.8
An insurance intermediary who assists a consumer in making a claim must on receipt of the completed claims documentation, transmit such documentation to the relevant regulated entity within one business day.

7.9
Where a regulated entity engages the services of a loss adjustor and/or expert appraiser it must notify the claimant of the contact details of the loss adjuster and/or expert appraiser it has appointed to assist in the processing of the claim and that such loss adjuster and/or expert appraiser acts in the interest of the regulated entity and the regulated entity must maintain a record of this notification.

7.10
In the case of motor insurance and property insurance claims, and other claims where relevant, the regulated entity must notify the claimant that the claimant may appoint a loss assessor to act in their interests but that any such appointment will be at the claimantís expense and the regulated entity must maintain a record of this notification.

7.11
At the claimantís request and with the claimantís written consent, a regulated entity must engage with a third party which a claimant has appointed to act on his or her behalf in relation to a claim.

7.12
A regulated entity must be available to discuss all aspects of the claim with the claimant, including assessment of liability and damages, during normal office hours, or outside of these hours if agreed with the claimant.

7.13
Where an insurance undertaking appoints a third party to undertake restitution work in respect of a claim, the insurance undertaking must provide the claimant in advance and on paper or on another durable medium, with details of the scope of the work that has been approved and the cost.

7.14
Where a method of direct settlement has been used, a regulated entity:

  1. must not ask the claimant to certify any restitution work carried out by a third party appointed by the insurance undertaking; and
  2. must certify, on paper or on another durable medium, to the claimant that the restitution work carried out by the third party appointed by the insurance undertaking has been carried out to restore the claimantís property at least to the standard that existed prior to the insured event.

7.15
A regulated entity must ensure that any claim settlement offer made to a claimant is fair, taking into account all relevant factors, and represents the regulated entityís best estimate of the claimantís reasonable entitlement under the policy.

7.16
A regulated entity must, within ten business days of making a decision in respect of a claim, inform the claimant, on paper or on another durable medium, of the outcome of the investigation explaining the terms of any offer of settlement. When making an offer of settlement, the regulated entity must ensure that
the following conditions have been satisfied:

  1. the insured event has been proven, or accepted by the regulated entity;
  2. all specified documentation has been received by the regulated entity from the claimant; and
  3. the entitlement of the claimant to receive payment under the policy has been established.

7.17
A regulated entity must allow a claimant at least ten business days to accept or reject the offer. Where the claimant waives this right and accepts the settlement offer within this timeframe, the regulated entity must retain a record of this decision.

This provision does not apply in the case of surrender or encashment of life assurance investment policies or to claims on life assurance protection policies where the settlement amount is set out in the policy terms and conditions and/or the policy schedule.

7.18
Where a claimant has agreed to accept the offer made by the regulated entity to settle a claim, the regulated entity must discharge the claim within
ten business days from the date the claimant has agreed to accept the offer, once the appropriate amount has been agreed subject to finalisation of legal costs, where applicable.

Where a method of direct settlement is being applied, the regulated entity must discharge the claim without delay.

7.19
If the regulated entity decides to decline the claim, the reasons for that decision must be provided to the claimant on paper or on another durable medium.

7.20
A regulated entity must provide a claimant with written details of any internal appeals mechanisms available to the claimant.

7.21
Where the policyholder who is a consumer is not the beneficiary of the settlement the policyholder must be advised, on paper or on another durable medium, by the regulated entity, at the time that settlement is made, of the final outcome of the claim including the details of the settlement. Where applicable, the policyholder must be informed that the settlement of the claim will affect future insurance contracts of that type.


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