Is backdating a letter legal?

I’ve been getting the run around from my insurance company. After calling to confirm we are covered and it’s ok to start demo on property to fix offending damage on the 22/3/21, to which they agreed that it’s fine and to send plumbers report in, I received a letter yesterday saying we aren’t covered. Envelope is postmarked 24/3/21. Priority. Letter saying we aren’t covered is dated 11 March 2021. Is this illegal? All telephone conversations are recorded I believe? I’m trying to find my letter in writing that we are accepted for the claim.

 

Why does the date matter?

 

I tried to get my doctor to back date a medical certificate but he refused for legal reasons.

So I printed off my own. So what, it was only for one day.

Point I want to make is that although something is illegal it doesn’t mean it’s not valid.

 

When I spoke to them on the 22nd they confirmed I was covered by insurance for the claim. As my husband is a plumber, and half owner of the property I wanted to confirm if he could do the plumbing and still be covered by the claim. I also asked if there was a specific way they wanted us to get to the plumbing. They said, “yes” we were covered for the claim. “Yes”, my husband could do the work and send a report. “It was up to him to decide how to access the leak”. Then yesterday I received a backdated letter saying we aren’t covered as we haven’t maintained the property. Posted two days after they said we were.

 

Okay I understand that, but what I meant was - "why does the date on the letter matter?"

Short answer - it probably doesn't.

 

They said it wasn’t covered, escalated -still not covered. Phone call to me asking if I wanted to escalate further - I said, “no, I’m over it, what they are saying isn’t true, I’ll pay thousands more just to not deal with this again” After that, Got contacted by insurance company saying we are sending a builder out to decide if we still want to cover you. Me, “really, ok, whatever”. Think, I know your decision Is untrue but I’m over fighting it so you won’t find any reason to not insure me as I’ve only been following your leak detectors instructions. Then their builder came out, said we should start a new claim as it’s a claimable occurrence. So I start a new claim, they accept it, now they are saying it’s not accepted. So now I have 15 business days to Appeal the decision Which might give me a couple of days from the dated letter. It’s insane! I might just start demo/repairs. Then consider fighting it.

 

I don’t really get why date isn’t important

 

Yes, I”ll keep that in mind. If I’m going by the letter date my time is up to discuss the letter. What a joke.I’ve got a feeling though the post Mark date may be what can be used for important documents.

 

What is the event you are claiming for? You mention a leak - but where/what context?

 

Suspected small leak under bath/ bath waste. Everything else has been ruled out after making small changes as instructed by insurers leak detector and monitoring moisture levels. Everything has been tested and inspected several times! (5-10 times) Insurance demanded I get grout /waterproofing repaired or they’d stop insuring us. I had someone out, got it all tested, he said he couldn’t fix as nothing wrong with it. Bathroom is possibly under ten years old. Second claim as there was a leak under the bath previously, damage reoccurred but to a much lesser extent. Not going to know exactly until we knock out a hole in the wall. Insurance somehow lost my claim for this incident so the process to have it repaired has been re-started about 4 times, also they were trying to determine if it was part of previous claim, new claim , get 2nd opinions. Had about 12-20 inspections organised by insurance company

 

Maybe claimable from the first repairer if the job wasn’t done properly and the problem recurred.

 

Thanks, I’ll need to look into that! I think the insurance company reduced my no claim bonus when they accepted the 2nd claim also, so I’ll check.

 

Sounds like a confusion in terminology.

You lodged a claim. They accepted the claim. But they didnt accept to pay for damage. Acceptance of a claim is just that. It now needs to be assessed and then approved. Thats how insurers work. And they may authorise emergency repairs but it remains subject to claim approval. So if its declined the cost is yours to pay.

They then asssessed the validity of the claim and found it was not a defined event. eg Water leaking from a pipe. You probbaly told them by phone and so they declined the cover. Usually you must be able to demonstrate the pipe was damaged by a defined event (eg a tree fell on the bathroom and broke pipe to bath and it flooded house). Then they may split the claim so the pipe repair (and wall etc) is one claim arising from the tree under the building policy and the water damage within the house is a second as a contents claim. Two claims, two excesses.
Costs to explore a damaged pipe are often excluded or highly conditional. Its maintenance. Insurance doesnt cover wear and tear. eg a flexible hose bursts. The hose will not be covered. The water damage may be. And they wont fix water damage until the hose is replaced.

Read your policy. It is in plain english. Ask them what policy clause they are relying on. Their letter likely will explain that. eg NRMA cover water damage from a burst pipe. They dont cover the pipe. And it must "burst".

We don’t cover damage caused by water leaking or escaping from a shower recess or shower base. We don’t cover loss from erosion or other earth movements. We don’t cover the costs to repair or replace the item that the water or oil leaked or escaped from.

 

Because it probably doesn't mean anything. Why do you think it means anything?

 

So if they told me on the phone I was covered for insurance for my claim, get a plumber in then send them a report, then they’ll start on repairs, then posted me a backdated letter a couple of days later saying my claim isn’t covered, I’m guessing they would need to honour the phone call if I took it further. I think I’m done though, moving my 7 policies, it’s just a waste of my time. I can’t imagine the plumber will admit he did anything wrong also.

 

We are just going around in circles. All for this same incident I have now lodged three claims. First - they somehow lost my paperwork and all reports. 2nd-they knocked back saying it’s either faulty silicon around bath or not waterproofed properly. Then they sent out another builder who said to lodge a new claim as it looks like a leak with bath waste. They were saying our claim was covered, then sent backdated letter saying it’s either the bath not siliconed or a leak with bath waste and therefor not covered. My husband has scraped out the silicon and re-applied a few times. I tried to argue it was done last claim they knocked back also. My husband is also a plumber and it’s a quick job to remove old silicon and reapply. I give up.

 

Possibly, but honestly I doubt the phone call or the letter is that important.

You're either covered or you're not. Because of the terms of your insurance contract. Everything else is a side show. The date on a letter is like a side show within a side show.

I still don't fully understand what the issue is currently, or whether you're just anticipating a problem that hasn't materialised yet.

 

Thanks, I do really appreciate your feedback and everyone else that has posted. I guess because they said I had 15 business days to agree to their decision, giving me 1 day from when I received it. Or I could go through the conflict resolution process. Spending 1 hour on the phone last claim and she couldn't understand english very well, then she wrote stuff that wasn't true, such as the siliclon around the bath was in bad condition. The bathroom is around 10 years old. We've replaced the silicon around the bath 4 times to prove that's not the issue. My husband being a plumber has asked several other opinions of what the issue could be. It keeps coming up as leak under the bath travelling up the wall. Doesn't matter how much silicon or waterproofing you do. So the latest report from insurance company's builder is saying the leak is from the bath waste, their leak detector who said the damage is either caused from moisture behind the shower plate, or moisture behind the bath plate, did another report, re-assessed after they were ruled out, and said that it was either silicon failure around the bath or bath waste leak. How many chances do they get to establish the cause?

 

So we are getting knocked back for not maintaining the property