One man's emergency is an insurer's 'wear and tear': A policy to pay for domestic crises turned out to have some expensive exclusion clauses. Maria Scott reports

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WAKING up to stone-cold radiators is no way to start a chilly holiday weekend but John Hickman of Milton Keynes was not too concerned when this happened to him on Good Friday.

For pounds 38 he had bought a new insurance policy marketed by Europ Assistance, called Homecare. It was designed to sort out - and pay for - just such a domestic emergency. Or so he thought.

He contacted Europ Assistance and it arranged for a plumber to visit. The plumber arrived and said that the problem was a burnt-out valve at the side of the central heating pump and this would cost pounds 145 plus VAT to replace.

Mr Hickman was irritated that the plumber insisted he be paid on the spot, rather than sending his invoice to Europ Assistance, which is the system the company said it operated.

But worse was to come. On 14 April Mr Hickman presented the bill to Europ Assistance for a refund. A month of fruitless telephone calls followed, he says, until he was told in mid-May that a cheque was being posted.

'An envelope duly arrived but it turned out to be a letter from Europ Assistance saying that they had now decided the whole episode wasn't covered by the policy anyway.'

Mr Hickman had fallen foul of the policy's fine print, which he says he did not receive until after he had paid the premium.

Europ Assistance claimed that the valve had burnt out because of wear and tear, rather than a breakdown. This had been stated in a report by the company that sent out the plumber.

The Homecare policy contract lists among its exclusions 'any costs due to fair wear and tear'.

'How many breakdowns in the home could owe nothing to wear and tear?' asks a frustrated Mr Hickman. 'When my car breaks down the RAC doesn't say they won't come out because I had used the car and caused wear and tear.'

Europ Assistance says it can use some judgement in deciding what constitutes wear and tear but it will normally be guided by a repair company's opinion.

Hugh McMurray, assistant general manager of UK operations, said he was confident his company was on firm ground when it rejected Mr Hickman's claim, although he had referred it to the underwriters for a second opinion.

The terms and conditions in Mr Hickman's Homecare policy also included a string of other exclusions, which might lead a sceptic to wonder exactly what was covered.

The section on home emergency assistance excluded 'incidents which do not give rise to a home emergency', incidents arising from leakage from flexible water hoses or washing appliances and damage to contents which did not involve damage to the home.

The section on boiler breakdown excludes not only wear and tear but defects 'attributable to the original design or installation of the boiler', descaling and work resulting from hard water deposits and costs arising from the unavailability of replacement parts.

But according to Europ Assistance, the policy covered far too much. Claims outstripped premiums, partly because people claimed to have whole boilers replaced. It had proved too easy for people to claim for routine maintenance jobs, the company said.

However, the company denied that Mr Hickman had been singled out unfairly in a cost-cutting exercise.

The definitions of wear and tear and of an emergency had been clarified so that policyholders did not have unreasonable expectations, the company said.

The Homecare premium has also increased to pounds 52.

(Photograph omitted)

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