The effect of the extreme weather phenomena which have recently hit our country are severe losses, including damage to buildings and movable property. The amount of damage caused by atmospheric phenomena has resulted in an increase in the number of telephone calls to expert stands, where injured parties seek information and advice on their rights and assistance in solving problems that arise in reporting the damage. Examples of the most common questions and answers from the Financial Ombudsman’s experts in such situations are presented below.
We also encourage you to contact the Financial Ombudsman’s experts. You can call them during the on-call time. The telephone number 22 333 73 28 is available from Monday to Friday from 8.00 am to 3.00 pm. You can also write an email to porady@rf.gov.pl.
What should I do immediately after the damage, if I have household insurance?
Above all, protect the property from further damage. If, for example, a windstorm has blown the roof off, the damage should – as far as possible – be secured so that the rain does not cause more damage. If possible, move your belongings to another part of the house or other building where there is no risk of flooding. It is worth emphasising that you are entitled to have the costs associated with such work covered. These include, for example, the costs of work and materials used to protect the property from further damage. If you buy, for example, sheeting or other materials to secure a broken roof, or pay someone to do so, take a receipt or invoice. This will be the basis for reimbursement of such costs by the insurer. It is worth noting that voluntary contracts also more and more often include an assistance service, providing for the organisation and coverage of costs of, for example, a roofer’s service. Therefore, after the damage, it is worth calling the insurer at once, describing the whole situation and finding out what kind of help you can count on under the terms of the contract.
Do I have to wait for the arrival of the insurer’s appraiser before removing the consequences of flooding or a windstorm?
You do not have to wait for the arrival of the insurer’s appraiser to start removing the consequences of flooding or a windstorm and carry out repairs. Simply take photos and list what has been damaged in order to have grounds for making claims to the insurer.
The more photos you take and the more accurately they show the damage, the less grounds there are for the insurer to question the extent of the damage. It is also a good idea to collect the damaged dismantled parts in one place so that they can be inspected by the insurer’s representative.
Settlement by phone, is it safe?
In the case of damage resulting from storms or windstorms, insurers are increasingly using so-called simplified claim settlement paths. Then they do not send their experts to look at a blown-off roof or a flooded house. They ask the client to send photos, a description of the incident or information from the cooperative. Sometimes they use smartphone applications that allow them to inspect the damage in real time. On this basis, they decide whether to accept liability and assess the cost of repair. Then they call the client offering to pay a certain amount.
Before making a decision, a renovation contractor should be consulted. It is advisable to agree with the contractor at once on a detailed, preferably written estimate of the work. The point is to have a clear idea of the cost of repair at the time of making a decision on settlement. The aim is to avoid a situation in which, after the settlement has been accepted and work has been undertaken, it turns out that the cost of renovation is higher than the amount of compensation received. Withdrawing from a settlement can be troublesome, especially if 14 days have passed since the settlement was reached. It is also worth remembering that people using their household insurance only have 14 days from the date of the settlement to possibly withdraw from it.
It is important to remember that a settlement is reached through negotiation and mutual concessions. This means that if the offer made does not suit you, you can make your own proposal. This, in turn, may result in a counter-offer from the insurer. This is normal in this claim settlement procedure. It is important to remember that in a settlement, the parties do not agree on the amount of damage, but on the amount of compensation, which may be an estimate and will not always reflect the value of the damage. If the terms of the settlement do not suit you, you have every right to a standard claim settlement, with the participation of an appraiser, preparation of a detailed cost estimate. The possibility of filing a complaint is also open, and if you are still not satisfied with the amount of compensation, there is still the possibility of entering into a dispute, e.g. with the support of the Financial Ombudsman.
A reminder! More about claim settlement ‘by phone’ in a special Financial Ombudsman’s Analysis (click the link below).
I was paid the undisputed amount, I got the compensation, but still not enough to cover the entire damage. What should I do?
If you dispute the amount of the compensation offered, you should first ask the insurance company for an accurate estimate showing how the compensation was calculated. This will show you which elements were included and which were not, and how the damaged elements were valued. You should remember that the insurance company is obliged by law to provide you with all the information you are interested in relating to the compensation procedure.
With this information you can write a complaint to the insurance company. If you wish to dispute the values given in the estimate, a real estate appraiser can help you with this.
In the case of legal doubts, e.g. double calculation of the wear and tear indicator of the building in compulsory insurance of agricultural buildings on a farm or application of the proportion principle in the voluntary household insurance, you may contact the Financial Ombudsman. However, please remember that you can contact the Financial Ombudsman in this regard only after exhausting the complaint procedure.
How long does the procedure take from the submission of the compensation claim to the payment of compensation?
The insurance company should pay compensation within 30 days of the submission of the claim. Only in exceptional cases can the company exceed this 30-day period, and it must have grounds for doing so. This can include problems with explaining the circumstances of the incident or determining the amount of compensation.
In any event, in this period you should, firstly, receive the so-called undisputed amount of compensation, and secondly, receive an explanation as to what circumstances prevented the completion of the claim settlement process.
The maximum waiting time for the total compensation depends on your contract. In the case of voluntary household insurance, the regulations provide that the insurance company has 14 days to pay the benefit from the day on which, by exercising due diligence, it was possible to clarify the above-mentioned circumstances.
As regards compulsory insurance of agricultural buildings, it is somewhat different. In this case, the regulations also provide that the insurer has 14 days to pay the benefit from the day on which, by exercising due diligence, it was possible to clarify the above-mentioned circumstances. However, this may not exceed a period of 90 days from the date of establishment of the notification of claim. However, the legislator has provided for one exception to justify an extension of this deadline. This is possible if the determination of the insurer’s liability or the amount of compensation depends on pending criminal or civil proceedings.
What should I do if I do not agree with the insurer’s estimate of the loss?
In this case, a complaint must be made to the insurance company. But before doing so, read the letter from the insurer carefully. At this point it is worth noting the problem which the Financial Ombudsman notices after every major windstorm that passes through Poland – insurers pay out the so-called indisputable amount of PLN 1-3 thousand very quickly after notification. This money is not the compensation finally agreed upon. It is intended to cover expenses such as securing damaged property.
Insurers do not always explain this issue clearly and precisely enough. This is why there are calls to the Financial Ombudsman helpline from people who are concerned that this is the final amount and request the intervention of the Financial Ombudsman. In this case, however, it is premature, given that the claim settlement procedure has not been completed and, therefore, the compensation may be added to the undisputed amount.
It is worth emphasising that the Financial Ombudsman is not able to intervene on the basis of a telephone call. It should also be remembered that the Ombudsman can only intervene or conciliate after the insurer has rejected the customer’s complaint.
When should I receive the insurance company’s reply to my complaint?
If it happens that you have to make a complaint to the insurance company, the insurance company will have 30 days from the date of receipt to respond. The mere fact that the insurance company sends its reply to the complaint is sufficient to meet this deadline.
In particularly complicated cases, which make it impossible to handle the complaint and provide a reply within the aforementioned time limit, the insurer explains to the customer the reason for the delay, indicates the circumstances that need to be established in order to handle the case and sets an expected time limit for handling the complaint and providing a reply, which may not exceed 60 days. If it fails to do so, the complaint is deemed to have been handled as requested by the customer. If it provides a timely but negative response, you can ask the Financial Ombudsman to intervene.
The wind destroyed our house, which we renovated with our own efforts two years ago. However, the insurer only paid us part of what we had spent on, for example, laying the roof. What can I do to get more compensation?
Most likely, the insurer did not take into account the fact that the building had been renovated. If so, it should prepare new calculations. If you have receipts for what was renovated two years ago, please collect them and keep them. If not, it’s also worth looking for photos, the ones from a mobile phone showing the state of the building before and after the renovation will also be useful.
Maybe someone in the family took some photos before and after the renovation? You should also keep the remains of the new part of the roof, metal roofing tiles, windows or doors. An appraiser should come and reassess the damage. This should be enough to show that these were new elements.
The type of contract may also affect the method of calculating compensation. In the case of voluntary insurance, property no more than 20-50 years old can be insured at the new (also called replacement) value, depending on the type of property or the terms of the contract.
In the case of older buildings, the so-called real value applies, i.e. technical wear and tear is taken into account when calculating compensation. But the insurer should take into account any renovations to the building and adjust upwards the valuation of the property.
The wind destroyed my wooden barn built in the 1950s. Will I get compensation from compulsory insurance of agricultural buildings to build a new brick one?
According to the law governing the conditions of compulsory insurance of agricultural buildings at the so-called new value (i.e. allowing the reconstruction of the property), only relatively new buildings and buildings whose degree of wear and tear on the date of conclusion of the insurance contract does not exceed 10% can be insured without additional formalities.
In the case of older buildings, especially those that have not been renovated, the percentage of wear and tear is higher and then the compensation is paid at the so-called real value. This means including technical wear and tear in the reconstruction costs at the rate indicated in the policy when insuring the building, so the compensation will not be enough to build a new barn using new technology.
In fact, some insurers calculate this technical wear and tear twice: before the conclusion of the contract and after the damage. It should also be remembered that the upper limit of the insurance company’s liability is always the sum insured indicated in the policy, i.e. corresponding to the value of the building insured. Therefore, the compensation will never exceed the value of the old barn, built in the 1950s.
I had compulsory insurance of agricultural buildings. The compensation paid does not take into account the furniture destroyed after the roof was blown off. Why?
Compulsory insurance of agricultural buildings does not cover movable property stored in the house. This means that if furniture, carpets, clothes, etc. are damaged after the roof has been blown off, compensation under such a policy will not be available. However, damage to the structure of the building (e.g. blown-off roof, damaged walls) should be covered by insurance. Therefore, when taking out compulsory insurance of agricultural buildings, it is worth considering taking out voluntary insurance of movable property stored in the house as well.
In this context, it is worth recalling that the insurance company is obliged to reimburse the policyholder, justified by the circumstances of the event, for the costs incurred in order to prevent the loss from increasing. This means that if, for example, in order to prevent further flooding of floors or walls after the roof has been blown off or damaged, you buy sheeting and hire a specialist to temporarily secure the damage, the insurer should reimburse you for the costs incurred. The only thing to remember is to document the purchase of materials and work with receipts.
Is a photovoltaic installation covered by compulsory insurance of agricultural buildings if it is located next to buildings?
According to the Financial Ombudsman’s experts, compulsory insurance of buildings on a farm should also cover photovoltaic installations located next to buildings.
There is no doubt that if such devices are installed directly on a building, their possible destruction will be covered by compulsory insurance of buildings on a farm. Of course, it should be remembered that after their installation the sum insured for a given building should be increased accordingly.
The background to a dispute with the insurer may be liability for damage to a photovoltaic installation located next to buildings. If you are refused by your insurer, it is worth asking for expert support from the Financial Ombudsman. In their opinion, the insurance company should also accept liability for damage to the installation located next to the building under compulsory insurance of agricultural buildings.
Please note that according to Article 2(2) of the Act on Compulsory Insurance, a building forming part of a farm is a civil structure with an area exceeding 20 m² as defined in Article 3(2) of the Construction Law. According to this provision, a civil structure is a structure which is permanently connected to the ground, separated in spatial terms by means of building partitions and has foundations and a roof. In turn, pursuant to Article 3(1) of the Construction Law, a civil structure is a building, a structure or a small architectural object, including installations ensuring that the structure can be used for its intended purpose, erected using construction products.
In view of these provisions, the Ombudsman’s experts are of the opinion that photovoltaic installations – as well as any other installations ensuring the possibility of using the structure, such as electrical or gas systems – are covered by the insurance. The regulations do not specify where the installations should be located. The functional relationship is important here. If the installation is intended to ensure that the structure can be used for its intended purpose, it is irrelevant whether it is located on the building or next to it. There are also decisions of administrative courts stating that photovoltaic systems are technical infrastructure facilities. It should therefore be assumed that photovoltaic installations should be covered by compulsory insurance.
The same applies, for example, to central heating furnaces, air conditioning systems or electrical systems. If they are damaged by the elements provided for in the terms of the compulsory insurance contract for agricultural buildings, the damage should be covered by such a policy.
Does compulsory insurance of agricultural buildings also cover damage resulting from so-called surge and damage due to its occurrence to, for example, a central heating furnace, an air conditioner or a photovoltaic installation?
According to the Financial Ombudsman’s experts, yes, although it is worth being aware that this issue can be the background to a dispute with the insurer. Compulsory insurance of buildings on a farm covers damage caused by fortuitous events in the form of fire, storm, flood, flooding, torrential rain, hail, snowfall, lightning, explosion, landslide, rockfall, avalanche or aircraft crash.
So-called surge is not explicitly mentioned in this list. Normally, in the terms and conditions of voluntary contracts, it is defined as a sudden increase in voltage in the system due to a lightning strike in the vicinity. It can cause damage to photovoltaic installations, modern furnaces, air conditioning or electrical components.
The Act on Compulsory Insurance only refers to lightning strikes and consequential damage. An increase in the voltage on the network can undoubtedly be the result of a lightning strike.
It is also important to bear in mind the principle arising from Article 22(1) of the CIA, according to which, in matters not provided for in the Act, the provisions of the Civil Code shall apply. Therefore, general provisions on liability for damages will be applicable in this respect.
Recalling the statements of legal scholars, it is worth pointing out[1] that “according to Article 361 § 1 of the Civil Code, liability for damages relates to normal consequences of a given event. The Civil Code (nor the Act on Compulsory Insurance) does not therefore introduce a limitation in the form of a condition of directness of consequences. Therefore, indirect consequences of one of the events listed in Article 67(1) will also be covered insofar as their occurrence remains in an adequate causal relationship with the insured fortuitous event. There is no doubt that compensation under insurance contracts is subject to the same rules as compensation under the general provisions of the Civil Code, taking into account statutory and contractual modifications concerning insurance relations. The theory of adequate causal relationship will therefore also apply. Therefore, in the situations mentioned as examples above, the insurer’s liability will apply. Undoubtedly, in these cases, the damage is causally linked to the insured event and the criterion of normal consequences is fulfilled”.
[1] Nawracała Jakub in: Serwach Małgorzata (ed.), Komentarz do ustawy o ubezpieczeniach obowiązkowych, Ubezpieczeniowym Funduszu Gwarancyjnym i Polskim Biurze Ubezpieczycieli Komunikacyjnych, [in:] Prawo ubezpieczeń gospodarczych. Tom I, Komentarz, wyd. II, LEX 2010
What if I do not have insurance and a tree damages my car or house?
In theory, it is possible to pursue a claim against the person or entity responsible for maintaining this tree. This is due to the principle that the owner must keep it healthy, remove rotten branches. For example, if the trunk of a tree has rotted, it must be cut down completely so that it does not pose a safety risk. If the requirements were met – the tree was healthy – and it was broken or uprooted by the wind, it would be difficult to blame the responsible party.
And without specifying that they are at fault and not force majeure in the form of wind, coverage of damage under their third-party liability insurance policy (if any) will not be available. However, it is better to have your own motor hull insurance or household insurance.
