In 2022, cleaners found black mould in two wardrobes in Rāwiri’s Airbnb property. The mould was caused by a very slow leak in the roof that dripped down into the wardrobes over an extended period. Rāwiri spent $10,000 on repairs and removing the mould.
Rāwiri claimed under his insurance policy for the cost of the repairs and mould removal, but his claim was declined, and he complained to FSCL. He also complained that the insurer delayed processing his claim.
Dispute
Rāwiri said that his insurer caused unreasonable delays and led him to believe that he would be covered if he got a report from an independent assessor about the damage.
The insurer said that they were not responsible for the delays. They also said Rāwiri hadn’t shown that an event covered by his policy had caused the damage to the roof. The damage appeared to have been caused by gradual deterioration of the roof, and gradual damage was not covered by the policy. They said that they hadn’t told Rāwiri he would be covered if he got the assessor’s report, they told him that he needed to show that the event that caused the damage was an insured event.
Review
When we reviewed the file, we looked at two main issues:
- whether Rāwiri’s policy covered him for the costs of repairs and removal?
- if Rāwiri wasn’t covered, why wasn’t he told this sooner?
We agreed with Rāwiri’s insurer that the mould damage was caused by a gradual deterioration of his roof over time, meaning that roof water wasn’t being directed away like it should have been. We said the insurer had correctly declined his claim because gradual damage was not covered by the policy.
We agreed with Rāwiri that there had been delay in processing his claim and that he had believed (and still believed during the FSCL process) that he was covered under his policy. However, the insurer only contributed in a very small way to the delay because there was a two-month period where the insurer and Rāwiri’s insurance broker, who was helping with his claim, weren’t communicating with each other at all. We could see that most of the delay and confusion about the cover was caused by the brokers not passing on information from the insurer to Rāwiri.
Resolution
Rāwiri decided to discontinue the complaint against his insurer and pursue a complaint against his broker.
Insights for participants
All participants should ensure that communication channels with consumers and brokers remain open, to ensure that important information is not missed.
