July 27, 2024
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By insurancenews

Roof damage caused by the Cyclone Seroja of 2021 in WA will result in a WA home owner not receiving his claim after it is found that there was pre-existing wear.

The claim was filed on 11 April 2021 after a category 3 cyclone with wind speeds up to 170kph hit the home of the complainant.

Suncorp offered to pay for some damage. The insured was given $73,631 based on the scope of work plus a contingency of 5%.

The insurer refused to cover the damage, saying that “multiple factors” had contributed to the condition of the roof. These included corrosion, wear, tear and defects which are excluded by the insurance policy.

A complainant-appointed engineer, referred to as ME, says the cyclone was the proximate cause of the damage, citing that the roof’s structure exhibited “signs of load distress consistent with having undergone overstress”.

ME claims that no roof cladding was dislodged by the storm and the building had been built “well”.

The insurance company engaged an engineer (CR) who said that the cyclone damages were “relatively mild”, highlighting the fact that there was no damage done to the roofing sheeting, or framing separation.

CR claims that the main source of damage was caused by corrosion in the roofing sheeting, and the fact that there were no gable end or soffit linings.

Australian Financial Complaints Authority, (AFCA), acknowledged both experts’ compelling evidence but preferred the explanation of the insurer for the cause.

AFCA said that photographic evidence showed the roof was “aged” and “corroded”, and that rusty nails were visible in the sheeting that had not been sealed, indicating the roof has been raised prior to the storm.

AFCA stated, “I’m convinced CR’s findings are plausible and logical. They also match the information exchanged.”

The roof would have been vulnerable to the upward-draft winds, and possibly some damage caused by the cyclone.

However, I’m not convinced that the cyclone caused the damage. “I acknowledge that it might have caused damage to the roof. However, I’m not convinced it was the primary cause.”

AFCA claims Suncorp had the right to deny the claim due to its exclusions relating pre-existing damages and wear and tears.

The ruling, however, required that the insurer increase their contingency to 15% in order to compensate for the risk transfer for repairs as well as the loss of the lifetime warranty for approved repairs. This increased contingency fee brought the total settlement to $84,675.

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