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Proximate cause

Printed From: AussieLegal
Category: Superannuation, Financial Planning, Insurance
Forum Name: Super, Managed Funds, Wealth, Insurance, SMSF, Pensions
Forum Discription:
Printed Date: 23/January/2019 at 04:11

Topic: Proximate cause
Posted By: Rowan
Subject: Proximate cause
Date Posted: 07/January/2018 at 23:01

First off apologies if there is already a discussion on this, i tried several time to search but received an error each time.

My question relates to an insurance claim for damages resulting from a burst water pipe.

The facts are:

A water pipe burst in our (double brick) wall behind our shower.

Our house insurance policy covers us for damage cause by burst pipes but i am not covered for "The cost to repair the item from which the water leaked or escaped".

The plumber has repaired the pipe but now there is a hole in the wall where he had to access the pipe and likely a large bill to re-tile the whole bathroom.

Insurance has denied my claim based on the above exclusion and have said there is no resultant damage from the burst pipe.

I have already paid for the repair to the pipe so essentially i believe we are arguing over the cause of the damage to the wall and likely need to re-tile the whole bathroom.

To me the proximate cause of the damage is the burst pipe, but i am wondering if the exclusion above has any impact.

I was hoping someone could let me know if there is a flaw in my logic/argument. I have been searching for some information before i go to the Ombudsman and have found a lot of information on proximate cause, but given my lack of expertise in this field i could be off base.

Thankyou in advance.

Posted By: citizen-joe
Date Posted: 08/January/2018 at 21:34
If the policy states that cover is only for consequential damage and not for the repair of the original fault, I believe you are out of luck.

Re-tiling the bathroom is usually unnecessary, it may take a bit of searching to find the same tiles but usually it can be done. Have a look around the property for discarded surplus tiles from the original job, there usually are some and not everyone throws them out. Failing that go to a reputable tile shop with a sample and see what they say. When I had such a problem years ago, the tile shop knew the make and style of the tile but didn't have any, but by email found a box at another of their companies outlets and had it sent, only cost me the cost of the box and some freight. The job was small so I did the tiling myself.

Good luck.

Posted By: Rowan
Date Posted: 09/January/2018 at 12:59
Thanks CJ

I have some tiles as we only did the bathroom 5 years ago, but because the waterproof membrane will need to be replaced pretty much the whole bathroom needs to be redone (this is what the insurance assessor said too).

I am covered for consequential damages, but I am responsible for "repairing the item from which the water escaped". I would argue the "item" is the pipe which I have repaired but the damage to the wall is a direct result of the water leak and therefore should be covered.

I am just trying to determine if the exclusion impacts on the proximate cause being the leak.

Posted By: citizen-joe
Date Posted: 10/January/2018 at 01:27
All you can do is lodge a claim and take it to the ombudsman if the insurance company knock it back. It's not worth going to court over the matter, the money would be better spent fixing the bathroom.

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