Case study

Navigating Complex Coverage: How a Discretionary Decision Helped Repair Critical Ceiling Damage

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a child sit inside the playhouse

Challenge

A business owner faced significant property damage after a major rain event revealed two unforeseen issues:

  • Faulty Construction: Missing waterproof sarking in a section of the roof, leading to water ingress and visible damage such as ceiling stains and discolouration.
  • Vermin Damage: Rats had chewed away pipe insulation, causing condensation to drip onto the ceiling and result in further water damage.

Unfortunately, their policy excluded damage caused by faulty workmanship and vermin, leaving the owner with extensive repair costs and no immediate coverage.

The business owner avoided bearing the full financial burden of the repairs, with the discretionary decision ensuring their ceiling was repaired and the property could return to safe operation.

Solution

While these exclusions are standard in insurance policies, the Discretionary Trust team assessed the situation with empathy. After a thorough review, a discretionary decision was made to assist the member by covering part of the repair costs. Specifically:

  • Covered: Replacement of the water-damaged ceiling, supported by evidence of the rain event.
  • Not Covered: Installation of the missing waterproof sarking and replacement of the chewed pipe insulation, as these were excluded under the policy terms.

Results

The business owner avoided bearing the full financial burden of the repairs, with the discretionary decision ensuring their ceiling was repaired and the property could return to safe operation. This decision demonstrated the team’s commitment to balancing policy constraints with the real-world needs of the members.

Protect your childcare centre with a policy that includes expert advice and discretionary support when you need it most. Contact us today for a no-obligation insurance review.

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