Partially upheld: Motor insurance, total loss valuation complaint against Tokio Marine Kiln Insurance Limited

Decision detail

Summary

Mr H, a self-employed building contractor, claimed on his business protection insurance policy after damaging a ceiling and causing water ingress at a property. TMK assessed two separate claims with two £500 excesses and disputed various settlement elements including Mr H's hourly rate, hours worked, mileage, protective materials, and other costs. The ombudsman upheld the complaint in part, requiring TMK to pay Mr H's full claimed hours and rate, 127 miles of travel at 45p per mile, and costs for protective materials (underlay, cable ties, dust sheets), plus 8% simple interest for 3.5 years. The ombudsman rejected claims for photograph costs, tarpaulin costs, and additional cleaning costs beyond the £100 already offered.

The Ombudsman's reasoning

The ombudsman found that two separate claims with two excesses were fair given the five-day gap, different locations, and lack of causal link between incidents. TMK's agreement to pay Mr H's full hours and rate implied acceptance that he needed to attend the property, therefore mileage costs should be covered. The ombudsman distinguished between photograph costs (required to validate the claim, policyholder's duty) and protective material costs (reasonable mitigation measures taken by Mr H in his professional capacity to prevent further liability). TMK's failure to inspect the property meant it could not reasonably dispute the necessity of protective items. The tarpaulin was not covered as it could have been reused, and Mr H failed to mitigate losses by not confirming reusability. Cleaning costs were fairly settled at £100 without receipt.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website