Upheld: Home insurance claim disputes complaint against Markel International Insurance Company Limited

Decision detail

Summary

P, a residential care provider, claimed on its business protection insurance policy for loss of income following a fire at a rented property. Markel rejected the claim because the property was not listed in the policy schedule. P argued that Markel's proposal form only requested details of properties requiring property damage cover, not rented properties, and that the business interruption section contained no request for such information. The ombudsman upheld the complaint, finding that Markel's specific questions in the proposal form implicitly waived P's duty to disclose information about rented properties. Markel was ordered to reassess the claim in line with remaining policy terms, with any additional premium deductible from any indemnity owed.

The Ombudsman's reasoning

The ombudsman applied the Insurance Act 2015 fair presentation of risk requirements but concluded that an insurer can waive an insured's duty to disclose information by implication through the specific questions asked in a proposal form. Since Markel's detailed, sector-specific proposal form only asked for property addresses where property damage cover was required and did not ask about rented properties, P could reasonably have concluded that providing such information was not necessary. The Key Facts document, while mentioning rented properties could be covered, did not clarify that their details needed to be on the policy schedule. Therefore, it was unfair for Markel to reject the claim based on the property not being listed in the schedule.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website