Partially upheld: Home insurance claim disputes complaint against Europ Assistance SA

Decision detail

Summary

Miss W and Mr W complained that Europ Assistance declined their travel insurance claim for a theft and injury that occurred abroad, requiring a police report which Mr W was unable to obtain due to barriers including potential bribery. The ombudsman found that whilst the policy terms required a police report, Europ Assistance acted unreasonably in declining the claim outright. Mr W provided persuasive testimony, photographic evidence of injuries, and demonstrated active attempts to report the incident to both the police and Europ Assistance, which together constituted sufficient supporting evidence of the theft. The ombudsman partially upheld the complaint and directed Europ Assistance to reassess the claim in line with the remaining policy terms.

The Ombudsman's reasoning

The ombudsman found that whilst the policy terms required a police report, it was not fair and reasonable to decline the claim in these specific circumstances. Mr W provided plausible and persuasive testimony supported by circumstantial evidence including his active attempts to report the incident, photographic evidence of injuries, and contact with security officials. The ombudsman was satisfied that sufficient evidence indicated a theft had occurred and that the lack of a police report, given the barriers Mr W faced in obtaining one, should not prevent fair consideration of the claim.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website