Not upheld: Other regulated complaint complaint against QBE UK Limited
Financial Ombudsman decision DRN-5647729 of 2025-06-26T00:00:00+00:00. Other regulated complaint complaint against QBE UK Limited. Outcome: Not upheld.
Decision detail
| Reference | DRN-5647729 |
|---|---|
| Decision date | 2025-06-26T00:00:00+00:00 |
| Firm | QBE UK Limited |
| Product | Other regulated product |
| Claim type | Other regulated complaint |
| Outcome | Not upheld |
| Remedy | No remedy ordered. The Ombudsman declined to uphold the complaint and did not award the £500 compensation for poor handling that the Investigator had recommended, noting that F is a company and therefore distress cannot be awarded, and finding no recognizable inconvenience to F. |
Summary
F, a company providing maintenance services, held a security and fire protection insurance policy with QBE. In April 2018, an employee of F's client was seriously injured by a security gate that F had previously maintained. F did not notify QBE of this incident. In March 2023, when F received a breach of contract claim from the injured party's employer, F finally notified QBE. QBE declined the claim citing breach of the policy's 30-day notification condition for incidents that may give rise to a claim. F complained that it was not aware the incident would lead to a claim against it. The Ombudsman found that the circumstances of the serious injury involving equipment F had maintained created a real risk of a claim that F should have recognized, and that the 5-year delay caused QBE substantial prejudice. The complaint was not upheld.
The Ombudsman's reasoning
The Ombudsman found that the policy terms clearly required notification of any incident that may give rise to a claim within 30 days. The key issue was whether F should have reasonably known in April 2018 that the serious injury incident might give rise to a claim against F. The Ombudsman concluded that given F's role in maintaining the security gates that caused the injury, a reasonable person would have recognized a real (not fanciful) risk that a claim might be brought, even if F believed it was not responsible. The fact that Company A continued the contract and HSE did not pursue F did not eliminate this real risk. The Ombudsman rejected arguments that the test should be whether a claim was more likely than not, finding instead that 'may give rise to a claim' means a real and appreciable possibility. The Ombudsman also found QBE was prejudiced by the 5-year delay in notification, as it could not investigate contemporaneously or engage with parties at an early stage. The Ombudsman disagreed with the Investigator's finding that QBE should have obtained more information before declining the claim.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| QBE UK Limited, all decisions | 55 | 32% |
| Other regulated complaint, all decisions | 19,202 | 17% |
| Other regulated product, all decisions | 51,105 | 30% |
Source
Read the original decision on the Financial Ombudsman Service website