Not upheld: Home insurance claim disputes complaint against Antares Insurance Company Limited

Decision detail

Summary

Mrs F complained about Antares' declination of a horse euthanasia claim and its service during the process. The claim form was received on 3 February 2025 with the procedure scheduled for 10am the following day, but the horse had not been seen by the vet since 20 January 2025, failing to meet the policy requirement that the horse be seen within 24 hours of form completion. Antares also lacked sufficient time to obtain a required second veterinary opinion. The ombudsman found Antares fairly declined the claim as it did not meet policy terms and that the firm's service was reasonable, including its attempt to contact Mrs F before the procedure to allow an informed decision. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that the policy terms for non-emergency euthanasia were not satisfied because: (1) Antares only had 3-4 working hours to obtain a second veterinary opinion, which was insufficient notice; (2) the horse had not been seen within 24 hours of the form being completed, as required; and (3) the attending vet had not provided necessary information about why further treatment options were not pursued. The ombudsman was satisfied the follow-up email on 3 February clearly communicated the 24-hour requirement, even if the initial email was ambiguous. The ombudsman found Antares acted fairly in attempting to contact Mrs F before the procedure to give her an informed decision opportunity, and fairly in offering Mrs F the option to repay the claim to avoid full year premium charges.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website