Upheld: Motor insurance, claim handling complaint against Aioi Nissay Dowa Insurance UK Limited
Financial Ombudsman decision DRN-5874172 of 2026-02-05T00:00:00+00:00. Motor insurance, claim handling complaint against Aioi Nissay Dowa Insurance UK Limited. Outcome: Upheld.
Decision detail
| Reference | DRN-5874172 |
|---|---|
| Decision date | 2026-02-05T00:00:00+00:00 |
| Firm | Aioi Nissay Dowa Insurance UK Limited |
| Product | Motor insurance |
| Claim type | Motor insurance, claim handling |
| Outcome | Upheld |
| Remedy | Toyota must: (1) settle Mrs P's claim on a proportionate basis reflecting the percentage difference in premium price for business use; (2) cover the equivalent proportionate amount of third party claim costs; (3) pay Mrs P £150 compensation for distress and inconvenience within 28 days, plus 8% simple interest if paid late. |
Summary
Mrs P purchased a car insurance policy with 'social and commuting' use coverage but was involved in a collision while travelling to a client's address as a care supervisor. Toyota rejected her claim in full, arguing she should have selected 'business use' cover. The ombudsman upheld Mrs P's complaint, finding she had been careless rather than deliberate in her selection but that fairness required proportionate settlement of the claim based on the premium difference for business use, rather than full rejection. Toyota was ordered to settle the claim proportionately, cover equivalent third party costs, and pay £150 compensation for distress and inconvenience.
The Ombudsman's reasoning
While CIDRA does not technically apply to this case, the ombudsman applied a fair and reasonable approach similar to CIDRA principles. Mrs P did not deliberately misrepresent her information but failed to take reasonable care in selecting the appropriate use category. A reasonable consumer in her position should have selected 'business use' given her regular travel to client locations. However, rather than rejecting the claim entirely, fairness requires Toyota to settle proportionately based on the premium difference between the cover purchased and the cover that should have been purchased, consistent with CIDRA remedies for careless misrepresentation.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Aioi Nissay Dowa Insurance UK Limited, all decisions | 55 | 38% |
| Motor insurance, claim handling, all decisions | 12,798 | 32% |
| Motor insurance, all decisions | 24,036 | 35% |
Source
Read the original decision on the Financial Ombudsman Service website