Upheld: Misadvice regarding claim settlement amount, service failures, and delayed payment processing complaint against Aioi Nissay Dowa Insurance UK Limited
Financial Ombudsman decision DRN-5892742 of 2026-04-01T00:00:00+00:00. Misadvice regarding claim settlement amount, service failures, and delayed payment processing complaint against Aioi Nissay Dowa Insurance UK Limited. Outcome: Upheld.
Decision detail
| Reference | DRN-5892742 |
|---|---|
| Decision date | 2026-04-01T00:00:00+00:00 |
| Firm | Aioi Nissay Dowa Insurance UK Limited |
| Product | Other regulated product |
| Claim type | Misadvice regarding claim settlement amount, service failures, and delayed payment processing |
| Outcome | Upheld |
| Remedy | ANDI directed to ensure Miss T receives the additional £150 compensation (if not already paid) to bring total compensation to £450. No additional settlement payment directed for the claim itself, as the original settlement was calculated correctly under policy terms. |
Summary
Miss T claimed on her GAP insurance policy following a total loss of her car in a non-fault accident. ANDI misadvised her on multiple occasions that she would receive the maximum benefit of £9,590.08, but actually paid £3,815.72 (the difference between her purchase price of £8,228.22 and the motor insurer's settlement of £4,712.50, plus £300 additional allowance). Miss T complained that the settlement was unfair and that the misadvice caused her to purchase a more expensive replacement car. The ombudsman found ANDI's settlement calculation was correct under the policy terms, but upheld the complaint due to the misadvice and service failures including delayed payment and broken callbacks. The ombudsman awarded £450 total compensation as fair and reasonable, finding that Miss T would have been unable to afford her preferred car regardless and that she ultimately received her full policy entitlement.
The Ombudsman's reasoning
The ombudsman found that while ANDI's settlement calculation was correct under the policy terms (the difference between purchase price and insurance payout), ANDI had unfairly misadvised Miss T on multiple occasions that she would receive the maximum benefit amount. The ombudsman accepted that ANDI's service failures, including delayed payment processing and broken callback promises, caused inconvenience and emotional impact. However, the ombudsman determined that Miss T would have been unable to purchase her preferred replacement car regardless, as the correct settlement amount would always have been lower than she initially expected. The £450 total compensation was deemed fair as it reflected the inconvenience and emotional impact from ANDI's errors while acknowledging that some suffering was inevitable from the accident itself and that Miss T ultimately received her full entitlement under the policy.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Aioi Nissay Dowa Insurance UK Limited, all decisions | 55 | 38% |
| Other regulated product, all decisions | 52,408 | 30% |
Source
Read the original decision on the Financial Ombudsman Service website