Not upheld: claim decline and policy voidance based on alleged exaggeration; incorrect application of policy exclusions complaint against Haven Insurance Company Limited

Decision detail

Summary

Mr W claimed on his home insurance policy for damage caused by a leak discovered when contractors attended to renovate his kitchen. Haven initially declined based on exclusions for defective design and rot, which it later acknowledged were incorrectly applied and offered £150 compensation. However, Haven subsequently declined the entire claim and voided the policy, citing the fraud condition and alleging the claim was exaggerated. The ombudsman found Haven's position reasonable, noting that Mr W's initial account stated kitchen renovation works were starting that day, yet he later claimed the leak alone necessitated complete kitchen removal and sought replacement costs. The three-hour timeline between the initial call and photographic evidence of full strip-out, combined with the disposal of items before inspection and failure to provide a homebuyer's survey report, supported Haven's conclusion that the claim had been exaggerated. The ombudsman upheld Haven's decision to decline cover and void the policy.

The Ombudsman's reasoning

The ombudsman found that Haven had reasonable grounds to question the legitimacy and extent of the claim based on material inconsistencies between the initial notification and subsequent accounts. The initial phone call clearly indicated kitchen renovation works were commencing, yet Mr W later claimed the kitchen damage was solely from the leak and sought replacement costs. The complete removal and disposal of kitchen items before inspection, combined with the three-hour timeline between the initial call and photographic evidence of full strip-out, supported Haven's conclusion that the kitchen removal was part of planned renovation rather than necessitated by leak damage. The failure to provide the homebuyer's survey report when requested, despite assurances it was available, further supported concerns about the claim's legitimacy. These factors collectively demonstrated the claim had been exaggerated, justifying reliance on the fraud condition.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website