Not upheld: Home insurance claim disputes complaint against Allied World Assurance Company (Europe) dac

Decision detail

Summary

Mr B claimed under his landlord insurance policy for roof and internal damage he believed was caused by storm damage. Allied World settled the internal damage but declined the roof damage claim, concluding that poor maintenance was the main cause and that the storm, which occurred weeks before the claim, was not the primary cause. The ombudsman applied the three-part test for storm damage claims and found that pre-claim photographs supported Allied World's position regarding maintenance issues. The ombudsman concluded that Allied World fairly declined the claim as there was insufficient evidence that storm conditions were the main cause of the damage, and did not uphold the complaint.

The Ombudsman's reasoning

The ombudsman applied the three-part test for storm damage claims: (1) whether storm conditions occurred on or around the damage date, (2) whether the damage is consistent with typical storm damage, and (3) whether storm conditions were the main cause. While a storm was identified weeks before the claim, the ombudsman found insufficient evidence that storm conditions were the main cause of the roof damage given the clear pre-existing maintenance issues documented in photographs. The ombudsman noted that Mr B's builder's report failed to address the maintenance issues or comment on causation, and that earlier roof inspection and repair may have limited any storm damage.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website