Not upheld: claim decline - damage not covered under policy terms complaint against Acasta European Insurance Company Limited

Decision detail

Summary

Mr D claimed on his furniture insurance policy for damage to a sofa and chair allegedly caused by his pets while he was on holiday. Acasta declined the claim, stating the damage was not consistent with a single incident but rather had accumulated over time. The ombudsman reviewed the technician's inspection report, which described the furniture as 'abused and left neglected' with widespread stains and scratches, and found this assessment was supported by photographic evidence and unchallenged by any other professional opinion. The policy terms explicitly exclude damage that has accumulated or worsened over time, covering only sudden and unintentional incidents. The ombudsman concluded Acasta's decision to decline was fair and reasonable and did not uphold the complaint.

The Ombudsman's reasoning

The policy clearly limits cover to accidental damage from a sudden and unintentional incident, explicitly excluding damage that has accumulated or worsened over time. The technician's report, supported by photographic evidence and unchallenged by any other professional opinion, indicated the damage was a build-up of stains and scratches across a widespread area rather than consistent with a single incident. Although professional reports on such damage are rarely definitive, the commentary was persuasive and supported by the available evidence. The fact that Mr D was on holiday when the damage allegedly occurred does not change the policy terms or the nature of the damage itself.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website