Not upheld: claim handling, settlement adequacy, scope of investigation complaint against AXA Insurance UK Plc

Decision detail

Summary

Mr S complained about AXA's handling of his home insurance claim for storm damage to Property A, specifically challenging AXA's refusal to investigate external damage and its settlement offer of £1,757 for internal damage. Mr S argued that a freeze-thaw process from a 2018 ice storm caused external damage and that the settlement was insufficient, particularly given a £2,500 estimate from 2020. The ombudsman found no persuasive evidence of external storm damage in any of the expert reports, including those commissioned by Mr S, and noted that Mr S failed to provide competing contractor estimates despite multiple opportunities. The complaint was not upheld as AXA's approach was reasonable and its settlement offer fair.

The Ombudsman's reasoning

The ombudsman found that AXA was entitled to require evidence of an insured peril before investigating external damage claims. Since no persuasive evidence of external storm damage was provided by Mr S, despite multiple expert reports, AXA acted reasonably in declining to investigate further or appoint a building pathologist. Regarding the settlement offer, without competing contractor estimates to challenge AXA's detailed and costed schedule of works, the ombudsman could not fairly find the offer unreasonable. The March 2020 estimate was not a suitable comparison as it related to the liability claim rather than the storm damage claim.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website