Not upheld: claim declined - causation dispute complaint against Intact Insurance UK Limited (formerly Royal & Sun Alliance Insurance Ltd)

Decision detail

Summary

Mr and Mrs B claimed for chimney stack and roof damage caused by a named storm in January 2025. Intact declined the claim, arguing the damage was not consistent with storm damage and that water damage had been occurring for a long period. The ombudsman applied the standard three-part test for storm damage claims and found that while storm conditions existed and the damage type was consistent with storms, the policyholder failed to demonstrate the storm was the dominant cause. Evidence of severely corroded lead flashing and long-term water ingress suggested pre-existing structural weakness, making the storm a catalyst rather than the main cause. The ombudsman upheld Intact's decision to decline the claim and accepted the insurer's £150 compensation offer for handling delays.

The Ombudsman's reasoning

The ombudsman applied the standard three-part test for storm damage claims: whether storm conditions existed (yes), whether the damage was consistent with storm damage (yes), and whether the storm was the main cause (no). The ombudsman found that while the storm may have been a catalyst, the underlying structural weakness evidenced by severely corroded lead flashing and long-term water ingress indicated the damage would have been less likely without pre-existing defects. The ombudsman noted that for cumulative damage from multiple storms, the particular storm causing the damage must be identified. The policyholder failed to sufficiently demonstrate that the January 2025 storm was the dominant cause rather than merely triggering pre-existing deterioration.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website