Upheld: unfair claim handling, failure to progress claim, mixed messaging on policy cover complaint against Aviva Insurance Limited

Decision detail

Summary

Mr and Mrs H complained about Aviva's handling of a home insurance claim for trace and access work following a leak in their ensuite shower in May 2025. Aviva initially told Mr H to arrange the works himself, referenced the wrong excess level, and later agreed to arrange the works but failed to follow through or respond to Mr H's inquiries. Mr H subsequently paid for repairs himself. The ombudsman upheld the complaint, finding Aviva acted unfairly in its initial refusal and failure to progress the claim, particularly given Mr H's vulnerability. However, the ombudsman rejected Mr H's request for reimbursement of £1,665 in repair costs due to insufficient evidence of what works were completed and whether they fell within trace and access cover. Aviva was directed to progress the claim and pay £250 compensation for distress and inconvenience.

The Ombudsman's reasoning

Aviva acted unfairly by giving Mr H mixed messages about his trace and access claim, initially insisting he arrange works himself despite his vulnerability and clear claim under that cover, and by failing to follow through on its commitment to arrange the works. The ombudsman found Aviva did not fairly apply its discretion in claim settlement. However, the ombudsman could not direct payment of Mr H's claimed costs (£1,665) because it was unclear what works were completed, what portion related to trace and access versus damage repair, and whether all costs would have been covered under the policy. The ombudsman also rejected the excess protection claim as Mr H had not yet paid an excess to trigger that cover.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website