Not upheld: Home insurance claim disputes complaint against The New India Assurance Company Limited

Decision detail

Summary

Mr S claimed for property damage he attributed to a storm on or around 30 January 2025. NIA declined the claim in April 2025, and Mr S complained in October 2025. The ombudsman applied the three-question test for storm damage claims and found that recorded wind speeds of 45-47 mph were notably below the policy's 55 mph threshold, making it reasonable for NIA to conclude a storm of required severity did not occur. Additionally, the ombudsman found the Senior Adjuster's assessment that the damage was largely caused by lack of maintenance and wear and tear was reasonable and unrebutted. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman applied the three-question test for storm damage claims: (1) Was there a storm? (2) Was the damage typical of storm damage? (3) Was the damage caused wholly or mainly by the storm? The ombudsman found the answer to the first question was 'No' because recorded wind speeds of 45-47 mph were notably below the policy's 55 mph threshold, making it reasonable for NIA to conclude a storm of required severity was not present. The ombudsman rejected Mr S's argument that regional weather data was unreliable, noting that insurers and the FOS generally rely on the best available regional data. Although the ombudsman found the damage was typical of storm damage, they concluded that even if storm conditions had existed, the Senior Adjuster's assessment that the damage was largely caused by lack of maintenance and wear and tear was reasonable in the absence of contrary expert evidence. The ombudsman also found the Accidental Damage claim was properly excluded under the policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website