Not upheld: misrepresentation - failure to disclose car modifications; customer service complaint regarding claims process complaint against One Insurance Limited (OIL)

Decision detail

Summary

Mr S complained that OIL unfairly declined his car insurance claim and avoided his policy after he failed to disclose modifications (a sports air filter and racing stripe stickers) made to his car. He also complained about poor customer service during the claims process, including long telephone wait times and multiple live chat interactions. The ombudsman found that Mr S failed to take reasonable care not to make a misrepresentation under CIDRA, as the modification questions were clear and a reasonable person would recognize a sports air filter as a mechanical modification requiring disclosure. OIL demonstrated through their underwriting guide they would not have offered cover if the modifications had been disclosed, entitling them to avoid the policy and decline the claim. The ombudsman also found the customer service issues did not warrant compensation as the level of inconvenience was reasonably expected from a claim of this nature.

The Ombudsman's reasoning

The ombudsman applied The Consumer Insurance (Disclosure and Representations) Act 2012 (CIDRA) and found that Mr S failed to take reasonable care not to make a misrepresentation. The modification questions were clear and unambiguous, specifically highlighting cosmetic modifications. A reasonable person would recognize that a sports air filter is a mechanical modification requiring disclosure, particularly as Mr S himself disclosed it unprompted during the validation interview. OIL demonstrated through their underwriting guide that they would not have offered cover if the modifications had been disclosed, making this a qualifying misrepresentation. As a careless qualifying misrepresentation, CIDRA entitled OIL to avoid the policy and decline the claim. Regarding the customer journey complaints, the ombudsman found the level of inconvenience was reasonably expected from a claim of this nature and did not warrant compensation.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website