Not upheld: claim validation and handling; loss adjuster conduct complaint against Aviva Insurance Limited

Decision detail

Summary

Ms B and Mr T complained that Aviva treated them unfairly in handling their flood damage claim from October 2023. Ms B objected to Aviva's requests for further information to validate the claim, particularly an interview request with her contractor (her father), and complained about the loss adjuster's behaviour during a call. Aviva had concerns about occupancy conditions (Ms B moved abroad in June 2023), unauthorised contractor appointment, and an excessive repair quote. The ombudsman found Aviva's information requests were reasonable and proportionate, the loss adjuster was not unprofessional, and the £100 compensation for processing delays was fair. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that Aviva's concerns about occupancy conditions, the unauthorised contractor appointment, and the excessive repair quote were reasonable grounds for requesting further information. It is normal industry practice for insurers to validate claims and request information at various stages. The ombudsman noted that Aviva clearly outlined what information was needed and why. Regarding the loss adjuster's behaviour, the ombudsman listened to the call recording and concluded that both parties raised their voices, the loss adjuster was not unprofessional, and he was attempting to clarify the claim status and manage expectations.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website