Not upheld: unfair claim refusal based on policy breach complaint against AXA Insurance Designated Activity Company

Decision detail

Summary

Mr G claimed on his motor insurance policy following an accident where his car aquaplaned and hit a barrier on 1 September 2025. AXA deemed the car a total loss but refused to pay the claim, citing that the rear tyres were 0.5mm below the legal limit of 1.6mm, constituting a breach of policy conditions. Mr G complained that AXA's decision was unfair and premature, arguing the tyre wear was inadvertent and hidden, and that aquaplaning would have occurred regardless. The ombudsman found the claim refusal was fair and reasonable, as the policy explicitly required road-legal tyres and AXA had clear photographic evidence of the breach, with subsequent engineer confirmation. The ombudsman rejected arguments about procedural timing, hidden wear, and causation, finding Mr G responsible for tyre maintenance and that poor tread depth increases aquaplaning susceptibility.

The Ombudsman's reasoning

The ombudsman found that Mr G's policy explicitly required tyres to remain within legal limits and that AXA could decline claims for breach of this condition. The evidence conclusively showed the rear tyres were at 0.5mm, less than 32% of the legal limit. While AXA initially relied on an unsigned VDI form rather than an engineer's report, the subsequent engineer's inspection confirmed the same findings, so the procedural timing did not prejudice Mr G's position. The ombudsman rejected arguments that the tyre wear was hidden or that aquaplaning would have occurred regardless, noting that poor tread depth significantly increases aquaplaning susceptibility. The ombudsman also confirmed that AXA was required to register the salvage category regardless of the claim outcome.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website