Not upheld: claim decline and settlement adequacy complaint against Advantage Insurance Company Limited

Decision detail

Summary

Mr and Mrs W complained about Advantage Insurance's settlement of their home insurance claim following storm damage in February 2022 that was initially repaired by their neighbour. When Mrs W claimed in 2024 for ongoing damage and water ingress, Advantage initially offered £4,000 but then declined the claim, stating the damage was likely from gradual causes rather than the storm. Advantage later agreed to honour the original settlement and paid £200 compensation for poor service. The ombudsman found the claim decline was reasonable because Mrs W could not demonstrate the 2024 damage was caused by the storm rather than subsequent repair works or pre-existing conditions, supported by the expert surveyor's findings. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that while storm conditions were present in February 2022 and caused initial damage, Mrs W failed to demonstrate that the damage she was claiming for in 2024 was caused by the storm rather than subsequent events. The delay in claiming, combined with repairs carried out by the neighbour, meant the causal link between the storm and the current damage could not be established. The surveyor's expert opinion regarding the chimney's weathered condition and the water ingress being caused by repair works rather than the storm was reasonable and not contradicted by similarly qualified professionals. Poor workmanship by the neighbour in repairs would be excluded under policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website