Not upheld: unfair claim decline complaint against Advantage Insurance Company Limited

Decision detail

Summary

Mr A and Mrs A complained that Advantage Insurance unfairly declined a home insurance claim for storm damage to a lean-to. Advantage declined the claim on the basis that weather conditions did not meet the policy's storm definition and the damage appeared to be wear and tear. The ombudsman examined weather data showing maximum windspeed of 37mph and rainfall of 16.6mm, which fell well short of the policy's storm definition requiring 55mph windspeed or 25mm per hour rainfall. Finding no evidence of storm conditions and no local evidence provided by Mr A to contradict the weather station data from 4 miles away, the ombudsman upheld Advantage's decision to decline the claim. The ombudsman accepted Advantage's offer of £50 compensation for a two-day delay in issuing the claim outcome.

The Ombudsman's reasoning

The ombudsman applied the three-part test for storm claims: whether storm conditions occurred, whether damage is consistent with storm damage, and whether storm was the main cause. Finding no evidence of storm conditions meeting the policy definition (37mph windspeed and 16.6mm rainfall fell significantly short of the 55mph/25mm threshold), the first question was answered negatively, making it unnecessary to consider the other questions. The weather station 4 miles away was considered sufficiently proximate and reliable, and Mr A's failure to provide evidence of local storm conditions meant the decline was reasonable.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website