Not upheld: unfair claim denial complaint against Aviva Insurance Limited

Decision detail

Summary

Mr O and Mrs O complained about Aviva's denial of their water damage claim following a leaking pipe discovered in December 2024. The leak was not repaired until May 2025, approximately five months later, due to Mr O being out of the country and practical difficulties in arranging repairs. Aviva declined the claim, citing breach of policy conditions requiring reasonable precautions and property maintenance. Mr O argued Aviva should have warned him that delays could affect the claim outcome under FCA Consumer Duty principles. The ombudsman found that allowing a known leak to persist for several months was unreasonable under the policy terms and that Aviva was not required to provide a specific timeframe warning. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that while Aviva did not specify a timeframe for repairs in the policy, allowing a known leak to persist for several months after identification goes beyond what is reasonable under the policy's general conditions. The ombudsman was satisfied that Aviva was not required to warn Mr O that a five-month delay could affect claim coverage, as it was fairly expected that repairs would be undertaken promptly once identified. The ombudsman concluded that Aviva's decision that it would be impossible to distinguish between original damage and damage caused by inaction was reasonable and fairly based on the policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website