Upheld: Motor insurance, claim handling complaint against Assurant General Insurance Limited

Decision detail

Summary

Mr B claimed for a lost mobile phone under his insurance policy provided via a packaged bank account and underwritten by Assurant. He had placed the phone in a deep, unzipped jacket pocket while at a leisure centre and discovered it missing after playing basketball and going for a run. Assurant declined the claim, arguing Mr B failed to take proper care of the device. The ombudsman upheld the complaint, finding Assurant failed to prove Mr B was careless or reckless, as he had recognised the risk and taken steps to minimise it by using a deep pocket while needing the phone to access his car. The ombudsman also upheld the £75 compensation for claims handling delays as reasonable.

The Ombudsman's reasoning

The ombudsman applied the legal test from Sofi v Prudential, which places the burden of proof on the insurer to show the policyholder failed to take reasonable care. The test requires showing the policyholder recognised a risk and was then reckless (not caring if loss occurred). Mr B needed his phone to access his car and placed it in a deep pocket, demonstrating he both recognised the risk and took steps to minimise it. The policy does not impose a blanket ban on using phones during activities or wearing jackets without zipped pockets, and such restrictions would need to be clearly specified. With hindsight, different choices could have been made, but this does not equate to lack of care. Assurant failed to discharge its burden of proof.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website