Upheld: unfair claim decline complaint against Fortegra Europe Insurance Company Ltd

Decision detail

Summary

Mr P purchased leather sofas in 2022 with a five-year furniture protection policy underwritten by Fortegra. In June 2025, he claimed for peeling leather and foam loss. Fortegra declined both claims, citing the foam loss was within tolerance and the peeling was caused by normal use and soiling. The ombudsman upheld the complaint, finding the foam claim was properly declined but the peeling claim should have been accepted, as the evidence did not conclusively show the damage resulted from normal wear rather than a manufacturing defect. The peeling occurred in non-high-traffic areas and the policy explicitly covered peeling as a result of defects. Fortegra was ordered to accept the peeling claim and pay £100 compensation.

The Ombudsman's reasoning

The ombudsman agreed with the investigator that while the foam claim was properly declined as it fell within the 30% tolerance exclusion, the peeling claim should have been accepted. The evidence did not conclusively demonstrate that exclusion 4.13 (deterioration through normal use or soiling) applied. The peeling occurred in non-high-traffic areas where normal wear would not typically occur, and while soiling was detected, the exposed raw hide in the damaged areas could naturally hold more dirt than undamaged areas. The policy explicitly covers peeling or cracking as a result of a defect, and the evidence did not rule out a manufacturing defect. Therefore, Fortegra acted unfairly in declining this element of the claim.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website