Not upheld: Home insurance claim disputes complaint against Covea Insurance plc

Decision detail

Summary

Mr V purchased a property in 2021 that had missing roof purlins, which the builder assured him were not needed due to alternative load distribution. In 2025, ceiling cracks appeared and Mr V claimed on his Covea buildings insurance. Covea declined the claim, arguing the damage resulted from structural issues excluded from the policy and that Mr V lacked accidental damage cover. The ombudsman upheld Covea's decision, finding that damage from prolonged structural loading does not meet the definition of accidental damage and that Mr V's policy did not include this cover.

The Ombudsman's reasoning

The ombudsman agreed that the damage did not constitute accidental damage because the cracks resulted from prolonged inappropriate loading of the roof over time, not a sudden unexpected event. Although the cracks appeared suddenly, they were caused by extended forces exerted on the roof structure. Additionally, Mr V's policy did not include accidental damage cover, so there was no insured peril covered by the policy.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website