Not upheld: claim decline - wear and tear exclusion; alleged mis-selling; delays in claim assessment complaint against Red Sands Insurance Company (Europe) Limited

Decision detail

Summary

Mr B complained that Red Sands unfairly declined his motor warranty claim for a clutch fault under the wear and tear exclusion, arguing the clutch was listed as a covered part and that he was misled about coverage. He also complained about delays in the claim decision and additional costs incurred due to multiple evidence requests. The ombudsman found the wear and tear exclusion was clearly stated in the policy and IPID, the photographic and video evidence supported a finding of wear and tear rather than sudden mechanical failure, and Red Sands acted reasonably in requesting clarification. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that Red Sands' decision to decline the claim was fair and reasonable because: (1) the wear and tear exclusion was clearly stated in the policy terms and IPID; (2) the photographic and video evidence supported a finding of wear and tear rather than sudden mechanical failure; (3) there was no evidence the parts failed more quickly than expected given the car's age and mileage; (4) Red Sands acted fairly in requesting clarification on whether the failure was sudden or gradual, as this was central to the claim outcome; and (5) Red Sands responded to repairer communications within a week each time, which was reasonable.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website