Not upheld: claim declined — exclusion based on date of occurrence complaint against UK Insurance Limited trading as Direct Line

Decision detail

Summary

Mr and Mrs W claimed on their landlord's insurance policy with Direct Line for legal expenses to recover funds owed by a letting agent. Direct Line declined the claim, stating the date of occurrence was in 2017 when issues with the letting agent first arose, before the policy commenced in 2023. The ombudsman upheld Direct Line's decision, finding that although the unresolved non-payment occurred in 2023, the originating events (non-payment, unsigned contract, missing statements) dated to 2017 and were directly linked. Under the policy's terms, the date of the first linked event constitutes the date of occurrence, placing the claim outside the scope of cover.

The Ombudsman's reasoning

The ombudsman found that the policy's definition of 'date of occurrence' as 'the date of the first of these events' when multiple events arise from the same originating cause was applicable. Although the 2023 non-payment was unresolved and caused ongoing loss, it was not the first event leading to the claim. The issues with the letting agent (non-payment, unsigned contract, missing statements) all originated in 2017 and were directly linked to the later 2023 non-payment. Therefore, the date of occurrence was reasonably determined to be 2017, before the policy commenced in 2023, making the claim outside the scope of cover.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website