Not upheld: claim declined - policy coverage interpretation complaint against Fortegra Europe Insurance Company Ltd

Decision detail

Summary

Mr G claimed on his tyre and alloy insurance policy after hitting a kerb and needing a tyre replacement. Fortegra reimbursed the tyre shop costs but declined to reimburse costs from a manufacturer's garage that performed suspension alignment checks. Mr G believed the checks should be covered as they related to wheel balancing. The ombudsman found the policy covers the actual task of wheel balancing, not diagnostic checks, and that Fortegra's decline was fair and in line with policy terms.

The Ombudsman's reasoning

The policy covers the actual task of wheel balancing as part of repair or replacement, not diagnostic checks to determine if balancing is needed. The manufacturer's garage performed suspension alignment checks, not balancing work. A policy only needs to clearly state what it covers, not what it excludes. The tyre shop's recommendation to seek alignment checks was made by an independent third party, not Fortegra's agent, so Fortegra cannot be held responsible for that advice.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website