Not upheld: claims handling - fault determination and recovery decision complaint against esure Insurance Limited

Decision detail

Summary

Mr S complained that esure Insurance Limited unfairly recorded his motor insurance claim as a fault claim after his car skidded on ice in a car park and hit another vehicle. Mr S argued the car park manager was at fault for failing to maintain and grit the car park, and that esure should have pursued recovery from them. esure declined to pursue the car park, stating that the mere presence of ice does not constitute negligence under UK law and that recovery was not economically viable. The ombudsman found that esure acted reasonably within their policy rights to make commercial decisions about recovery and that their decision not to pursue the claim was fair, despite Mr S providing evidence of the car park manager's maintenance obligations. The complaint was not upheld, though esure was required to pay £100 compensation for delay in issuing a final decision.

The Ombudsman's reasoning

The ombudsman determined that esure acted reasonably within their policy rights to settle claims and make commercial decisions about recovery prospects. While the ombudsman acknowledged Mr S's arguments about the car park manager's maintenance obligations, they found that insurers are entitled to assess whether pursuing recovery is economically viable and that esure's decision not to pursue the claim was a reasonable commercial judgment. The ombudsman noted that esure explained their decision and rationale to Mr S, and that the fault claim recording was standard practice when costs cannot be recovered from third parties.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website