Not upheld: claim decline - storm damage complaint against Aviva Insurance Limited

Decision detail

Summary

Mr G and Mrs G claimed under their commercial property insurance policy for water ingress damage following a reported storm event. Aviva declined the claim, citing wear and tear and poor workmanship (incorrect batten gauge) as the causes. The ombudsman applied the three-question storm damage test and found that while storm conditions did occur and the damage was consistent with storm damage, the storm was not the main cause. Expert inspections by both a contractor and Aviva's loss adjuster identified underlying roof deterioration and defective construction that predated the storm. The ombudsman found Aviva's reliance on these expert findings and application of the policy exclusions to be fair and reasonable, and therefore did not uphold the complaint.

The Ombudsman's reasoning

The ombudsman applied the three-question test for storm damage claims: (1) Did storm conditions occur? Yes - 40mph winds and gale force gusts were recorded. (2) Is the damage consistent with storm damage? Yes - the wind speeds typically cause this type of damage. (3) Was the storm the main cause? No - both the contractor and loss adjuster identified that the roof had underlying deterioration due to age and wear and tear, and defective workmanship (incorrect batten gauge). The contractor's clarification that the storm 'exacerbated' rather than caused the deterioration was key. The ombudsman found it reasonable for Aviva to rely on expert inspection findings and to apply the policy exclusions for wear and tear and defective workmanship. The fact that the roof had previously remained watertight did not establish that the storm was the main cause, as the underlying issues were simply highlighted by the storm event.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website