Not upheld: Home insurance claim disputes complaint against UK Insurance Limited trading as Direct Line

Decision detail

Summary

Mr H claimed on his home insurance policy with UKI for significant boiler damage that occurred in late 2025. UKI declined the claim based on the mechanical and electrical breakdown exclusion after reviewing engineer X's report, which concluded the damage was caused by an explosive ignition due to a fault with the boiler's ignition component. Mr H disputed this decision, suggesting alternative causes such as increased gas pressure or blocked pipes due to cold weather, and complained to UKI and subsequently to the FOS. The ombudsman upheld UKI's decision, finding that the insurer fairly relied on the uncontested expert opinion that the damage resulted from a mechanical fault, which fell squarely within the policy's exclusion for mechanical or electrical breakdown.

The Ombudsman's reasoning

The ombudsman determined that UKI acted fairly in relying on engineer X's expert opinion that the damage was caused by a mechanical/electrical fault with the ignition. The ombudsman noted that the service deems it reasonable for insurers to rely on expert opinion unless conflicting expert evidence is provided, which was not the case here. The ombudsman found the ignition to be a core mechanical component, and that had it been functioning properly, no damage would have occurred. Therefore, the mechanical/electrical breakdown exclusion was applicable and UKI fairly declined the claim under both the Home Emergency cover (explosion exclusion) and Buildings cover (mechanical/electrical breakdown exclusion).

How this compares

Source

Read the original decision on the Financial Ombudsman Service website