Not upheld: claim declined - application of policy exclusion complaint against UK Insurance Limited

Decision detail

Summary

Mrs A claimed for water damage to her home under her home insurance policy with UKI. UKI's surveyor and leak detection firm both concluded the damage was caused by deteriorated shower sealant and grout, which was excluded under the policy. Mrs A disputed this and provided evidence from her plumber of a leaking loft pipe as the cause. The ombudsman found UKI's expert evidence more persuasive and upheld the firm's decision to decline the claim based on the policy exclusion. UKI had already awarded £100 compensation for poor communication, which the ombudsman deemed appropriate.

The Ombudsman's reasoning

The ombudsman had to determine which expert evidence was more persuasive where there was a difference of opinion. The leak detection firm's findings were consistent with the initial surveyor's report and supported by photographs, videos, and testing results showing the damage was caused by failed sealant and grouting rather than the loft pipe leak. The firm's evidence that moisture readings were low on bathroom ceilings (inconsistent with an active loft leak) and that spray testing showed water leaking through the shower area supported the conclusion that the policy exclusion applied.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website