Not upheld: third party claim handling, liability investigation delay, unfair recording of fault claim complaint against West Bay Insurance Plc

Decision detail

Summary

Mr A and Mrs A complained about West Bay Insurance Plc's handling of a third party motor insurance claim following an accident in July 2023. West Bay made a part settlement of the third party's claim on a without prejudice basis before receiving Mr A's evidence, and the claim remained open and recorded as a fault claim for over two years while liability was investigated. This resulted in increased premiums at renewal and non-renewal of the policy. The ombudsman found that West Bay acted reasonably in making the commercial decision to part-settle to minimize costs, that the evidence available at the time supported their decision, and that the investigation timeframe was not unreasonable given the disputed and contradictory nature of the evidence. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that West Bay acted reasonably in making the part settlement on a without prejudice basis before receiving all evidence, as the engineer's report appeared thorough and credible, and Mr A's photos were not inconsistent with the claimed damage. The policy gave West Bay discretion to settle claims as they saw fit. The time taken to investigate was not unreasonable given the contradictory evidence and involvement of litigation. Recording an open claim as a fault claim is standard industry practice, and Mr A could request a premium adjustment once liability was finally decided.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website