Not upheld: misrepresentation on insurance application; claim denial; policy voidance complaint against Admiral Insurance (Gibraltar) Limited

Decision detail

Summary

Mr D and Miss H complained that Admiral refused to pay their car theft claim and voided their policy after discovering Mr D had two undisclosed driving convictions when he was added to the policy in December 2024. Admiral found that one conviction was later withdrawn by the court, but the other remained valid. The ombudsman applied CIDRA and found that Miss H failed to take reasonable care by answering 'no' to the question about motoring offences, as both convictions fell within the 5-year disclosure period. Evidence showed Mr D and Miss H were aware of both convictions, as they had attempted to add Mr D to the policy in November 2024 with full disclosure, which Admiral declined. The ombudsman determined the misrepresentation was deliberate or reckless, and that Admiral's underwriting rules confirmed it would not have offered cover regardless. Therefore, Admiral's actions to refuse the claim, void the policy, and retain the premium were fair and compliant with CIDRA, and the complaint was not upheld.

The Ombudsman's reasoning

The ombudsman applied the Consumer Insurance (Disclosure and Representations) Act 2012 (CIDRA) and found that Miss H failed to take reasonable care not to make a misrepresentation by answering 'no' to the question about motoring offences when Mr D had two convictions from summer 2020 within the 5-year period. The misrepresentation was qualifying because Admiral's underwriting rules confirmed it would not have offered cover had it known about either conviction. The ombudsman found the misrepresentation was deliberate or reckless rather than careless, based on evidence that Mr D and Miss H were aware of both convictions (evidenced by the November 2024 quotation attempt and the timing of the December addition). Under CIDRA, Admiral was entitled to refuse the claim, void the policy, and retain the premium. The ombudsman rejected the argument that the urgency of their medical situation changed their responsibility to disclose accurate information.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website