Not upheld: claim decline and handling delay complaint against UK Insurance Limited (UKI)

Decision detail

Summary

Mr M claimed on his home insurance policy after a named storm damaged flat dormer roofs and caused internal ceiling damage. UKI's surveyor found the roofs in poor condition due to age, deterioration, and lack of maintenance over 20+ years, and concluded the damage was not caused by the storm but by wear and tear. UKI declined the claim for external roof damage and rear bedroom ceiling damage but accepted liability for front bedroom damage (£2,398). Mr M also complained about a delayed response to his query about asbestos found in artex ceilings. The ombudsman upheld UKI's decision to decline the claim based on expert evidence and found the £200 compensation for delayed asbestos advice to be fair and reasonable.

The Ombudsman's reasoning

The ombudsman applied the three-question test for storm damage claims: (1) was there a storm (accepted), (2) is damage consistent with storm damage (yes for flat roofs generally), and (3) was the storm the main cause (no - expert evidence showed wear and tear and poor maintenance were the cause). The surveyor's expert evidence and photographs supported the conclusion that the roofs were not well-maintained and damage was due to deterioration rather than the storm. The policy excludes wear and tear damage. Regarding asbestos advice, while UKI should have responded more timely to this health and safety query, the £200 compensation offered was fair and reasonable.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website