Not upheld: claim declined - not covered under policy terms complaint against Aviva Insurance Limited

Decision detail

Summary

Mrs M claimed on her travel insurance policy for additional costs incurred when a boat she planned to take was not operating during her August 2024 trip abroad. Aviva declined the claim on the basis that the boat trip had not been pre-booked, and the policy only covers disruption to pre-booked travel arrangements. The ombudsman upheld Aviva's decision, finding the policy terms were clear and unambiguous in requiring pre-booking, and that although Mrs M's losses were genuine and the disruption was outside her control, the circumstances did not constitute an insured peril. The ombudsman expressed sympathy for Mrs M's situation, including her health condition, but concluded Aviva had acted reasonably in declining the claim.

The Ombudsman's reasoning

The ombudsman applied the test of whether the claim falls under agreed areas of cover within the policy. The policy terms explicitly state cover only applies to 'pre-booked travel arrangements'. Since Mrs M had not pre-booked the boat trip, the disruption was not an insured peril. Although the boat not running was outside her control and she suffered genuine losses, the policy does not cover non-pre-booked travel disruption. The ombudsman noted that while pre-booking the boat was uncommon in that country, it was possible to do so, and Aviva should not act outside the policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website