Not upheld: Travel / life insurance claim disputes complaint against UK Insurance Limited (UKI)

Decision detail

Summary

Mr S claimed his car was stolen and sought reimbursement under his motor insurance policy with UKI. The car was recovered undamaged with an emergency key inside, which Mr S claimed he had no knowledge of. UKI declined the claim, invoking the fraud clause, after forensic analysis confirmed the emergency key was original to the car with signs of wear consistent with five-year use, making it unlikely a previous owner had retained and used it to steal the car. Although police confirmed a genuine theft had occurred and arrested two suspects, the ombudsman upheld UKI's decision to decline the claim and maintain the fraud marker, finding the forensic evidence and Mr S's non-disclosure of the key reasonably supported UKI's conclusion that his account was dishonest.

The Ombudsman's reasoning

The ombudsman found that UKI reasonably decided, based on probability and supporting evidence, that Mr S's account of the theft was highly unlikely to be true. The forensic evidence showing the emergency key was original, had signs of wear from five-year use, and was found in the recovered car made it improbable that a previous owner had retained and used it five years later. Mr S's failure to disclose the key's existence, combined with the forensic evidence, justified UKI's reliance on the fraud clause to decline the claim. The ombudsman noted that while the police confirmed a genuine theft occurred, this did not address the inconsistency regarding the emergency key's presence and Mr S's knowledge of it.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website