Not upheld: Home insurance claim disputes complaint against UK Insurance Limited (UKI)

Decision detail

Summary

Ms H claimed under her home insurance policy with UKI for damage caused by an underground pipe after being alerted to a leak by her water authority. UKI requested confirmation of the cause of damage to determine if the claim fell within the policy's definition of accidental damage (sudden and unintentional). Ms H provided information from the water authority and plumbers suggesting possible causes (ground movement, deteriorating pipes) but no definitive confirmation. The ombudsman found UKI's request for cause-of-damage confirmation was reasonable and necessary, as the evidence provided did not establish whether the damage was accidental or caused by gradual wear and tear (not covered). The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that UKI's request for confirmation of the cause of damage was reasonable and necessary to determine if the claim met the policy definition of accidental damage. The evidence provided by Ms H (high water usage, plumber reports, engineer opinion) did not confirm the cause of damage or establish that it was sudden and unintentional rather than gradual deterioration or wear and tear. The fact that water loss increased does not confirm the cause of damage or demonstrate it meets the policy's definition of accidental damage. Therefore, UKI's decision to not meet the claim pending receipt of a report confirming the cause of damage was fair and in line with the policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website