Not upheld: claim decline - no insured peril complaint against Haven Insurance Company Limited

Decision detail

Summary

Mrs O claimed on her home insurance for damage to a flat roof sustained during high winds and rain in January 2026. Haven declined the claim, stating the wind speeds (36 mph) did not meet the policy's storm definition (55+ mph). The ombudsman upheld Haven's decision, finding that the wind speeds were insufficient to damage a sound building and that Mrs O failed to identify any alternative cause qualifying for accidental damage cover. Additionally, Mrs O had not complied with a policy endorsement requiring roof inspection every three years. Haven's £100 compensation for poor claim communication was deemed adequate.

The Ombudsman's reasoning

The ombudsman found that wind speeds of 36 mph were insufficient to cause damage to an otherwise sound building, falling well below the policy's storm definition of 55+ mph. While the damage was sudden and unexpected, accidental damage cover did not apply because Mrs O could not identify any alternative cause of damage beyond the insufficient winds. The ombudsman applied the principle that policyholders must demonstrate an insured loss caused by an insured event, rather than insurers proving exclusions apply. Additionally, Mrs O's failure to comply with the three-yearly roof inspection endorsement would have excluded cover even if a storm had occurred.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website