Not upheld: claim handling delay and disproportionate investigation complaint against Hiscox Insurance Company Limited

Decision detail

Summary

H, a micro-enterprise, made a claim on its business protection insurance policy for items stolen from Mr S's car boot in November 2024. Hiscox appointed loss adjusters to investigate and requested evidence of ownership, as some items (Kindle, spectacles, expensive pen) did not appear to be business items. The broker complained that the investigation was slow, disproportionate, and created an impression the claim was being treated as suspicious. The ombudsman found the investigation was reasonable and not unreasonably delayed, as it was necessary to establish whether items met the policy definition of 'Insured property', and the main delay was during the Christmas period while waiting for a signed statement. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman applied the relevant industry rules requiring insurers to deal with claims promptly and fairly. The starting point was the policy terms defining 'Insured property'. The ombudsman found that the investigation timeline was reasonable, with the only significant gap (20 December 2024 to 14 January 2025) explained by waiting for a signed statement and the Christmas holiday period. The ombudsman considered it reasonable for Hiscox to request evidence of ownership given that some items (Kindle, spectacles, expensive pen) did not appear to be business items and evidence showed they were purchased by Mr S before H was established. The ombudsman rejected the broker's concerns about the appointment of loss adjusters as based on past experience rather than issues with H's claim, and found that any record inaccuracies did not affect the outcome of the investigation complaint.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website