Not upheld: Home insurance claim disputes complaint against Aviva Insurance Limited

Decision detail

Summary

Miss M complained that Aviva Insurance Limited unreasonably settled her car insurance claim as a fault claim following an incident with a third party vehicle. Miss M disputed liability, claiming the third party was responsible. Aviva investigated both versions of events and, finding no independent evidence but noting that damage patterns suggested Miss M's vehicle had encroached into the third party's lane, settled the claim as a fault claim. The ombudsman found Aviva properly investigated the claim and reasonably applied its policy terms in deciding to settle on the best available terms given the balance of probabilities, and therefore did not uphold the complaint.

The Ombudsman's reasoning

The ombudsman found that while FOS cannot decide liability (a role for courts), it can assess whether an insurer reasonably applied policy terms and treated the customer fairly. Aviva properly investigated the claim and considered both versions of events. The ombudsman found Aviva's reasoning sound: the lack of damage to stationary vehicles suggested Miss M's vehicle had encroached into the third party's lane rather than the reverse. Aviva was entitled to settle on the best terms possible given its assessment of low prospects of successfully defending liability in court.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website