Not upheld: claim handling - causation dispute complaint against Admiral Insurance (Gibraltar) Limited

Decision detail

Summary

Mr T complained about Admiral's handling of his commercial vehicle insurance claim following an accident in February 2023 that damaged his van. Mr T reported that a traction control warning light came on after the accident, but did not proceed with repairs until November 2024. Admiral's in-house engineers and an independent assessor both concluded the light was not accident-related, citing the 600+ day delay, multiple MOTs with no reference to the issue, and 6,000 miles of subsequent driving. Although Mr T obtained a garage report suggesting the light was impact-related, the ombudsman found the independent assessor's opinion more persuasive and upheld Admiral's decision to decline the claim. The ombudsman confirmed Admiral had taken reasonable investigative steps and was entitled to rely on expert opinion in the absence of persuasive evidence of accident causation.

The Ombudsman's reasoning

The ombudsman found that Admiral acted fairly and reasonably by obtaining an independent expert assessment to determine causation. The independent assessor's report was given greater weight because it was based on physical inspection, considered the vehicle's history over time, and provided reasoned analysis of accident causation. The fact that multiple MOTs over a prolonged period did not identify any traction control issue supported the conclusion that the fault was unlikely to have been present since the accident. While Mr T recalls the light coming on after the accident, the available expert evidence did not support accident causation, and the time gap, mileage covered, and absence of any recorded issues in subsequent inspections suggested the fault developed separately.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website