Not upheld: claim denial based on policy exclusion complaint against Accredited Insurance (Europe) Ltd

Decision detail

Summary

Mr T claimed under his legal expenses insurance policy for a legal nuisance claim against a property developer (A) who failed to properly reinstate roads and pathways after utility works. Accredited declined the claim citing a policy exclusion for professional fees arising from construction of housing work. Mr T disputed this, arguing the exclusion was applied too broadly and that the nuisance resulted from poor reinstatement, not the construction itself. The ombudsman upheld Accredited's decision, finding that the underlying cause of Mr T's intended legal claim was the construction work undertaken by A, which falls within the policy exclusion, and that Accredited's application of the exclusion was fair and reasonable.

The Ombudsman's reasoning

The ombudsman found that the cause of Mr T's intended legal claim arose from the construction work undertaken by A, not merely from the failure to reinstate. The ombudsman rejected Mr T's argument that the exclusion was applied too widely, reasoning that had the construction work not been undertaken, Mr T would be unlikely to pursue legal action. The escalation due to A's failure to properly reinstate did not change the underlying cause being the construction work itself, which falls within the policy exclusion.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website