Not upheld: Home insurance claim disputes complaint against AXA Insurance UK Plc

Decision detail

Summary

Mr G and Ms V claimed on their home insurance policy with AXA for damage to guttering, downpipes and fascia boards that came away during a storm. AXA declined the claim, arguing that the damage was caused by rotten, unmaintained timbers rather than the storm itself. The ombudsman upheld AXA's decision, finding that while a storm occurred, it was not the main or proximate cause of the damage. The ombudsman reasoned that insurance contracts are not maintenance contracts and that the policyholder must demonstrate loss caused by an insured peril, which they failed to do in this case.

The Ombudsman's reasoning

The ombudsman applied the principle that it is for the policyholder to show they have suffered loss due to an insured peril. In this case, while a storm occurred, it was not the main or proximate cause of the damage. The damage was caused by lack of maintenance and rotten timbers, which is not an insured peril. The storm simply highlighted an existing issue. Insurance contracts are not maintenance contracts, and it is not unfair for an insurer to decline a claim where the damage was not caused by an insured event.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website