Not upheld: claim declined - storm damage and accidental damage cover complaint against Aviva Insurance Limited

Decision detail

Summary

Mr W and Mrs W complained that Aviva unfairly declined a home insurance claim for window damage allegedly caused by wind. Aviva declined the claim on two grounds: first, that no storm occurred (weather data showed only 38-45mph gusts versus the policy's 55mph threshold), and second, that the damage to the window frame was not covered under the limited accidental damage cover which only applied to fixed glass. The ombudsman upheld Aviva's decision, finding the storm definition reasonable and the weather data reliable, and confirming the damage fell outside policy coverage. The ombudsman upheld Aviva's offer of £300 compensation for loss of expectation as fair and appropriate.

The Ombudsman's reasoning

The ombudsman applied the three-part test for storm claims: whether storm conditions occurred, whether damage is consistent with storm damage, and whether storm conditions were the main cause. The evidence showed maximum wind gusts of 38-45mph, which fell significantly short of the policy's 55mph storm definition threshold. The ombudsman found this definition reasonable and not ambiguous, and concluded the weather data was reliable. Additionally, even if storm cover applied, the damage was to the window frame and hinges, not the glass, so it would not have been covered under the limited accidental damage cover in the policy. The £300 compensation for loss of expectation was appropriate given Aviva's handling of the claim review process.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website