Not upheld: unfair claim decline - gradual deterioration exclusion complaint against AXA Insurance UK Plc

Decision detail

Summary

Mrs K claimed under her AXA property insurance policy for damage caused by a leak from pipework in an ensuite WC. AXA declined the claim, concluding the damage was caused by gradual deterioration rather than a sudden escape of water, and was therefore excluded under the policy's general exclusions. The ombudsman upheld AXA's decision, finding that the extensive damage pattern, including widespread ceiling collapse and salt formation on walls, was more consistent with prolonged moisture exposure over time than a one-off event, and therefore properly excluded from cover.

The Ombudsman's reasoning

The ombudsman concluded that while the policy covers escape of water as an insured event, the damage was excluded under the gradual deterioration/maintenance exclusion. The pattern of damage, including extensive ceiling collapse, widespread wall damage, and salt formation, was more consistent with prolonged moisture exposure over time rather than a sudden one-off escape of water event. The ombudsman found AXA's conclusion reasonable based on the available evidence and applied the balance of probabilities standard.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website