Not upheld: unfair claim decline - storm damage complaint against UK Insurance Limited trading as Churchill Insurance

Decision detail

Summary

Mr K claimed on his home insurance policy for roof damage (missing tile) following poor weather conditions between late 2024 and early 2025. Churchill declined the external roof damage claim, stating storm conditions were not met, but accepted the internal damage claim under accidental damage cover. The ombudsman found that while storm conditions likely existed (wind speeds of 47-50mph were close to the 55mph policy threshold), the loss adjustor's report evidenced the damage was caused by gradual deterioration rather than the storm event, which is excluded from the policy. Churchill's condition requiring external repairs before internal repairs was reasonable. The ombudsman upheld the claim decline but ordered £100 compensation because Churchill failed to explicitly explain the wind speed data to Mr K, causing him to feel his claim was not being properly considered.

The Ombudsman's reasoning

The ombudsman applied the three-question test for storm damage claims: whether storm conditions existed, whether damage was consistent with storm damage, and whether storm was the main cause. While storm conditions likely existed (wind speeds close to threshold), the loss adjustor's evidence of gradual deterioration over time meant the damage was not caused by the storm but by wear and tear, which is excluded from the policy. The condition requiring external repairs before internal repairs was reasonable to prevent ongoing deterioration. However, Churchill should have explained the wind speed data more explicitly to Mr K.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website