Upheld: unfair claims settlement and misapplication of policy excesses complaint against UK Insurance Limited
Financial Ombudsman decision DRN-6292254 of 2026-04-15T00:00:00+00:00. unfair claims settlement and misapplication of policy excesses complaint against UK Insurance Limited. Outcome: Upheld.
Decision detail
| Reference | DRN-6292254 |
|---|---|
| Decision date | 2026-04-15T00:00:00+00:00 |
| Firm | UK Insurance Limited |
| Product | insurance |
| Claim type | unfair claims settlement and misapplication of policy excesses |
| Outcome | Upheld |
| Remedy | UKI must pay: (1) Accidental damage: £278.61 (mirror/vanity unit) plus cost to fix hole in ceiling, with £100 excess deductible, plus 8% simple interest from date initially offered; (2) Malicious damage: £1,474.09 (upstairs doors) plus £850.59 (stair spindle) plus cost to resolve kitchen unit damage plus cost to fix solid banister, with £500 excess deductible, plus 8% simple interest from date initially offered; (3) £300 compensation (cancel uncashed £150 cheque and issue new £300 cheque, or issue £150 if original cheque was cashed); (4) UKI must discuss with Mr B and create an approved list of outstanding damage items for reconsideration, including: kitchen plastering/worktops/electrics, PVC external door, toilet cistern, solid floor by patio door, bedroom cupboard crack, carpets, light fittings, and damage shown in four photos sent 27 March 2026. |
Summary
Mr B complained that UKI unfairly refused to cover significant damage to his let property discovered when tenants were evicted, including a wrecked kitchen. UKI initially offered settlement for only three items and declined the kitchen damage, kitchen lino flooring, and a bedroom wall crack. The ombudsman found UKI misapplied policy excesses and unreasonably declined the kitchen unit damage, which showed signs of malicious damage through photos of damaged hinges and the fact the kitchen had been recently reinstated. The ombudsman upheld the complaint, requiring UKI to pay for the kitchen units, hole in ceiling, solid banister, and previously offered settlements with interest, plus £300 compensation, and to reconsider other outstanding damage claims through proper engagement with Mr B.
The Ombudsman's reasoning
The ombudsman found that UKI failed to handle the claim fairly and reasonably. Regarding excesses, the policy wording supported applying only one excess per claim type (£100 for accidental damage claims and £500 for malicious damage claims), not per individual item. On the kitchen damage, despite UKI's argument about prolonged neglect, the ombudsman was satisfied that malicious damage could reasonably be inferred from the photos showing damaged hinges and the fact the kitchen was recently reinstated. The loss adjuster's report did not provide sufficient evidence to rule out malicious damage. The ombudsman rejected UKI's position that deterioration over time precluded malicious damage findings. For the vertical bedroom wall crack, the ombudsman agreed with UKI that this was unlikely to be malicious damage. The hole in the ceiling was reasonably treated as accidental damage despite Mr B's changing explanations. UKI failed to properly consider several items of damage that were not included in the loss adjuster's report.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| UK Insurance Limited, all decisions | 3,730 | 33% |
Source
Read the original decision on the Financial Ombudsman Service website