Not upheld: claim settlement dispute; alleged prejudice to insurer's position due to delayed notification complaint against AXA Insurance UK Plc

Decision detail

Summary

Mrs B claimed on her let property insurance with AXA for damage caused by a leak from the flat above in October 2024. She initially pursued the neighbour for recompense before notifying AXA of the claim on 15 January 2025, by which time contractors had already completed emergency works and drying. AXA settled most costs but limited reinstatement costs to £4,598.58 against Mrs B's invoice of £8,810.88 plus VAT, citing prejudice to its position due to the delayed notification. Mrs B complained, arguing the work was urgent due to fire risk concerns and that AXA should have been clearer about the prejudice. The ombudsman upheld AXA's position, finding that Mrs B breached the policy requirement to notify as soon as practical, and that AXA's settlement represented a fair amount equivalent to what AXA would have paid to complete the work itself.

The Ombudsman's reasoning

The ombudsman found that Mrs B breached the policy requirement to notify AXA of the claim as soon as practical by completing all reinstatement work before notification. Although Mrs B cited fire safety urgency and initial pursuit of the neighbour, the ombudsman noted that the property had to be dried before ceiling reinstatement anyway, providing an opportunity for notification. AXA's reservation of rights when notified was sufficient notice that the delay could affect liability. The ombudsman was satisfied that AXA's settlement of £4,598.58 represented a fair and reasonable amount equivalent to what AXA would have paid to complete the work itself, and that AXA would have taken the opportunity to control the work and costs had it been given the choice.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website