Not upheld: claim declined - breach of policy exclusion terms complaint against Admiral Insurance (Gibraltar) Limited

Decision detail

Summary

Miss D claimed for the theft of her car on her motor insurance policy with Admiral. The named driver had left the car unoccupied with the engine running while briefly retrieving something from another vehicle, and a thief drove it away. Admiral declined the claim, citing policy terms that exclude coverage where a car is left unoccupied without keys removed. The ombudsman found the policy terms were clear and that Admiral fairly applied them, as the exact circumstances of the breach had occurred. Although sympathetic to Miss D's distressing situation and concurrent health issues, the ombudsman determined these factors did not override the fair application of agreed policy exclusions, and the complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that Admiral's decision to decline the claim was fair and reasonable because the policy clearly excluded claims where a car is left unoccupied with keys in the ignition. This is a standard commercial judgment for insurers in designing policies. The policy terms were clear, agreed to by Miss D when purchasing, and the exact circumstances of the breach occurred. While sympathetic to Miss D's distressing situation and health issues, these do not override the fair application of agreed policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website