Not upheld: claim handling - refusal to accept and settle buildings insurance claim pending investigation complaint against Aviva Insurance Limited

Decision detail

Summary

Miss K complained about Aviva Insurance Limited's handling of her buildings insurance claim for structural damage at her property. Aviva required further investigations including a distortion survey and trial pit to confirm the cause of the damage before accepting the claim, which Miss K disputed. Miss K appointed a structural engineer who suggested defective drains as a possible cause but also recommended further investigation. The ombudsman did not uphold the complaint, finding that Aviva was entitled to establish the root cause of damage before proceeding to repairs, as repairs must be lasting and effective. The available evidence did not confirm subsidence or a definitive cause, and the structural engineer's report aligned with Aviva's proposed investigations rather than contradicting them.

The Ombudsman's reasoning

Although cracking can indicate subsidence, it is not always the cause. The available evidence does not currently establish a root cause of the damage or specifically that subsidence has occurred. An insurer must ensure repairs are lasting and effective; repairing without addressing the underlying cause would likely result in recurrence of damage. Aviva's requirement for further investigation (distortion survey, trial pit, borehole investigation) is reasonable and necessary before accepting the claim. The structural engineer's report, being based on visual inspection and not referencing Aviva's previous investigations, does not materially change the position. Aviva was entitled to rely on its experts' opinions.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website