Not upheld: claim declined - scope of cover complaint against AmTrust Specialty Limited

Decision detail

Summary

Mr B and Mr M, joint policyholders of legal expenses insurance with AmTrust, complained that AmTrust unfairly declined a claim for legal expenses to pursue the former employer in County Court regarding personal data handling and data protection law compliance. AmTrust declined cover, and the investigator found the decision fair. The ombudsman examined whether any policy section could reasonably cover the claim and concluded that the Employment Disputes section only covers Employment Tribunal matters, the Legal Defence section only covers defending actions against the policyholder, and the Contract Disputes section does not apply. The complaint was not upheld as the claim fell outside the policy scope.

The Ombudsman's reasoning

The ombudsman assessed whether any section of the policy could reasonably be interpreted to extend to Mr B's claim concerning his former employer's handling of personal data and data protection compliance. The Employment Disputes section only covers Employment Tribunal matters, not County Court claims for compensation. The Legal Defence section only covers defending actions against the policyholder as a data controller, not enforcing the policyholder's rights. The Contract Disputes section does not apply as the claim does not relate to purchase, sale or rental of goods or services. Insurers are entitled to define the scope of cover they offer, and the onus is on the policyholder to demonstrate the claim falls within the policy scope.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website