Partially upheld: unfair claim rejection and improper invocation of fraud condition complaint against Admiral Insurance (Gibraltar) Limited
Financial Ombudsman decision DRN-6306337 of 2026-04-22T00:00:00+00:00. unfair claim rejection and improper invocation of fraud condition complaint against Admiral Insurance (Gibraltar) Limited. Outcome: Partially upheld.
Decision detail
| Reference | DRN-6306337 |
|---|---|
| Decision date | 2026-04-22T00:00:00+00:00 |
| Firm | Admiral Insurance (Gibraltar) Limited |
| Product | travel insurance |
| Claim type | unfair claim rejection and improper invocation of fraud condition |
| Outcome | Partially upheld |
| Remedy | Admiral must: (1) reinstate Mr and Mrs T's policy; (2) remove all internal and external fraud markers; (3) pay Mr and Mrs T's cancellation claim excluding cruise costs and costs incurred travelling to support Ms T, in line with remaining policy terms and less any applicable excess; (4) add interest at 8% simple annual rate from one month after claim was made until settlement date. |
Summary
Mr and Mrs T purchased annual travel insurance and booked a December 2024 trip with flights and hotel in September 2024. They later booked a cruise in early October 2024 without adding cruise cover. When Ms T suffered a medical incident on the cruise on 31 October 2024, Mr and Mrs T added cruise cover approximately 22 minutes after being notified. They subsequently cancelled their entire trip and claimed cancellation costs. Admiral rejected all claims citing breach of the fraud condition and cancelled the policy with fraud markers applied. The ombudsman partially upheld the complaint, finding Admiral reasonably rejected cruise-related costs but improperly invoked the fraud condition for the original trip elements booked before any medical incident. The policy was reinstated, fraud markers removed, and Mr and Mrs T were awarded cancellation costs for non-cruise trip elements with interest.
The Ombudsman's reasoning
The ombudsman found that while it was reasonable for Admiral to reject cruise-related costs (as the triggering event occurred before cruise cover was added), it was not fair to invoke the fraud condition. The ombudsman distinguished between the cruise booking (made after the medical incident) and the original trip elements (flights and hotel booked in September 2024, weeks before any medical incident). The ombudsman found no evidence of deliberate dishonesty, false representations, or failure to disclose information with intent to defraud. Instead, the evidence pointed to confusion about timelines and lack of insurance expertise. The original trip cancellation was a covered risk that Mr and Mrs T could not have anticipated when booking in September 2024.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Admiral Insurance (Gibraltar) Limited, all decisions | 1,935 | 44% |
Source
Read the original decision on the Financial Ombudsman Service website