Not upheld: unfair claim decline complaint against Chubb European Group SE

Decision detail

Summary

Mrs N claimed travel insurance benefits following a driving accident abroad but Chubb declined her claim under a 'breaking the law' exclusion after a police report stated she failed to stop at a stop sign. Mrs N disputed the police report, claimed she was not charged with an offence, and stated she had video footage and witness testimony contradicting it. The Ombudsman found Chubb acted fairly in relying on the police report as the evidence available to it at the time, noting Mrs N had multiple opportunities to provide additional evidence but did not do so before the claim was declined. The complaint was not upheld.

The Ombudsman's reasoning

The Ombudsman determined that Chubb acted fairly in declining the claim based on the police report, which was the evidence available to it at the time of assessment. The Ombudsman noted it was not her role to investigate the accuracy of the police report or Mrs N's actions, but rather to assess whether Chubb acted reasonably based on available evidence. Mrs N had multiple opportunities to provide additional evidence but did not submit the video footage or witness testimony before the claim was declined. The policy exclusion for breaking the law is clear and not ambiguous, and its application was reasonable.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website