Not upheld: claims handling delay and assessment complaint against Aviva Insurance Limited

Decision detail

Summary

Mrs B claimed on a legal expenses insurance policy with Aviva for an employment dispute. After initial contact in 2018 and 2022 without response, Mrs B provided information in February 2025 suggesting issues predated Aviva's cover period. Aviva initially referred her to the previous insurer but accepted the claim in May 2025 following clarification. A qualified employment solicitor assessed the claim as lacking reasonable prospects of success, leading to rejection. The ombudsman found Aviva's handling reasonable throughout, including reliance on the solicitor's assessment, and upheld the £100 compensation already offered for minor delays.

The Ombudsman's reasoning

Aviva acted reasonably in requesting information in 2018 and 2022 when Mrs B did not respond. When Mrs B provided information in February 2025, Aviva reasonably concluded the claim related to pre-2014 issues outside its cover period based on policy terms. Upon May 2025 clarification that the claim arose during Aviva's period, Aviva properly referred it to a qualified employment law specialist. The solicitor's assessment was properly reasoned and Aviva was entitled to rely on it. While there were minor delays, these did not prevent funding as the claim lacked reasonable prospects of success regardless. The £100 offered adequately compensates for any service failings.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website