Partially upheld: claim handling delay and refusal to pay loss assessor fees complaint against Aviva Insurance Limited

Decision detail

Summary

Mr H complained that Aviva delayed handling his subsidence claim and refused to pay the fees of the loss assessor he employed to assist him. Aviva's initial settlement offer of around £90,000 was increased to approximately £270,000 by the time the claim concluded in 2025. The ombudsman found that the insurance policy clearly excluded fees for preparing claims and that Mr H's appointment of the loss assessor was a contractual matter between them, so Aviva was not obligated to pay those fees. However, the ombudsman determined that Mr H's complaint about delay in the first year of the claim had not been previously addressed in Aviva's final responses and therefore fell within the ombudsman's jurisdiction, requiring referral back to the investigator for further investigation.

The Ombudsman's reasoning

The ombudsman found that the policy clearly excludes fees for preparing any claim, and there was no evidence that Aviva agreed to pay the loss assessor's fees or that this was part of settlement discussions. The appointment of Mr J was a contractual matter between Mr H and Mr J. While Mr H found the loss assessor's support useful, there was no evidence it was essential to obtaining a satisfactory settlement. Regarding delay, the ombudsman determined that the complaint about delay in the first year had not been previously addressed in Aviva's final response letters, so it fell within jurisdiction and required further investigation.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website