Not upheld: unfair claim decline complaint against Haven Insurance Company Limited

Decision detail

Summary

Mr G claimed for water damage to his home caused by what he believed was a storm, but Haven Insurance declined the claim on the basis that weather conditions did not meet the policy definition of a storm. The ombudsman reviewed weather data from both Haven and its own searches, which showed wind speeds of 40-42mph and rainfall of 3.6-6.5mm—both well below the policy thresholds of 55mph or 25mm per hour rainfall required for a storm claim. The ombudsman found Haven had fairly and reasonably declined the claim in accordance with the policy terms and did not uphold Mr G's complaint. Haven also advised Mr G of his legal cover which might help recover costs from those responsible for poor roof workmanship.

The Ombudsman's reasoning

The ombudsman found that insurance policies only cover damage caused by specific insured events. The policy clearly defines a storm with specific severity thresholds. The weather data from both Haven and the ombudsman's searches showed that conditions did not meet the policy definition of a storm (wind speeds were 40-42mph, well below the required 55mph minimum, and rainfall was 3.6-6.5mm, well below the required 25mm per hour). Therefore, Haven reasonably declined the claim in line with the policy terms. While the ombudsman acknowledged the significant water damage, the policy terms were clear and unambiguous.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website