Partially upheld: Home insurance claim disputes complaint against Aviva Insurance Limited

Decision detail

Summary

Mr O complained that Aviva unfairly declined his legal expenses insurance claim related to a subsidence matter, citing poor quality legal opinion, lack of transparency about the assessment author, delays in handling, and an unreasonable requirement to self-fund alternative legal opinion. The ombudsman found Aviva's reliance on Company L's well-reasoned legal assessments showing lack of reasonable prospects of success was fair and consistent with policy terms, and that requiring self-funded alternative opinions was a standard approach. However, the ombudsman upheld the complaint in part due to Aviva's poor handling including delays, inadequate communication, and failure to chase the solicitor, awarding £200 compensation for distress and inconvenience.

The Ombudsman's reasoning

The ombudsman found that Aviva was entitled to rely on the legal opinions from Company L as they were well-reasoned, clear, and overseen by a suitably qualified solicitor, with nothing suggesting they were obviously wrong. The policy terms explicitly allow Aviva to require Mr O to self-fund alternative legal opinions, which is consistent with FOS approach and the policy wording. However, Aviva's handling of the claim was deficient in several respects including delays, poor communication, and failure to adequately chase the solicitor, warranting compensation for distress and inconvenience, though these failings were not material to the outcome.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website