Not upheld: claim decline and poor claim handling complaint against Intact Insurance UK Limited trading as RSA

Decision detail

Summary

Miss G complained that Intact Insurance declined her home insurance subsidence claim for damage to a boundary wall, conservatory and patio, and handled the claim poorly with significant delays in communication. Intact initially suggested parts of the claim would be covered but later declined the entire claim based on a policy exclusion for defective design, workmanship or materials, supported by an expert report attributing the damage to poor ground and construction materials. Intact paid £4,000 compensation for service failures and delayed communication. The ombudsman upheld Intact's decision to decline the claim as reasonable and fair, and found the £4,000 compensation already paid to be appropriate for the distress caused by poor claim handling, declining to order any further remedy.

The Ombudsman's reasoning

The ombudsman found it reasonable for Intact to decline the claim based on the policy exclusion for defective design, workmanship or materials, as the expert report persuasively demonstrated the damage was caused by poor ground and construction materials. While Intact's delayed communication and poor handling of the claim was acknowledged as a service failure, the £4,000 compensation already paid was deemed fair and proportionate to the distress caused, as it did not require Intact to pay a claim that was legitimately excluded under the policy terms.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website