Not upheld: claim refusal - property damage complaint against Aviva Insurance Limited

Decision detail

Summary

S, a medical partnership, claimed for roof repairs following water damage during a storm in November 2025. Aviva's surveyor found no evidence of storm damage to the roof but identified signs of gradual deterioration and failed mortar. Aviva covered the internal water damage but refused to cover roof repairs. S argued that the one-off nature of the leak during a storm, with no recurrence despite subsequent rainfall, proved storm causation. The ombudsman upheld Aviva's refusal, finding that S failed to establish the storm caused damage to the roof structure itself, and that the evidence supported the conclusion that gradual deterioration allowed water penetration during the storm.

The Ombudsman's reasoning

The ombudsman distinguished between water penetrating the building during a storm (which was covered) and damage to the roof caused by the storm (which was not established). The key finding was that while a roof can be temporarily overwhelmed by heavy rain without visible damage, there was no reliable evidence that the storm caused damage to the roof structure itself. The surveyor's evidence of deteriorated mortar, wear and tear, and lack of any storm-related damage supported the conclusion that gradual deterioration allowed water to penetrate during the storm, rather than the storm causing damage to the roof. The burden was on S to establish a valid claim, and S failed to do so.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website