Not upheld: claim denial / coverage exclusion / assessment of prospects of success complaint against AmTrust Specialty Limited
Financial Ombudsman decision DRN-6357395 of 2026-06-12T00:00:00+00:00. claim denial / coverage exclusion / assessment of prospects of success complaint against AmTrust Specialty Limited. Outcome: Not upheld.
Decision detail
| Reference | DRN-6357395 |
|---|---|
| Decision date | 2026-06-12T00:00:00+00:00 |
| Firm | AmTrust Specialty Limited |
| Product | Other regulated product |
| Claim type | claim denial / coverage exclusion / assessment of prospects of success |
| Outcome | Not upheld |
| Remedy | None. The complaint was not upheld. However, the ombudsman noted it remains open to Mrs M to provide further information to Amtrust on the value of the claim and how disruption resulted from the property damage, and expected Amtrust to review and seek further legal advice if such information is provided. |
Summary
B, a limited company represented by its director Mrs M, complained that AmTrust Specialty Limited wrongly declined a legal expenses claim arising from construction work that caused access problems to B's premises, including a fire exit being cemented shut. Mrs M sought to pursue claims for sexual discrimination, harassment, property damage, and against the local authority. Amtrust declined the claim, citing policy exclusions and lack of coverage for discrimination/harassment. For the property damage claim, Amtrust obtained a panel solicitor's assessment concluding the claim lacked proportionate prospects of success given the contractor's £400 offer. The ombudsman found that most claims fell outside policy coverage and that Amtrust reasonably relied on the qualified solicitor's assessment regarding prospects and proportionality for the property damage claim. The complaint was not upheld.
The Ombudsman's reasoning
The ombudsman applied the principle that for cover to be available, a claim must fall within one of the policy's insured events, with the onus on the policyholder to demonstrate this. For claims involving sexual discrimination, harassment, and the local authority, no insured event was identified. For the property damage claim, while an insured event existed under 'Property Legal Protection', the policy required reasonable prospects of success. The ombudsman found it reasonable for Amtrust to rely on a qualified solicitor's assessment that the claim lacked proportionate prospects given the £400 offer already made and the relatively minor nature of the damage. The assessment, though brief, provided clear reasoning and was produced by an experienced solicitor, making it reasonable to rely upon. Mrs M's subsequent claims about broader business impact were not further quantified or clearly linked to the property damage element covered by the policy.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| AmTrust Specialty Limited, all decisions | 140 | 30% |
| Other regulated product, all decisions | 52,408 | 30% |
Source
Read the original decision on the Financial Ombudsman Service website