Not upheld: claim recording and classification complaint against esure Insurance Limited

Decision detail

Summary

Mr G complained that esure recorded his motor insurance claim for tree damage as a 'fault' or 'bonus disallowed' claim, which he believed was misleading since he was not at fault for the incident. He argued this recording caused his premiums to increase and reduced his access to competitive quotes. The ombudsman found that the 'fault' label accurately means 'claim cost not fully recovered' rather than apportioning blame, which is standard industry practice and understood by other insurers. The ombudsman concluded that esure acted fairly, consistently with its policy terms and good industry practice, and did not uphold the complaint.

The Ombudsman's reasoning

The ombudsman found that the 'fault' label, while potentially concerning to policyholders, accurately reflects the underlying meaning of 'claim cost not fully recovered' rather than apportioning blame. This is consistent with good industry practice and widely understood throughout the motor insurance market. Recording the claim as 'non-fault' would be inaccurate as claim costs were not fully recovered. Other insurers understand this meaning and will factor it into their risk assessments. esure acted in line with its policy terms, good industry practice, and the Consumer Duty.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website