Upheld: irresponsible claim denial; misapplication of policy exclusion complaint against Intact Insurance UK Limited
Financial Ombudsman decision DRN-6359935 of 2026-06-09T00:00:00+00:00. irresponsible claim denial; misapplication of policy exclusion complaint against Intact Insurance UK Limited. Outcome: Upheld.
Decision detail
| Reference | DRN-6359935 |
|---|---|
| Decision date | 2026-06-09T00:00:00+00:00 |
| Firm | Intact Insurance UK Limited |
| Product | Home insurance |
| Claim type | irresponsible claim denial; misapplication of policy exclusion |
| Outcome | Upheld |
| Remedy | Intact must: (1) reconsider and settle the building claim in line with remaining policy terms; (2) reconsider and settle the contents claim in line with remaining policy terms; (3) add interest at 8% per annum from 1 February 2025 until settlement date; (4) pay £500 compensation for distress and inconvenience. Reimbursement will cover costs already expended by Mr A and Mr A for repairs. |
Summary
Mr A and Mr A claimed for storm damage after their late 1800s terraced home's roof collapsed under heavy snow in January 2025. Intact declined the claim, citing a policy exclusion for slow-acting damage such as decay, despite both surveyors acknowledging that snow was an operative factor in the collapse. The ombudsman found insufficient evidence of decay and determined that the policyholders could not have known of any such damage, particularly given recent roof refurbishment. The complaint was upheld, and Intact was directed to reassess and settle both the building and contents claims with interest and £500 compensation.
The Ombudsman's reasoning
The ombudsman acknowledged that where two contributing causes exist and one is excluded by the policy, businesses may fairly decline a claim. However, the ombudsman found that while the surveyor speculated about gradual decay, there was insufficient evidence of this. Critically, the ombudsman applied the service's approach of considering whether the consumer should have been aware of any damage occurring. Since two surveyors could not clearly demonstrate decay had occurred, and recent refurbishment had been undertaken to prevent water ingress, the policyholders could not reasonably have known of any decay. Therefore, it was not reasonable to decline the claim based on an excluded cause that was not clearly evidenced and of which the policyholders could not have been aware.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Intact Insurance UK Limited, all decisions | 197 | 37% |
| Home insurance, all decisions | 20,668 | 38% |
Source
Read the original decision on the Financial Ombudsman Service website