Not upheld: claim handling - downpipe repair coverage, excess payment timing, conflict of interest complaint against Intact Insurance UK Limited trading as RSA Insurance

Decision detail

Summary

Mr and Mrs S claimed for subsidence damage to their home caused by neighbouring trees. Intact arranged repairs through approved contractors but required payment of the £1,000 policy excess upfront, which Mr and Mrs S disputed. They also requested coverage for downpipe repairs and raised concerns about a potential conflict of interest between the tree surgeon and loss adjuster. The ombudsman found Intact acted fairly in requiring the excess before repairs, reasonably refused downpipe coverage as it was not damaged by subsidence and not necessary for stabilisation, and did not act unfairly regarding the alleged conflict of interest. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman applied the principle that insurance cover is limited to repairing damage caused by insured events, not preventing future damage. While stabilisation costs are covered as necessary for lasting repairs, the downpipe was not damaged by subsidence and was not required for stabilisation based on the loss adjuster's professional opinion. Regarding the excess, the ombudsman found the policy defines it as 'the first part of any claim' Mr and Mrs S must pay, supporting Intact's right to request it before repairs commenced. No conflict of interest was established that would have affected the claim outcome.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website