Partially upheld: unfair claim decline and unnecessary inconvenience complaint against Great Lakes Insurance UK Limited

Decision detail

Summary

Mr and Mrs W claimed for storm damage to a boundary garden wall caused by storm Eowyn in January 2025. Great Lakes declined the claim based on pre-loss condition, citing 2022 online photos showing deterioration including cracking and outward movement. Mr and Mrs W provided an engineer's report arguing the wall was in fair condition and the damage was caused by a fence blown into it by high winds. The ombudsman found the wall's pre-existing deterioration was the underlying cause of damage, making the claim decline reasonable. However, the complaint was partially upheld because Great Lakes unnecessarily requested repair quotes before declining, causing Mr and Mrs W significant inconvenience in obtaining quotes. The ombudsman awarded £100 compensation for this unnecessary hassle.

The Ombudsman's reasoning

The ombudsman applied the three-question test for storm damage claims: (1) did storm conditions occur - yes, wind speeds exceeded 55mph threshold; (2) is damage consistent with typical storm damage - yes, fence blown down causing further damage is typical; (3) was storm the main cause - no, the wall's pre-existing deterioration was the underlying cause. The 2022 photos clearly showed deterioration including cracking, spalled bricks, and outward movement. A properly constructed wall in good condition should withstand the recorded wind speeds. A relatively lightweight fence should not cause such damage unless the wall was already weakened. The deterioration resulted from wear and tear, which is excluded under the policy. However, Great Lakes caused unnecessary inconvenience by requesting repair quotes when it could have declined the claim immediately based on available online photos.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website