Not upheld: Home insurance claim disputes complaint against AWP P&C S.A.

Decision detail

Summary

Mr B claimed on his home emergency insurance policy after an electrical fault affected appliances and a fish tank in his home. AWP declined the claim as it did not fall within the policy's definition of a covered emergency. Mr B accepted AWP followed the policy terms but argued the policy wording did not cover genuine emergencies. The ombudsman found that the policy required a complete failure of the electricity system to trigger cover, but Mr B's situation involved only a partial failure (a 'split board' with half the board off power). Therefore, AWP acted fairly in declining the claim, and the complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that for cover to apply under the policy, there must be both a complete failure of the electricity system AND that failure must result in the home becoming unsafe/insecure, damaged, or losing main heating, lighting or water. Since there was no complete failure (lights were still working and only half the board was off power), the claim did not fall within the scope of cover provided. The ombudsman noted that while Mr B may consider his situation an emergency, the ombudsman can only assess cover against the actual policy terms and has no power to determine what insurers should cover.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website