Partially upheld: Motor insurance, claim handling complaint against SCOR UK Company Limited

Decision detail

Summary

Mr A claimed under his legal expenses insurance policy with SCOR for a dispute with his landlord regarding repairing obligations, including moth infestation and a blocked toilet. SCOR initially declined the claim without completing a full prospects assessment, but corrected this error within days by obtaining a proper assessment from panel solicitor R. R concluded the claim lacked reasonable prospects of success as there was insufficient evidence the landlord was responsible for the issues. The ombudsman upheld the complaint regarding the poor claim handling but not the decision to decline the underlying claim, awarding £200 compensation for the service failure.

The Ombudsman's reasoning

SCOR acted unfairly by declining the claim without first obtaining a full prospects assessment as required by the policy terms, although this was corrected within days. However, once a proper prospects assessment was obtained from qualified legal counsel, SCOR was entitled to rely on that advice to decline the claim, as the ombudsman does not reassess the merits of underlying claims but only whether the insurer acted fairly in obtaining and relying on qualified legal advice. The legal advice was not obviously wrong or based on factual mistakes.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website