Not upheld: unfair claim settlement valuation complaint against Aviva Insurance Limited

Decision detail

Summary

Miss R claimed on her landlord insurance policy for damage caused by a leak in April 2024. Aviva requested supporting documentation including a plumbing report and damage evidence, which Miss R did not provide, leading Aviva to close the claim in July 2024. In December 2024, Miss R resubmitted the claim with an invoice for £8,250 for works she had already completed. Aviva assessed the repairs and offered £1,244.44 based on what it would have cost its own contractors, citing concerns about the cost discrepancies. The ombudsman upheld Aviva's settlement as fair and reasonable, finding that Miss R should not have undertaken works without first obtaining Aviva's validation of the claim, and that Aviva's assessment methodology was appropriate under the policy terms.

The Ombudsman's reasoning

The ombudsman found that Aviva acted reasonably in assessing the claim based on its own contractor costs rather than reimbursing Miss R's actual expenditure, as this aligns with standard insurance policy terms. Aviva was entitled to request validation information before accepting the claim, and Miss R's failure to provide this documentation before undertaking works at her own cost was her responsibility. Aviva's attempts to understand the cost discrepancies were reasonable, and the absence of explanation from Miss R or her contractor justified Aviva's pricing based on available information. The ombudsman rejected the argument that Aviva should have appointed a loss adjuster, as it had not been given the opportunity to do so.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website