Upheld: unfair application of policy limits and excess complaint against HDI Global Specialty SE
Financial Ombudsman decision DRN-6383120 of 2026-05-26T00:00:00+00:00. unfair application of policy limits and excess complaint against HDI Global Specialty SE. Outcome: Upheld.
Decision detail
| Reference | DRN-6383120 |
|---|---|
| Decision date | 2026-05-26T00:00:00+00:00 |
| Firm | HDI Global Specialty SE |
| Product | pet insurance |
| Claim type | unfair application of policy limits and excess |
| Outcome | Upheld |
| Remedy | HDI Global Specialty SE directed to settle Mrs W's claim at £289.27. If HDI has already paid £129.27, it must pay the difference of £160. HDI must also pay interest on the claim settlement from the date Mrs W paid her vet to the date of reimbursement, calculated as simple interest using the time-weighted average method. |
Summary
Mrs W claimed £451.24 under her pet insurance policy for emergency out-of-hours veterinary treatment for her dog. HDI accepted the claim but only paid £129.27 after applying policy limits and a £160 excess. The ombudsman found that HDI incorrectly applied the policy limits before deducting the excess, contrary to FOS's established approach. The correct calculation requires deducting the excess first from the claimed amount, then applying policy limits and exclusions, resulting in a payment of £289.27. The complaint was upheld and HDI was directed to pay the difference plus interest.
The Ombudsman's reasoning
The FOS has a well-documented and published approach that insurers should deduct the excess and co-payment from the claimed amount before applying any policy limits. HDI applied the policy limits first and then the excess, which is not in accordance with this established approach. The correct calculation should deduct the £160 excess from the total claimed amount (£451.24) first, resulting in £291.14 payable, then apply the policy limits and exclusions to determine the final amount of £289.27.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| HDI Global Specialty SE, all decisions | 284 | 46% |
Source
Read the original decision on the Financial Ombudsman Service website