Not upheld: misrepresentation on insurance application; claim declined; exclusions added complaint against Allianz Insurance Plc
Financial Ombudsman decision DRN-6383190 of 2026-05-26T00:00:00+00:00. misrepresentation on insurance application; claim declined; exclusions added complaint against Allianz Insurance Plc. Outcome: Not upheld.
Decision detail
| Reference | DRN-6383190 |
|---|---|
| Decision date | 2026-05-26T00:00:00+00:00 |
| Firm | Allianz Insurance Plc |
| Product | pet insurance |
| Claim type | misrepresentation on insurance application; claim declined; exclusions added |
| Outcome | Not upheld |
| Remedy | None. The complaint was not upheld. The exclusions remain in place, backdated to the policy start date, and the claim remains declined. |
Summary
Mr I complained that Allianz Insurance Plc unfairly declined his pet insurance claim and added exclusions after his dog required surgery to remove a sock from her intestine in July 2025. Allianz alleged Mr I misrepresented his dog's medical history when taking out the policy in April 2025. During the phone application, Mr I initially disclosed no illness, then after prompting mentioned a 2022 sickness incident but failed to disclose multiple 2023 incidents of his dog eating socks and grass and vomiting, despite being directly asked about further incidents. The ombudsman found this constituted a qualifying misrepresentation under CIDRA, as Mr I should have disclosed the scavenging behaviour he was aware of, and Allianz would have added the exclusions if accurate information had been provided. The complaint was not upheld.
The Ombudsman's reasoning
The ombudsman applied the Consumer Insurance (Disclosure and Representations) Act 2012 (CIDRA), which requires consumers to take reasonable care not to misrepresent information. The ombudsman found that Mr I failed to disclose his dog's scavenging behaviour and multiple incidents of eating socks and grass followed by vomiting in both 2022 and 2023. Although Mr I disclosed one incident from 2022 after prompting, he explicitly stated there had been no further incidents when directly asked, which was inaccurate. The ombudsman rejected arguments that the questions were ambiguous or that Mr I lacked knowledge of the behaviour, noting that he was specifically asked about further incidents and should have disclosed what he was aware of. The ombudsman concluded this was a qualifying misrepresentation because Allianz would have added the exclusions for scavenging, gastrointestinal issues, and foreign bodies if accurate information had been provided.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Allianz Insurance Plc, all decisions | 2,436 | 19% |
Source
Read the original decision on the Financial Ombudsman Service website