Partially upheld: claim decline and poor claim handling complaint against Lloyds Bank General Insurance Limited

Decision detail

Summary

Mr H claimed on his home insurance policy for water damage to his roof and bedroom following bad weather in January 2025. Lloyds declined the claim, stating the weather did not constitute a storm under the policy definition (windspeeds of 43-51 mph fell short of the 55 mph threshold, and rainfall of 14.3mm was below the 25mm torrential rain threshold). The ombudsman upheld the claim decline, finding the damage pattern (including pre-existing mould and cracking from 2018) indicated long-term water ingress rather than sudden storm damage, and no evidence supported Mr H's theory that an object had struck the roof. However, the complaint was partially upheld because Lloyds acknowledged and failed to adequately investigate the claim and communicate clearly with Mr H, causing unnecessary distress. The ombudsman directed Lloyds to pay £100 compensation for these service failures.

The Ombudsman's reasoning

The ombudsman applied a three-part test for storm damage claims: (1) was there a storm as defined by the policy, (2) is the damage consistent with typical storm damage, and (3) were storm conditions the main cause. All three questions were answered 'no'. Weather records confirmed windspeeds fell short of the 55 mph policy threshold. The damage pattern, including pre-existing mould and cracking from 2018, suggested long-term water ingress rather than sudden storm damage. The accidental damage section also would not apply as damage appeared to have built up over time and the policy excludes water ingress from lack of maintenance. However, Lloyds' claim handling was poor - they could have investigated more thoroughly and communicated more clearly, causing Mr H unnecessary distress.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website