Upheld: unfair claim decline based on strict interpretation of notification requirements complaint against AmTrust Specialty Limited
Financial Ombudsman decision DRN-6407826 of 2026-06-08T00:00:00+00:00. unfair claim decline based on strict interpretation of notification requirements complaint against AmTrust Specialty Limited. Outcome: Upheld.
Decision detail
| Reference | DRN-6407826 |
|---|---|
| Decision date | 2026-06-08T00:00:00+00:00 |
| Firm | AmTrust Specialty Limited |
| Product | Home insurance |
| Claim type | unfair claim decline based on strict interpretation of notification requirements |
| Outcome | Upheld |
| Remedy | AmTrust must: (1) reconsider Mr W's 2024 claim in line with the remaining terms and conditions of the policy, carrying out any further investigations necessary; (2) pay for the cost of any further inspections or investigations; (3) pay for repair or reinstatement costs where a defect causing damage is established and other policy terms are met; and (4) pay Mr W a further £1,000 in compensation for trouble and upset (in addition to the £500 already paid), totalling £1,500 compensation. |
Summary
Mr W purchased a new build property in 2017 with AmTrust warranty coverage. He reported various defects including water ingress and poor window installation in 2017 and 2019, within the required notification period. In 2024, he claimed for condensation and mould damage, but AmTrust declined the claim because he had not specifically mentioned condensation or mould within six months of the defects period ending. The ombudsman upheld Mr W's complaint, finding that his earlier reports of airtightness and watertightness issues constituted proper notification of the underlying defects causing the condensation and mould, as later confirmed by expert evidence. AmTrust was ordered to reconsider the claim and pay £1,000 additional compensation.
The Ombudsman's reasoning
The ombudsman reasoned that Mr W, as a domestic customer without expert knowledge, should not be required to identify the precise technical cause of defects or their long-term consequences at the time of notification. By reporting water ingress, poor window installation, and lack of airtightness in 2017 and 2019, Mr W had effectively notified AmTrust of the underlying defects causing the condensation and mould. Expert evidence later confirmed that the condensation issues were indeed caused by the poor window installation and loft insulation defects that Mr W had reported. It would be unfair and unreasonable to decline the claim solely because Mr W did not use the specific terminology 'condensation' or 'mould' or did not predict these consequences.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| AmTrust Specialty Limited, all decisions | 140 | 30% |
| Home insurance, all decisions | 20,668 | 38% |
Source
Read the original decision on the Financial Ombudsman Service website