Not upheld: claim decline - causation and policy coverage complaint against Acromas Insurance Company Limited

Decision detail

Summary

Mrs T complained that Acromas unfairly declined her home insurance claim for water damage to kitchen cupboards. Acromas declined the claim on the basis that the damage was not caused by a new insured event, noting Mrs T had made similar claims with previous insurers D and E. The ombudsman found that Mrs T bore the burden of proving the damage was caused by an insured event occurring while on cover with Acromas. Evidence showed the water problem was longstanding, dating back to 2021 with insurer D and with similar circumstances reported to insurer E in 2023. The ombudsman concluded Acromas' decision to decline the claim was reasonable and not upheld the complaint.

The Ombudsman's reasoning

The ombudsman found that as the policyholder, Mrs T bore the burden of demonstrating the damage was caused by an insured event which occurred while on cover with Acromas. The evidence showed the water problem was longstanding, with similar claims made to previous insurers in 2021 and 2023, predating or occurring outside the Acromas policy period. Therefore, Acromas' decision to decline the claim was reasonable and not contrary to available evidence.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website