Not upheld: Home insurance claim disputes complaint against Astrenska Insurance Limited trading as Collinson Insurance

Decision detail

Summary

Mrs L and Miss L claimed on their travel insurance policy following a serious car accident abroad, seeking reimbursement for medical treatment, lost belongings, alternative accommodation, and lost income. Astrenska Insurance Limited requested additional evidence to support the claim and declined to settle it in full, citing insufficient documentation and policy exclusions for UK-based expenses. Mrs L complained to the Financial Ombudsman Service, alleging regulatory failures, evidence tampering, and breach of policy terms. The ombudsman found that Astrenska's requests for evidence were reasonable and proportionate, that it is the claimant's responsibility to prove losses, and that UK medical expenses and accommodation are standard policy exclusions. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman applied the principle that it is the claimant's responsibility to demonstrate a valid claim under the policy by providing appropriate evidence of losses incurred, not the insurer's responsibility to prove the claim is invalid. The ombudsman found that Astrenska's requests for evidence were reasonable and proportionate, including medical records from the treating hospital abroad, details of accident circumstances, and evidence of lost items. The ombudsman noted that UK medical expenses and UK accommodation are standard exclusions in travel insurance policies and are not covered under the policy terms. The ombudsman found no compelling evidence of fraudulent conduct by Astrenska and was satisfied they handled the claim fairly with adequate regard for the claimants' vulnerability.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website