Not upheld: claims handling - request for substantiation of costs complaint against Zurich Insurance Company Ltd
Financial Ombudsman decision DRN-6416229 of 2026-06-11T00:00:00+00:00. claims handling - request for substantiation of costs complaint against Zurich Insurance Company Ltd. Outcome: Not upheld.
Decision detail
| Reference | DRN-6416229 |
|---|---|
| Decision date | 2026-06-11T00:00:00+00:00 |
| Firm | Zurich Insurance Company Ltd |
| Product | Other regulated product |
| Claim type | claims handling - request for substantiation of costs |
| Outcome | Not upheld |
| Remedy | No remedy ordered. The ombudsman advised that should H provide the information Zurich has requested and mark it as commercially sensitive and confidential, Zurich should treat it appropriately. The ombudsman also stated that should H provide the requested information, the validated claim should be promptly paid. |
Summary
H, owner of 19 residential flats, claimed reimbursement from Zurich for costs incurred in relocating tenants after a six-day water supply outage. H used a third-party managing agent to arrange accommodation and submitted invoices with unit costs. Zurich requested itemised evidence of actual accommodation, food, laundry and travel costs, which H refused to provide, arguing this required disclosure of commercially sensitive vendor arrangements. H also complained of GDPR breach regarding information sharing with the managing agent. The ombudsman upheld Zurich's position, finding the policy covers actual accommodation costs not vendor fees, and that requesting substantiation is standard practice and fair. The ombudsman rejected the GDPR complaint as the managing agent already possessed the shared information and H had not marked information as confidential.
The Ombudsman's reasoning
The ombudsman found that Clause R1 covers the reasonable additional cost of comparable accommodation incurred by the lessee, not the fees charged by third-party vendors for outsourcing. The policy terms require supply of full details and evidence reasonably required for investigating and verifying claims. Zurich was entitled to request evidence of actual costs incurred (accommodation, food, travel) rather than unit prices charged by the vendor, as this is what the policy reimburses. Insurers have a duty to validate claims carefully to protect other customers and prevent inflated premiums. Requesting further information is standard practice. Regarding GDPR, the managing agent already possessed the shared information, and H did not mark information as commercially confidential when provided. However, if H provides further information marked as confidential, Zurich should treat it appropriately under ICOBS 2.5.1R.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Zurich Insurance Company Ltd, all decisions | 184 | 23% |
| Other regulated product, all decisions | 52,408 | 30% |
Source
Read the original decision on the Financial Ombudsman Service website