Upheld: Travel / life insurance claim disputes complaint against Haven Insurance Company Limited

Decision detail

Summary

Mr M took out a car insurance policy on 29 September 2025 and agreed to a declaration that he was not unemployed. When a claim arose from an accident the same day, Mr M told the claims handler on 2 October 2025 that he was unemployed and had been for a year. Haven declined the claim based on this alleged misrepresentation. However, the ombudsman found that Mr M was self-employed as a painter/decorator with evidence of active work during the policy inception period (23 September to 1 October 2025), making his declaration truthful at the time. The ombudsman upheld the complaint and required Haven to settle the claim in accordance with the policy terms.

The Ombudsman's reasoning

The ombudsman found that the employment declaration was part of the Statement of Fact, not the policy terms and conditions themselves. Applying the Consumer Insurance (Disclosure and Representations) Act 2012, the burden was on Haven to prove Mr M failed to take reasonable care as a reasonable consumer. The evidence showed Mr M was actively working as a self-employed painter/decorator during the period when he took out the policy (23 September to 1 October 2025), evidenced by an invoice and payment. Therefore, Mr M was entitled to agree to the declaration that he was not unemployed on 29 September 2025. The statement made on 2 October 2025 that he was unemployed was explained by the fact he no longer had work at that later date, but this did not retroactively make the earlier declaration false.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website