Upheld: Home insurance claim disputes complaint against Aioi Nissay Dowa Insurance UK Limited
Financial Ombudsman decision DRN-6465357 of 2026-07-01T00:00:00+00:00. Home insurance claim disputes complaint against Aioi Nissay Dowa Insurance UK Limited. Outcome: Upheld.
Decision detail
| Reference | DRN-6465357 |
|---|---|
| Decision date | 2026-07-01T00:00:00+00:00 |
| Firm | Aioi Nissay Dowa Insurance UK Limited |
| Product | Other regulated product |
| Claim type | Home insurance claim disputes |
| Outcome | Upheld |
| Remedy | Aioi must: (1) settle the claim by arranging repair at a repairer of its choice; (2) provide a courtesy or hire car for the duration of repairs; (3) pay £100 for fuel costs; (4) pay £200 compensation for distress and inconvenience; (5) reimburse £60 for the estimate plus 8% per annum simple interest from date paid to date of payment. |
Summary
Ms F claimed under her Vehicle Minor Damage Insurance policy for repair of a dent in her car door. Although Aioi accepted the damage met the policy definition of 'Minor Damage', it limited payment to £250, arguing the repair required bodyshop methods outside cosmetic repair techniques. A manufacturer-approved bodyshop estimate was £1,577.81. The ombudsman found the policy definition of 'Cosmetic Repair' was unclear and unhelpfully worded, and that a reasonable interpretation would cover the repair methods needed. The complaint was upheld and Aioi was required to settle the full claim, provide a courtesy car, pay fuel costs, compensation, and reimburse the estimate fee with interest.
The Ombudsman's reasoning
The ombudsman concluded that the policy definition of 'Cosmetic Repair' was unclear because the techniques mentioned were not defined or explained in the policy document. A reasonable interpretation of this definition in its widest sense would cover the repair methods needed for Ms F's car. The damage to the door could be repaired using cosmetic repair techniques, and the removal and replacement of a trim does not constitute 'replacement of a part' in the ordinary everyday meaning. Aioi was not entitled to rely on policy exclusions to decline the claim.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Aioi Nissay Dowa Insurance UK Limited, all decisions | 58 | 38% |
| Home insurance claim disputes, all decisions | 24,376 | 38% |
| Other regulated product, all decisions | 51,462 | 30% |
Source
Read the original decision on the Financial Ombudsman Service website