Upheld: Home insurance claim disputes complaint against Cigna Europe Insurance Company SA
Financial Ombudsman decision DRN-8275084 of 2018-01-15T00:00:00+00:00. Home insurance claim disputes complaint against Cigna Europe Insurance Company SA. Outcome: Upheld.
Decision detail
| Reference | DRN-8275084 |
|---|---|
| Decision date | 2018-01-15T00:00:00+00:00 |
| Firm | Cigna Europe Insurance Company SA |
| Product | Travel insurance |
| Claim type | Home insurance claim disputes |
| Outcome | Upheld |
| Remedy | Cigna Europe Insurance Company SA must settle Mr A's claim in line with the policy's remaining terms and conditions. Cigna must pay interest at 8% per year simple from the date of claim (September 2017) until the date of settlement. |
Summary
Mr A held travel insurance covering personal property damage. During an October 2015 diving holiday, he dropped and damaged his underwater flash gun but did not immediately seek repairs. In June 2017, a camera repair shop advised him to claim on insurance. Mr A contacted Cigna, was advised to get it repaired and submit the claim with an invoice, and did so in September 2017. Cigna declined the claim, requiring proof that damage occurred during the October 2015 holiday and citing the delay as prejudicial. The ombudsman upheld Mr A's complaint, finding the policy did not require corroborating evidence, Mr A's explanation was credible, and he had claimed as soon as reasonably possible after becoming aware of the coverage.
The Ombudsman's reasoning
The ombudsman found that Mr A provided a consistent and credible explanation for the damage and the delay in claiming. The specialist nature of the underwater flash gun (only used for diving) made it more likely to be damaged during the holiday than when packed away. Mr A's explanation for only becoming aware he could claim when advised by the repair shop was entirely credible. The policy did not require corroborating evidence or mandate a specific claims timeframe, only that claims be made 'as soon as possible'. Mr A made his claim as soon as he knew he could, satisfying this requirement. The delay would not have prejudiced Cigna's position regarding repair costs for this type of equipment.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Cigna Europe Insurance Company SA, all decisions | 11 | 23% |
| Home insurance claim disputes, all decisions | 25,682 | 38% |
| Travel insurance, all decisions | 7,644 | 37% |
Source
Read the original decision on the Financial Ombudsman Service website