DRN-6151316

The complaint Mrs R has complained about that esure Insurance Limited failed to properly investigate a third party claim made against her car insurance policy. Mrs R is being represented by the named driver Mr S in her complaint. For ease I will refer to Mr S on Mrs R’s behalf in my decision. What happened Mr S reported being involved in an incident with a third party vehicle (TPV) in January 2023 to Mrs R’s insurer esure. In June 2024 esure notified Mr S that it had closed the claim as a notification only incident. However, in September 2025 esure received a request from the TP Insurer to recover their payment for the total loss value of the TPV. esure reopened the claim and settled the TP claim in full. It closed the claim as a fault claim. Mr S complained to esure as he said the incident was a multi vehicle incident where two other vehicles had collided into the TPV before Mr S made minor contact with the rear of it. Mr S said there were icy conditions and this had led to multiple cars skidding into each other. Mr S said his car was the last car to make contact with the TPV which had already incurred damage elsewhere. Mr S said he had text messages between him and the TPV driver from January 2023 confirming that the TPV had been hit by other cars before Mr S’s collision. Although esure asked Mr S to provide the text messages for further investigation, it didn’t uphold Mr S’s complaint. It said as Mr S hadn’t taken photos of the TPV at the time, and hadn’t taken details of the other drivers that had collided with the TPV, there was no evidence to show that esure’s decision to settle the claim was wrong. esure said irrespective of the claim amount, the claim was correctly recorded as a fault claim as Mr S said he made contact with the rear of the TPV. Mr S disagreed with esure’s decision to pay the total loss settlement requested by the TP. He said his car was the last to make contact with the TPV and this was confirmed by the TP in the text messages provided. He remained unhappy that esure hadn’t shown it had properly investigated the claim to establish the extent of the damage caused by the impact of Mr S’s car. Mr S said his complaint was not about liability, but about the investigation esure had failed to carry out in deciding to pay the settlement it did. One of our Investigators issued two views. In the first, he didn’t recommend the complaint should be upheld. But when Mr S disagreed, the Investigator reviewed the information again and decided that esure hadn’t shown it had properly investigated the claim. So he recommended esure reopen the claim with the assistance of an engineer’s opinion as to the extent of the damage caused by Mr S’s car. And he recommended esure change the

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status of the claim on central databases to show liability remained in dispute – until the extent of liability is determined. Mr S accepted the Investigator’s view. esure doesn’t agree and wants an ombudsman to decide. In summary esure says; • The claim costs make no difference to the outcome for Mr S as the claim will be recorded as a fault claim and the No Claims Discount and premium will be affected. • Mr S didn’t provide details of the other drivers for it to pursue claim costs from. • The main issue is Mr S’s vehicle made contact with the TPV. So the case has been passed to me to decide. What I’ve decided – and why I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. As the Investigator explained, we don’t decide liability. This is the role of the courts. But we can look at whether an insurer properly investigated a claim and reached its decision in a reasonable way and in line with the policy. Like most if not all other standard motor insurance policies I’ve seen, esure’s policy says it can take over the defence and settlement of a claim in Mr S’s name. This means esure may make a decision Mr S doesn’t agree with, but the policy allows esure to do so. We don’t disagree with this term in principle provided an insurer shows it treated its customer fairly when applying it. In this case, I cannot see what information Mr S gave as to the circumstances of the incident. The claim notes provided by esure do not set out what Mr S said. From other information given by both parties, it is agreed that Mr S made contact with the rear of the TPV. And it is accepted that Mr S didn’t take photos of the vehicles at the scene. esure provided a copy of a letter from solicitors representing the TP insurer dated 22 September 2025. The solicitor requested recovery of the insurer’s outlay under the claim for £3,745. esure also provided a copy of a breakdown from the TP insurer of the costs. I note the following within this document: The market value for the TPV was £3,745 after a deduction for salvage. The damaged area was recorded as to the rear centre, and the severity was described as; “small dents/scratches”. The date of the report the TP insurer was relying on was dated 8 January 2024, which was almost a year after the date of the incident. I haven’t seen a copy of the report mentioned. Images provided by esure of the TPV show significant damage to the passenger side of the car. There is no reference made to this within the TP Insurer’s claim for costs – nor is there any clarification that this damage was pre-existing and therefore deducted from the market value settlement. This seems inconsistent with the area of damage set out in the breakdown provided by the TP Insurer, and with the severity reported. I have seen a copy of the text messages Mr S provided esure with. These shows that on the morning after the incident, the TP driver asked Mr S for his insurance details. Mr S offered to pay for the “tiny crack” he said he had caused. In response, the messages show the TP stated he had been hit three times and the damage to the side of his car was substantial – and that his insurer had asked him to provide details of all three cars.

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So, taking into account the information that was available to esure, I don’t find it properly investigated the extent of the damage Mr S was liable for. There are inconsistencies in the information provided by the TP Insurer to support their claim for costs equivalent to the market value of the TPV. I think when esure was made aware of the text messages in September 2025 it should have acted promptly in investigating the matter further, but it didn’t. So it follows that I don’t find esure reached its decision as to how it settled the claim in a reasonable way. Mr S says he was the last vehicle to make contact with the TPV. It is for esure to properly investigate the extent of Mr S’s liability in the incident and demonstrate that it has treated Mr S fairly when doing so. Some insurers apply a rating depending on the claim costs. So it isn’t correct for esure to say that the claim costs will make no difference to the outcome for Mrs R and Mr S when future premiums are calculated by insurers across the market. I am upholding the complaint in line with the remedy set out by the Investigator. To clarify, while a claim is open it is treated as a fault claim and the impact on a customer’s NCD will be as though it were a fault claim. As it is accepted by both parties that Mr S has some liability as he made impact with the rear of the TPV, the outcome of this information recorded on databases will not change. But the amount of the claim costs is the issue which should remain open while esure carries out a proper investigation. My final decision My final decision is that I uphold this complaint. I require esure Insurance Limited to do the following: • Properly investigate the extent of Mr S’s liability in the incident and demonstrate it has treated him fairly when reaching its decision. • Update all databases to show the claim amount is in dispute. Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs R to accept or reject my decision before 13 May 2026. Geraldine Newbold Ombudsman

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