DRN-6156300

The complaint Mr R complains that Policy Excess Insure LTD trading as Nova Direct (“PEX”) declined a claim he made on his home emergency policy. What happened Mr R took out a platinum home emergency policy with PEX. This provided cover for emergency events occurring in the home in relation to plumbing and drainage, general leaks, electricity supply, boiler breakdown and primary heating system. In September he contacted PEX to report a leaking pipe. Mr R says he was told it wasn’t an emergency and an excess would apply. Mr R says he was also told boiler cover wasn’t part of the current policy but would be covered the following year. Mr R wasn’t happy with the service. He wants PEX to either honour the claim or refund the premium he paid. Because Mr R wasn’t happy he complained to PEX. PEX replied to say the boiler service cover was clear that it was provided on renewal of the policy. It said this was confirmed to Mr R prior to purchase of the policy. PEX didn’t uphold the complaint that Mr R was mis-sold the policy since it was a non-advised sale. Mr R wasn’t provided with any referral rights since PEX said the boiler service was out of this Service’s jurisdiction. Mr R referred his complaint to this Service as he remained dissatisfied with the response from PEX. Our Investigator considered the evidence and concluded that it was made clear prior to the purchase of the policy that the annual boiler service is offered following renewal of the policy. The Investigator hadn’t seen any information to suggest a boiler service was included and so she didn’t think the policy had been mis-represented. Mr R didn’t agree so the complaint has come 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. I should explain that I won’t be repeating the entirety of the complaint history here in my decision, or commenting on every point raised. Instead, I’ve focused on what I consider to be the key points that I need to think about in order to reach a fair and reasonable conclusion. This reflects the informal nature of this Service, and our key function; to resolve disputes quickly, and with minimum formality. However I want to assure both parties I’ve read and considered everything provided. Its clear Mr R feels very strongly that his complaint should be upheld. My role here is to assess whether I think PEX made a mistake or treated Mr R unfairly.

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I’ve considered the terms and conditions of Mr R’s policy. I need to consider these because the policy terms detail what was agreed between Mr R and PEX when the policy was purchased. And to see whether PEX acted reasonably I need to decide whether it acted in line with what was agreed. The terms and conditions say, “the boiler service benefit of your policy is undertaken upon renewal of your policy providing renewal is completed on an annual basis”. So when Mr R was told he would need to wait for renewal of the policy before he was eligible for the boiler service, I think he was advised correctly given the policy terms. When Mr R purchased the policy he was provided with details of the policy terms and conditions. He was also given access to his policy documents after he purchased the policy. So I’m satisfied Mr R was given the opportunity to review and consider the terms of the policy to check it was suitable for his needs. Mr R thinks PEX should have told him he wasn’t entitled to the boiler service in the first year and wants it to return his premium. But I think given the policy terms, it was clear from the outset that the service wasn’t included until renewal. I also haven’t seen anything to suggest the annual service was included from the policy outset. Mr R wants PEX to refund his premiums. But since he has had the benefit of the policy I don’t think it’s fair to ask PEX to refund those premiums. I’m sorry Mr R is disappointed that PEX doesn’t offer a boiler service in the first year of coverage. But I don’t think PEX has treated Mr R unfairly since it was made clear at the outset that the boiler service was only available on renewal of the policy. So I won’t be asking PEX to do anything further in respect of this complaint. My final decision My final decision is that I do not uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr R to accept or reject my decision before 14 May 2026. Kiran Clair Ombudsman

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