DRN-6291119

The complaint Mr B complains about how Intact Insurance UK Limited has handled a claim on his buildings insurance policy. Throughout the claim and complaint process, Mr B has had a representative helping him. In this decision, any reference to Mr B includes the actions and comments of his representative. What happened The events of this complaint are well known to both parties so I won’t repeat all the details here. In summary, Mr B suffered subsidence at his property and raised a claim. The claim was accepted. Mr B has raised several complaints at different times with Intact. Mr B is unhappy with how the claim has been handled. He brought the complaint to this service. Our investigator didn’t uphold Mr B’s complaint. He didn’t think Intact’s complaint outcome was unfair or unreasonable. Mr B appealed. As no agreement could be reached, the complaint has been passed to me to make a final decision. Because I disagreed with our investigator’s view, I issued a provisional decision in this case. This allowed both Intact and Mr B a chance to provide further information or evidence and/or to comment on my thinking before I made my final decision. What I provisionally decided – and why I previously issued a provisional decision on this complaint as my findings were different from that of our investigator. In my provisional decision, I said: “I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. Based on what I’ve seen so far, I don’t intend to uphold Mr B’s complaint. When considering complaints such as this, I need to consider the relevant law, rules and industry guidelines. The relevant rules, set up by the Financial Conduct Authority, say that an insurer must deal with a claim promptly and fairly, and not unreasonably decline it. So, I’ve thought about whether Intact acted in line with these requirements with how they’ve handled Mr B’s claim. At the outset I acknowledge that I’ve summarised his complaint in far less detail than Mr B has, and in my own words. I’m not going to respond to every single point made. No discourtesy is intended by this. Instead, I’ve focussed on what I think are the key issues here. The rules that govern the Financial Ombudsman Service allow me to do this as it’s an informal dispute resolution service. If there’s something I’ve not mentioned, it isn’t because I’ve overlooked it. I’m satisfied I don’t need to comment on every individual point to be able to reach an outcome in line with my statutory remit. As a starting point, I need to set out the remit of this complaint. As set out above, Mr B has

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raised several complaints with Intact. As a service, we can only look into complaints brought to us within six months of a written response from the financial firm. In this case, only one of the final response letters were brought to us in this time period. So, I can only deal with complaint points raised between 13 April 2024 and 20 November 2024. Mr B has raised four main points for this service to look into. These were as follows: Damage to front wall Intact declined to cover damage to the front wall as they didn’t believe the issues were caused by subsidence. Intact believe the damage was caused directly by roots and vegetation. Mr B disagrees and says that as it’s been accepted there’s subsidence, it must have also caused the damage to the wall. I’ve considered the evidence from both sides and I don’t think it’s unreasonable for Intact to have declined this part of the claim. Whilst it has been accepted that subsidence was the cause of damage to Mr B’s property, I don’t think this would mean it had to also be the cause of the damage to the wall. Intact has provided photos showing damage to the pavement next to the wall caused by root growth. This damage is very close to the wall. Mr B has said the onus is on Intact to show that subsidence isn’t the cause of the damage. However, this isn’t correct. The onus is first on the policyholder to evidence they have a valid claim under the policy caused by an insured peril. As stated above, whilst this has been shown for subsidence damage to the property, I don’t think this automatically means this is the same for the wall when there is another potential peril which isn’t insured. Overall, based on what I’ve seen, I’m not persuaded that Intact have unfairly declined this part of the claim. Should Mr B provide further evidence for the damage to the wall, I’d expect Intact to assess this further. Water ingress from garage/utility roof Intact declined to cover this issue due to wear and tear. Mr B has said that it’s leaking after Intact had completed some repairs on it. However, Intact addressed this issue in their final response letter on 12 April 2024. So, this complaint point has been brought out of time and can’t be considered. Should Mr B want to dispute this being brought out of time, he can let me know and I’ll issue a separate full response considering this point. Refund of professional advice fees On considering this point, I couldn’t see that a complaint had been raised about it. Intact has said they didn’t think it had been raised with them. However, Mr B has provided an email chain with Intact’s complaints team from March 2025. In one of the emails, Mr B said: “I am compiling my seemingly ever increasing list of complaint issues for submission to The FOS…I also note you have made no comment about reimbursement of our Chartered Surveyors invoice costs which we were forced to incur in light of the maladministration handling of our 9 years of waiting for our claim to be settled fairly.” Based on the email chain, I do think the professional advice costs have been raised. As eight weeks have passed since being raised, this is a point I think this service can consider. Mr B has paid a significant amount of money to his representative to help him with the claim. Mr B wants Intact to refund him what he’s paid the representative.

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Hiring an expert to help with handling a complex claim is something policyholders often do. This isn’t an insured cost covered under the policy and would need to be paid for by the policyholder. There are free to use services, like this service, which can be used when there is a dispute with a financial firm. In some circumstances we may tell an insurer to help cover these costs, but this would usually only be when we’re upholding a complaint because the insurer has incorrectly declined part of a complaint. However, this hasn’t happened here. So, based on the circumstances, and whilst it will be a disappointment to Mr B, I don’t think Intact need to cover his professional advice costs. Maladministration of claim Intact have accepted there were delays from 13 April 2024 to 20 November 2024. They offered Mr B £450 compensation for the trouble and upset caused. I appreciate that it must have been frustrating for Mr B to have to have significant delays which have meant the repairs have had to be put back. Mr B would also have had to chase it up, taking up his time. Although this is a distilled version of events, I’ve considered everything in the round and I think Mr B has been caused considerable distress, upset and worry which has taken a lot of extra effort to sort out over several months. In line with our website guidelines, I think the £450 compensation is fair and reasonable in the circumstances.” Therefore, I wasn’t minded to direct Intact to do anything further as I thought the compensation they had already offered was reasonable. Responses to my provisional decision Intact didn’t respond to the provisional decision by the deadline. Mr B confirmed he didn’t agree with my provisional decision. He provided further comments on the damage to his wall. He also confirmed that he wasn’t unhappy about the limitations to roof repairs, he was unhappy with the repair work that actually took place. This was after the previous final response letter and provided evidence to support it. Mr B’s response didn’t change my outcome on the damage to his wall. However, I did think the roof repairs were something this service could review. I wrote to both parties to provide a further outcome and provided them with sufficient time to come back to me. I said the following: “I haven't seen that a further review has taken place to inspect the work completed by Intact’s contractors to confirm if the water ingress was caused by defective work or the wear and tear issues not covered by the claim. So, to put things right, I intend to instruct Intact to complete an inspection and produce a report confirming the cause of the water ingress. I also intend to award Mr B an additional £200 compensation due to the distress and inconvenience caused in not doing this sooner.” Intact responded and advised they hadn’t been able to get a response from their contractors, so were unable to provide any further comments. Mr B accepted the compensation and for a review to take place. Although he confirmed he’d had the repairs now completed himself but had photos of before and after. Mr B confirmed he accepted my outcome on the damage to his wall but he still wanted me to consider the costs associated with his adviser.

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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’ve thought carefully about the responses to my provisional decision. Having done so, while I appreciate it will come as a disappointment to both parties, my conclusions remain the same. I’ll explain why. Mr B has accepted my finding on the garden wall and hasn’t disputed my outcome on the maladministration of the claim, so I won’t cover these further. Mr B has also accepted my outcome on the water ingress of the garage/utility roof. I can’t consider the repair costs in this decision as Intact need the opportunity to review the work first. Should Mr B remain unhappy following Intact’s review, Mr B will be able to raise this as a new complaint. Whilst I have now upheld part of the complaint, I don’t think this was due specifically to reasoning provided by Mr B’s adviser. As set out in my provisional decision, this service is free to use and Mr B could have brought the complaint to us without employing a representative to help. I appreciate insurance claims can be complex and policyholders may want to employ someone to help them, however this isn’t covered by Mr B’s policy and would be at his own cost. In the circumstances of this complaint, I don’t think Intact should cover the costs of Mr B’s adviser. Putting things right To put things right, Intact should do the following: - Pay Mr B a total of £650 compensation. - Conduct a review of the work completed to Mr B’s garage/utility roof. My final decision For the reasons I’ve explained above, I uphold this complaint and direct Intact Insurance UK Limited to put things right by doing as I’ve said above, if they haven’t already done so. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr B to accept or reject my decision before 12 May 2026. Anthony Mullins Ombudsman

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