Fortegra Europe Insurance Company Ltd · DRN-5906979

The complaint Miss H complains that Fortegra Europe Insurance Company Ltd declined a claim for damage to furniture on her extended warranty. Where I refer to Fortegra, this includes its agents and claims handlers acting on its behalf. What happened In 2022 Miss H bought some furniture and took out an extended warranty, which provided cover for accidental damage. In January 2025 she made a claim on the policy, saying there had been an incident which caused damage to her sofa, but the claim was declined. Fortegra arranged for a technician to inspect the furniture and said this showed the damage was not a single incident of accidental damage, so it wasn’t covered. When Miss H complained, Fortegra maintained its decision, but acknowledged there had been some poor service and paid compensation of £100 for that. Our investigator said the decision to decline the claim was fair and so was the compensation for poor service. Miss H disagrees and has requested an ombudsman’s decision. 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. The relevant industry rules and guidance say insurers must deal with claims promptly and fairly, support a policyholder to make a claim, and not unreasonably reject a claim. The starting point when deciding whether the claim was declined fairly is the policy terms, which set out the terms of the insurance contract agreed between Miss H and Fortegra. The policy document sets out what the warranty covers as follows: “Important - The intention of the Cover The intention of the Plan is to provide: Cover for individual incidents of accidental staining and accidental damage… … The Plan does not cover for damage that naturally occurs due to normal use and ageing or for your product becoming gradually dirty and out of condition over time.” There are a number of exclusions, including: “accidental staining or accidental damage which has occurred at different times and has been allowed to accumulate/worsen.” “deterioration of the product’s appearance through normal use or general soiling, including but not limited to wear on high areas of traffic… over an extended period of time.”

-- 1 of 2 --

There is a summary of the above in the Insurance Policy Information Document (“IPID”). Having considered the policy wording and the evidence Fortegra relied on, I’m satisfied it was fair to decline the claim for the following reasons: • The policy terms are clear that cover is for individual incidents of accidental damage. • Miss H initially reported an issue in November 2024. The retailer arranged an inspection but said the damage was outside the initial 12 month warranty it provided and referred Miss H to Fortegra to claim on her extended warranty. • Nothing further happened until Miss H made a second claim in January 2025. It was this claim that led to Fortegra arranging an inspection and then declining cover. • The second report, arranged by Fortegra, is comprehensive and supported by photos. It highlights numerous issues and concludes these are not consistent with a single occurrence of accidental damage and are the result of misuse over time. • Miss H says there is a contradiction in the reports; the second report said the furniture was structurally broken, while the first technician told her there was no structural fault, but issues that were caused by overuse. • If that was a comment by the retailer’s technician, Fortegra wouldn’t have been aware of that. Its decision was based on the evidence it had. In any event, I think Miss H’s submissions are themselves contradictory. In her complaint, she said this was a single accident, but she reported more than one incident, and the comment from the retailer’s technician itself refers to issues caused by overuse – not a single incident causing accidental damage. • Overall, the evidence does not support Miss H’s claim this was a single incident but indicates various issues that occurred over time due to misuse, and the policy is clear that type of damage is not covered. • There was some poor service but Fortegra paid compensation of £100. Taking account of the time period involved and the impact of the delay, I think that was fair. My final decision My decision is that I don’t uphold the complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Miss H to accept or reject my decision before 13 May 2026. Peter Whiteley Ombudsman

-- 2 of 2 --