Aviva Insurance Limited · DRN-6258080

The complaint D has complained about its property insurer Aviva Insurance Limited, regarding a subsidence claim raised with it in 2020. What happened In 2020, following some prior issues at the property and dealings with Aviva, D made a new subsidence claim. Aviva completed an inspection in August 2021 and D was so dissatisfied with the report which resulted, an extensive rebuttal was issued in February 2022. D also sent an expert report to Aviva for its consideration. In 2023 a ceiling at the property collapsed. In the meantime Aviva had closed the claim because D would not agree to monitoring of the property taking place. D became frustrated that Aviva was not responding on any matters. In 2024 D told Aviva it would be referring a complaint to the Financial Ombudsman Service. That contact seems to have prompted Aviva to open a new claim for D – it reviewed the prior correspondence and undertook to monitor the property. Monitoring concluded in January 2025 and Aviva reviewed D’s concerns about how the claim had been handled. On 28 March 2025 Aviva issued a final response letter (FRL) on D’s complaint about the progress of the claim(s). It felt it had handled things reasonably. It noted the property was confirmed to be stable and that the claim would now progress to the reinstatement phase (with a meeting in that respect due to take place in April 2025). D remained unhappy. It set out a substantial submission to this Service – detailing matters back to 2020 and sharing concerns it has about the extent of repairs Aviva has said it will undertake. D also shared a list of costs it feels Aviva should pay under the claim, not all of which it has agreed to. Our Investigator wasn’t persuaded Aviva had caused unreasonable delays in the claim. She felt it had acted reasonably, so she didn’t uphold the complaint. In summary, D said it was disappointed by the outcome. The complaint was referred to me for an Ombudsman’s decision. Having reviewed the complaint, I thought there were a couple of occasions where Aviva caused delay to this claim, and I didn’t think it had acted fairly when it insisted on a second claim being opened. So I set out a provisional decision to explain my views in these respects. But in my provisional decision, I also noted the main issue of concern for D is the repair of the property. And my provisional findings explained that, in that respect, I wouldn’t be issuing any comment. My provisional findings were: “This complaint was made before the claim formally moved into the reinstatement phase. And, crucially, before Aviva set the scope for repair which D is disputing. Whilst I’m aware of the site visit to discuss necessary repairs which occurred in April 2025, I won’t be getting into

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the issue of what repairs Aviva reasonably needs to include, or what costs it should pay, within this complaint decision. So this complaint will only consider the course of the claim between it being accepted by Aviva in late 2020 and its FRL dated 28 March 2025. Aviva hasn’t shared its loss adjuster’s activity file with this Service. So I make my assessment based on what D has said and I consider should reasonably happen in a claim like this. If I find fault with Aviva on that basis and it wants to tell me why its actions should be considered reasonable in the circumstances here, I’ll review. Aviva accepted the claim in November 2020. Its loss adjuster did not attend the property to undertake a site visit until August 2021. I’ve seen no good reason for that delay. Given the time of year the claim was accepted, I’d have reasonably expected a visit to take place before the end of January 2021. So I think there was a seven-month delay by Aviva here. After the visit, when the loss adjuster completed their report, I understand D contested the findings. From what D has said there was some exchange of correspondence in the latter half of 2021 and it was then February 2022 when D had completed a full rebuttal. I can understand this was an important issue for D which it needed to take time to carefully reply to. But I can’t fault Aviva for the necessary pause to proceedings which this caused. I understand that, after this, the claim became hopelessly deadlocked for two years. In short Aviva wanted to monitor the property – on the face of it that was not an unusual request in a subsidence claim, but D felt that wasn’t appropriate and understood that Aviva would not reassess the damage without an agreement to monitor. The claim then did not progress meaningfully until D threatened further action in 2024. Clearly both sides have totally opposing views about who was right and wrong in the matter of monitoring in 2022. But from everything I’ve seen – even if either side had taken on the opposing party’s views – I think the claim would still likely have needed to pause. So whether the pause which actually occurred between 2022 and 2024 was the result of a fault on Aviva’s part or not, a pause would always have been needed. This claim arose because of water flowing under the property. Seemingly that was stopped sometime prior to 2022. But D’s argument in 2022, against monitoring, was that monitoring would be worthless until such a time as the moisture levels in the soil had been given time to reach their natural equilibrium. So the claim always needed to pause in order to allow for that to occur. And because the soil was capable of recovering, this Service would have been unlikely to say Aviva should have moved to an engineering solution at the property. Such is usually viewed as an option of last resort where a property can’t be stabilised, or isn’t likely to stabilise, by implementing other less invasive methods. As such, recovery of the ground, and the time that takes, is often a key element of many subsidence claims. So it seems to me that the pause until 2024 was necessary and, regardless of why it actually occurred, would always have needed to occur. When matters resumed in 2024, Aviva required a new claim to be opened, I’m not satisfied that is fair. This was the same claim. A new system ‘record’ might have been necessary, and if that is all Aviva did then I see no harm in that. But D should not have a second claim on its insurance record. If a second claim has been logged then Aviva will have to amend its own and any external databases to show just the one claim from 2020 – not one from 2020 and a second from 2024. Aviva should write to D confirming that since the start of 2020 D has made only one claim for subsidence – that recorded in 2020. To resume my timeline assessment – I understand it was February 2024 when D sent Aviva a revised version of its 2022 rebuttal. Aviva’s loss adjuster then attended the property in May 2024. I’ve no idea why that visit was so delayed – I’d have expected a relatively short

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period for review and arrangements to be made. The visit, I think should have taken place by the end of March 2024. So that is a two-month delay by Aviva. After the visit, it was decided monitoring would be needed. That began in July 2024, I think that was a reasonable period, and until that monitoring completed in January 2025, the claim couldn’t reasonably progress. I don’t think Aviva caused any delay during this period. Shortly after the monitoring completed D made its complaint to Aviva. And Aviva’s March 2025 final response letter considered what had happened in the claim journey – although in a very brief way – and confirmed a visit to the property to address the scope of repairs had been agreed. I’m satisfied that Aviva did not cause a delay in this period. As I’ve said above, I can’t get into the extent of the repair scope in this complaint. So, having considered the key movement markers in the course of this claim, I think Aviva has caused about nine months of delay in total. D is a company. Which means I can only take into account any inconvenience Aviva’s failings have caused it. I haven’t seen much detail about how D was affected – but I bear in mind that D, as a business, is not a working entity or professional trader. But I appreciate that, given the purpose of D, dealing with this claim over this unreasonably protracted period will likely have had some impact on the other commitments D needs to manage. So I accept some level of inconvenience has resulted. I’m minded to award £500 compensation.” Aviva confirmed it had only recorded one claim. It said it hadn’t caused any delays. It sent a word document of notes it had made from its files to help support that view. D replied at length. Amongst other things, D said it was “jaw-dropping” that I had chosen not to deal with the repair issues and costs. D also said that the real issue here was always the “criminal evasion and deception practiced by Aviva/[its loss adjuster]”. 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. Aviva has confirmed its loss adjuster had to set up two claims on its system, purely for billing purposes. Aviva itself has said it dealt with it as a single claim. I’m satisfied that is fair, I’ve adjusted my suggested award to account for Aviva just confirming this to D in writing (for D’s records). I’ve reviewed the word document Aviva has provided, it hasn’t changed my mind that Aviva caused some delays here. At the very least it, as the expert insurer, could most likely have handled matters better to avoid lengthy delays occurring. I can see D is very concerned about the repair, and the costs incurred which it feels Aviva should pay as part of the claim. But, as I’ve explained, I can’t get into those matters here. That is not to say this Service can’t consider a complaint for D about the activity which occurred after Aviva’s 28 March 2025 FRL. Including in respect of any scope or offer of settlement for repairs which has been made. If D complains to Aviva about that, once Aviva has issued an FRL (or eight weeks passes without it having done so), D’s complaint can come to us for our consideration. But, in this complaint I can only consider what happened up to the date of Aviva’s 28 March 2025 FRL.

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I know D says that could still include what is needed for repairs because there was a repair scope completed by Aviva in 2021, which was the focus of D’s 2022 rebuttal. I understand why D then thinks I could consider that – because that was activity which occurred during the period I am considering. However, that repair scope did not result in a complaint at that time, and when D did make its complaint to Aviva in 2024, the situation at the property had moved on and monitoring then took place. Aviva then agreed to review what was needed for reinstatement, based on the evidence then available. And that review occurred after the March 2025 FRL which is the point up to which I can consider in this decision. It is worth remembering that this Service is an independent dispute resolution service. We are not the regulator. It is not part of our role to punish a financial business, or to make awards which are intended to punish. Nor do we make findings about alleged criminal activity. Our role is to review what has happened between an insurer and its policyholder. Where an insurer uses an agent, such as a loss adjuster, anything the loss adjuster does the insurer is responsible for. So any delay or poor handling etc. by the loss adjuster is a failure of Aviva’s. I’ve reviewed what happened in this claim between Aviva and D. And I set out provisionally my views on the failures I felt Aviva had made which had materially impacted the claim journey. I’ve since reviewed matters in light of the parties’ responses to my provisional findings. My provisional view on the complaint has not changed. Putting things right I require Aviva to: • Provide a letter to D confirming that its own and any external industry database show only one claim was made in 2020 – not one in 2020 and then another in 2024. • Pay D £500 compensation. My final decision I uphold this complaint. I require Aviva Insurance Limited to provide the redress set out above at “Putting things right”. Under the rules of the Financial Ombudsman Service, I’m required to ask D to accept or reject my decision before 24 April 2026. Fiona Robinson Ombudsman

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