Fortegra Europe Insurance Company Ltd · DRN-6232217

The complaint Mr R has complained Fortegra Europe Insurance Company Ltd declined a claim he made on his breakdown assistance insurance policy and cancelled the policy. Where I refer to Fortegra below, I also include the actions of their agents. What happened Mr R took out a breakdown policy with Fortegra in July 2025 to cover him during his trip to France. He travelled over 900km across France to the town where his accommodation was. He said he heard an unusual noise, so he took his vehicle to a local garage. The garage couldn’t repair the vehicle that day, and Mr R drove it to his accommodation. Mr R said the vehicle made a noise and lost oil, so he made a claim on his breakdown policy. Fortegra declined the claim because Mr R’s vehicle was already seen by a garage. They also cancelled the policy and told Mr R he would need to pay a cancellation fee. Mr R complained to Fortegra and told them he expected them to pay more than £2,400 in travel and vehicle repatriation costs, confirm the cancellation fee wouldn’t be charged, and compensate him for distress, disruption and loss of enjoyment. In their complaint response, Fortegra agreed to waive the cancellation fee, but said they weren’t told about the breakdown until it had already been identified, garage attention sought, and the vehicle continued to be driven. They maintained the exclusion applied. Mr R referred his complaint to this Service, but the Investigator didn’t uphold it. The complaint couldn’t be resolved, so it came to me to decide. I wrote to both parties to let them know I didn’t think it was fair for Fortegra to rely on the exclusions they did. I said had they fairly covered the claim, I thought it was likely Fortegra would have opted to pay for hotel costs under the policy. And I said I would likely be directing Fortegra to pay these costs and £200 compensation. Fortegra accepted my recommendation. To help me calculate appropriate redress, I asked Mr R to send me evidence of the hotel booking he made while waiting for his vehicle to be repaired in France. But he didn’t respond. 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 ours is an informal service, I’m not going to comment on every point or piece of evidence Mr R and Fortegra sent us. Instead, I’ve focused on what I consider to be key or central to the complaint. But I’d like to reassure both that I have considered everything submitted. Fortegra has an obligation to handle claims promptly and fairly – and to not unreasonably decline a claim. I don’t think they’ve met these obligations and I’ll explain why. Mr R’s policy includes European Cover which covers assistance if his vehicle breaks down during a trip in Europe. It says if this happens, and a temporary repair isn’t possible, Fortegra will arrange for Mr R’s vehicle to be taken to the nearest suitable garage.

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It continues that if Mr R’s vehicle is recovered to a suitable garage and repairs can’t be carried out on the same calendar day, then, provided services were requested at the same time as the breakdown, Fortegra will pay for one of: • Rail travel for Mr R and up to four passengers to a destination in Europe – plus a return journey for someone to collect the vehicle upon completion of repairs; • The cost of up to three night’s hotel accommodation while the car is being repaired; • The cost of a car hire for up to seven days while the car is being repaired; • Or, in the event the vehicle can’t be repaired within seven days, Fortegra can consider repatriating the vehicle back to the UK. The policy says these options are on a reimbursement basis only and will not be paid for in advance by Fortegra. There are limits on cover for each option. So, If Mr R’s vehicle can’t be repaired at the roadside, Fortegra will cover the cost of taking it to a local garage. And if the garage deemed repairs would take more than one day, the policy covers Mr R for certain onward travel or expenses while waiting for the vehicle to be repaired. It isn’t in dispute Mr R’s vehicle broke down. But Fortegra has referred to two exclusions when explaining why they declined the claim. The first says Fortegra won’t pay for any claim where the policy is being used by the policyholder to avoid the cost of repairing or recovering Mr R’s vehicle. The second says Fortegra won’t cover any vehicle which is already at a garage or other place of repair. Fortegra said following notification of the breakdown and them arranging one of their agents to collect the vehicle, it was established that the breakdown had already been identified; garage attention sought; and the vehicle continued to be driven. From what I’ve seen, I don't think Mr R was trying to avoid repairing his vehicle – he took it to a garage before it broke down, and he wanted to have it repatriated to the UK to repair it. So, I think it’s likely he intended to repair it at his own cost. And I can’t see how he was trying to avoid recovering it either - he was willing to have it recovered to the garage local to him and just because the garage couldn't repair it straight away, it doesn't mean he was attempting to avoid taking it there himself. So, I don’t find that the first exclusion reasonably applies. The definition of 'breakdown' in the policy is where the vehicle is immobile and has ceased to function as a result of a mechanical failure. There's no dispute about whether Mr R’s vehicle broke down, and it wasn’t at the garage when it ceased to function, it was parked at his accommodation. So, I don’t think the second exclusion reasonably applies either. Since I don't think Fortegra demonstrated the exclusions reasonably apply, I don’t think it was fair to rely on them to decline the claim. I’ve gone on to think about what would have happened if the claim had been covered. Mr R sent me an invoice from a friend of his who recovered the vehicle from France. The invoice implies the friend came to the French garage local to Mr R’s accommodation with a new gearbox and that Mr R had the vehicle repaired there. When someone claims on the ‘Onward Travel in Europe’ section of the policy, one of the options available to Fortegra is to pay for hotel costs for up to three nights for him and up to four passengers while his vehicle is being repaired. The policy says it’s limited to a maximum of £40 per person or £600 in total. And I think it’s likely in the circumstances Fortegra would have opted to pay for Mr R’s hotel as this was more likely than not the most cost-effective solution. So, I’m directing Fortegra pay those hotel costs up to what the policy allows. I’ve asked Mr R to send me evidence to show how many nights he stayed there and the cost per person, but he hasn’t

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replied, so Fortegra can request this from Mr R before they pay this. For completeness, I don’t think it was fair for Fortegra to cancel the policy nor to charge any cancellation fee in the circumstances. But Fortegra have waived the fee they were intending to charge and there would have been no further incidents Mr R to claim for. I do think the unnecessary cancellation would have caused Mr R confusion and additional distress when they asked him to pay a cancellation fee instead of covering the claim. Mr R suffered distress and inconvenience in dealing with the declined claim when Fortegra should have accepted it and paid certain costs. In recognition of this and the cancellation of the policy, I’m directing Fortegra pay Mr R £200 compensation. I appreciate the situation with his vehicle and additional expenses in returning home will have also caused him distress and inconvenience, but considering the scope of the policy is limited, I’m satisfied this would have happened even if Fortegra had covered the claim in the way they should have. My final decision I uphold this complaint and direct Fortegra Europe Insurance Company Ltd to: • Pay Mr R the hotel costs while his vehicle was being repaired up to the limit set out in the policy terms (up to three nights at £40 per person per night up to a maximum of £600) – on the receipt of appropriate evidence. • Pay Mr R £200 compensation. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr R to accept or reject my decision before 15 April 2026. Andrew Wakatsuki-Robinson Ombudsman

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