Haven Insurance Company Limited · DRN-5877552

The complaint Mr F complains about Haven Insurance Company Limited’s handling of a claim under a home insurance policy. What happened Mr F had a home insurance policy with Haven that included accidental damage cover. In June 2024, he made a claim for damage to flooring on the ground floor. He sent Haven evidence to show the flooring was no longer available to purchase and couldn’t be repaired. So he provided a quote to remove and replace the flooring on the ground floor. In July 2024, Haven declined the claim. It said the damage was caused by the act of cleaning and this was excluded under the policy terms. Mr F then outlined a different cause of damage to what he’d initially said, so Haven proposed to instruct a Loss Adjuster to inspect the damage, so it could understand how it occurred. Mr F complained to Haven. He rejected the offer of an Adjuster and he felt he’d provided sufficient evidence already. He was unhappy with Haven’s decision to decline the claim based on damage being caused by cleaning. Because Mr F rejected Haven’s offer of its usual Adjuster, Haven offered to instruct an independent Adjuster, and gave Mr F two options to choose from. It followed this up with a complaint response in November 2024. Haven maintained its decision to decline the claim based on the information it had obtained so far, but it agreed to instruct an Adjuster chosen by Mr F from the options it had provided. Finally, Haven said the information it had requested from Mr F was necessary to process the claim. Mr F referred his complaint to the Financial Ombudsman Service. He said his actions at the time of the loss couldn’t fairly be described as cleaning. And he said his recollection of what caused the damage changed, after he’d been made to think further about it. He wanted Haven to replace all his ground floor flooring. The Investigator upheld the complaint. They said it wasn’t fair for Haven to have declined the claim for the reasons it gave. So they asked Haven to reassess the claim without relying on the exclusion for damage caused by cleaning. And they asked Haven to pay Mr F £100 compensation. Haven disagreed. It pointed out that it was still willing to progress the claim by appointing an Adjuster with Mr F’s agreement. Mr F felt Haven was deliberately avoiding the claim and wanted it to be directed to pay the claim with immediate effect. Because the complaint couldn’t be resolved, it’s been passed 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.

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Mr F has provided a lot of information in support of his complaint. I assure Mr F that I’ve taken everything he’s provided into account. But in this decision I’ve focused on what I think are the key issues in this complaint. No discourtesy is intended by this, but it simply reflects the informal nature of the way that the Financial Ombudsman Service reviews complaints. My role isn’t to decide the claim or decide what caused the damage to Mr F’s flooring. My role is to decide whether Haven acted fairly and reasonably in handling the claim. And in doing so, I’ve considered Haven’s initial claim decision and what it later proposed to do to progress the claim. Information Haven requested Mr F said he felt pressured by the extensive information Haven requested. I’ve reviewed the policy terms, and I can see the policy requires Mr F to provide Haven with reasonable evidence, in the event of a claim. I’ve gone on to review the evidence Haven requested from Mr F. This included proof of purchase, photos and videos of the damaged and undamaged sections, itemised quotes, and further details in relation to the quotes provided. Having reviewed everything, I’m satisfied the information Haven requested was reasonable and relevant to Mr F’s claim, so I don’t consider it acted unfairly in the circumstances. Haven’s initial claim decision The terms of the policy exclude any loss or damage: “directly or indirectly caused by or resulting from…The process of cleaning…or restoration of anything reaching the end of its serviceable life.” Because Mr F initially said the flooring was snapped when it was pulled upwards during hoovering, Haven relied on the above exclusion to decline his claim. It said the damage was caused solely as a result of the process of cleaning. I’ve also considered the policy definition of accidental damage: “Damage that is sudden, unforeseen, unexpected, and a one-off incident, not caused on purpose or as a result of wear and tear….” Taking all the above into consideration, I’m satisfied that accidental damage, as defined under the policy, can occur during the reasonable process of cleaning (hoovering). And I consider the exclusion outlined above, fairly applies in instances where damage was caused by the process of cleaning something, that was reaching the end of its serviceable life. Mr F provided evidence to show he installed the flooring in around 2020. I consider the lifespan of flooring such as Mr F’s (LVT flooring), to have a general lifespan in excess of the four years between the installation date and the date of the loss. And having reviewed the images and video of the flooring, I’m not satisfied this shows the flooring was reaching the end of its serviceable life. So in the circumstances, I don’t consider it was fair for Haven to rely on the exclusion relating to the process of cleaning (the cleaning exclusion), to decline the claim. So I will direct it to not rely on this exclusion in progressing the claim. Haven’s proposal to instruct a Loss Adjuster I’ve considered whether Haven’s proposal to instruct a Loss Adjuster is fair and reasonable in the circumstances.

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The terms of Mr F’s policy make it clear Haven may arrange a visit or inspection. And that if it decides to do so, Mr F must allow Haven, or its Loss Adjusters, access to inspect the damage. I understand Mr F’s recollection of how the damage occurred has changed over the course of the claim. I acknowledge Mr F’s reasons for why it changed, but I think it’s reasonable for Haven to say it hasn’t been able to establish how the damage was caused. It follows that I consider it fair for Haven to instruct a Loss Adjuster to inspect the damage, if it chooses to do so, in order to understand and verify how the damage occurred. I also acknowledge Mr F’s concerns about Haven’s usual Loss Adjuster, but because Haven offered Mr F the option of two other independent Loss Adjusters, I consider it acted fairly. So I won’t direct Haven to progress the claim without instructing a Loss Adjuster. This means Mr F will be required to cooperate with Haven, if it chooses to progress and reconsider the claim, by instructing a Loss Adjuster. Compensation I’ve outlined above why Haven unfairly declined Mr F’s claim by relying on the cleaning exclusion. And I consider this would’ve caused avoidable delay on the claim and Mr F some distress and inconvenience. Taking into consideration the small section of the flooring that was damaged, I agree with the Investigator that £100 compensation is fair and reasonable in the circumstances. So this is what I will direct Haven to pay. My final decision My final decision is that I uphold this complaint. Subject to my comments above, I require Haven Insurance Company Limited to: • Reconsider and progress the claim without relying on the cleaning exclusion. • Pay Mr F £100 compensation. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr F to accept or reject my decision before 27 April 2026. Monjur Alam Ombudsman

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