AmTrust Specialty Limited · DRN-6303963

The complaint Mr B and Mr M complain that AmTrust Specialty Limited (AmTrust) unfairly declined a claim made on a legal expenses insurance policy. Mr B and Mr M are joint policyholders, and so refer this complaint to our service jointly. However, the claim was made by Mr B and all the correspondence with both AmTrust and our service has been from Mr B. I’ll therefore refer to Mr B within this decision, but where relevant this should be taken to include Mr M. What happened Mr B and Mr M hold legal expenses insurance with AmTrust. Mr B has an ongoing dispute with a former employer, and has made a claim on the policy in respect of that. That claim has been accepted by AmTrust, although a complaint has been referred to our service about aspects of AmTrust’s handling of the claim. Separately, Mr B made a claim on the policy as he sought cover for his legal expenses in pursuing his former employer in County Court about its handling of his personal data and failure to comply with its obligations under data protection law. AmTrust declined cover for the claim. After it rejected his complaint, Mr B referred it to our service. Our investigator thought AmTrust’s decision to decline cover for the claim was fair. Mr B didn’t agree and asked for 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. My decision here is only considering whether the decision to decline cover for Mr B’s claim was reasonable. I’m not considering the claim made in respect of the employment dispute, or complaints made about AmTrust’s handling of that. Nor am I looking at the sale of the policy, the advice given when the policy was taken out or the information provided during the sales process. Mr B has made specific reference in correspondence to his belief that the description of the cover as being “Family Legal Protection” created an impression that the scope of cover would include data protection and handling matters. If he believes that this is the case, and that he was misled or the cover was misrepresented when the policy was purchased, that would be a separate complaint that would need to be directed to the party which sold the policy. My decision here is considering whether AmTrust, as the insurer could reasonably decline cover based on the policy terms and conditions. What that ultimately means is that I can’t read into the policy, or add additional cover to it, on the basis that Mr B thinks the policy should provide cover for certain aspects. Insurers are free to decide, when offering policies, what risks and perils they are willing to include cover for, and on what basis. What I need to assess is whether any section of the cover could

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reasonably be interpreted, either explicitly or implicitly, to extend to Mr B’s claim which concerns his former employer’s handling of his personal data and compliance with data protection regulations and law. AmTrust can’t decline claims unreasonably, but the onus is on Mr B to demonstrate that his claim falls within the scope of the cover outlined in the terms and conditions. AmTrust says there’s no section of the policy which provides cover for the circumstances of the claim Mr B seeks to advance. I’m conscious that Mr B’s claim originates from an employment dispute (and that he has an ongoing claim in respect of that dispute). However, he makes clear that he considers this a separate claim, and AmTrust has treated it as such. In any case, the employment disputes section only covers for costs related to matters referred to an Employment Tribunal, and so Mr B’s desire to exercise his rights under data protection legislation and take his former employer to court (including a claim for compensation) wouldn’t fall within that section of cover. It’s also apparent that AmTrust doesn’t consider there’s any cover for the claim Mr B seeks to make under any of other sections of the policy. I note the only reference to data rights is in the “Legal Defence” section of cover, which provides for cover to defend an action brought against the policyholder as a data controller. That plainly doesn’t apply to Mr B’s claim. There’s no similar cover, for example, to take action to enforce a policyholder’s rights under data protection legislation. I appreciate Mr B believes there should be, but as I’ve set out above, AmTrust is free to offer policies which have limits of cover, including what will be covered. A legal expenses insurance policy isn’t a policy which covers for any legal expenses incurred, or any claim made. AmTrust also looked at the “Contract Disputes” section of the policy, which provides cover for disputes about the purchase, sale or rental of goods and services. It concluded that this doesn’t apply here. Mr B’s claim relates to the release (or failure to release) personal detail by his former employer. That isn’t, by any reasonable interpretation, a dispute about a contract for the purchase, sale or rental of goods or services. Mr B hadn’t purchased, sold or rented anything relevant to the claim from or to his former employer. Mr B hasn’t pointed to any other section of the policy which could reasonably be considered to extend to cover the circumstances of his claim. I know how strongly Mr B feels that his claim should be covered, and he refers to his claim having good prospects of success. However, before such an assessment can be considered, the proposed legal action needs to be something that is covered by the policy. As I’ve outlined above, I think AmTrust has reasonably concluded that isn’t the case here. My final decision I don’t uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr B and Mr M to accept or reject my decision before 25 May 2026. Ben Williams Ombudsman

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