DRN-5892423

The complaint Mr W complains about the response of UIA (Insurance) Limited (‘UIA’) to a home insurance claim. UIA are the underwriters (insurers) of this policy. Any reference to them in this decision can be interpreted as covering the actions of any agents they’ve confirmed were working on their behalf. What happened The background to this complaint is well known to Mr W and UIA. I won’t repeat in detail what’s already known to both parties. Instead, in my decision I’ll focus on the reasons for reaching the outcome that I have. Mr R was the victim of a burglary in October 2017. Windows were broken and contents stolen. He contacted UIA. Mr R arranged for the windows to be boarded up and fearing for his safety and security, he decided to have the windows replaced the next day. UIA asked for further information and ultimately said they wouldn’t fully reimburse Mr R for the cost of the windows – only what it would’ve cost them. Settlement was offered on 19 April 2018. Mr R raised a data subject access request. UIA responded and no further communication was received (in relation to the buildings claim) from Mr W for over five years, until December 2023 when he queried the settlement. He raised a complaint and UIA partially upheld it. They reiterated that the settlment offered was fair, but offered Mr W £250 for a lack of communication. Remaining unhappy, Mr W referred his complaint to our Service for an independent review. Our Investigator considered the complaint but didn’t recommend that UIA needed to do anything further. As the dispute remains unresolved, it’s been referred to me for a final 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. Our Service is an alternative, informal dispute resolution service. Although I may not address every point raised as part of this complaint - I have considered them. This isn’t intended as a discourtesy to either party – it simply reflects the informal nature of our Service. I’m very sorry to hear of the impact of the break-in on Mr W and what he’s recently shared with us about his personal finances. From what he’s told us, being a victim of crime had a huge impact on his mental health. Having carefully considered this complaint, I’ve reached broadly the same outcome as our Investigator. I’ll explain my key findings below. I’ll only be considering the buildings

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(windows) part of this claim, as it appears an acceptable settlement has been made for the contents claim. Notwithstanding the impact this crime had on Mr W, a considerable amount of time passed between the complaint event (April 2018) and his raising of the complaint in December 2023. This puts Mr W right towards the edge of the relevant time limits that apply around making complaints (six years from the complaint event or, if later, three years from when he realised he had reason to complain). The passage of time has meant that not all relevant evidence has been retained by UIA. For example, call recordings. I don’t find this particularly unusual, especially as the policy was cancelled in early 2018 by Mr W. I’ve also noted that UIA say call recordings would’ve been provided to Mr W as part of his DSAR in 2018. The settlement offered At the heart of this complaint is what was discussed between Mr W and UIA in the very early days of this claim. The internal call records show the following calls (which I’ve summarised below) took place between Mr W and UIA: Date Time Summary 5/10/17 23.36 First notification of loss, Mr W let UIA know he was arranging for someone to board up the windows. 6/10/17 09.37 Brief call with Mr W, ended when police arrived at his property. 6/10/17 10.23 Mr W explained he hadn’t been offered UIA’s own contractors so he arranged for windows to be boarded up himself. UIA asked Mr W to send in evidence including photos quotes and receipts. 6/10/17 12.47 UIA received the invoice for £4,900 repair and Mr W wanted to know if the cost would be covered. UIA let Mr W know the cost was very high and would need to be reviewed. Mr W said the company were waiting outside his property to collect payment and UIA said it couldn’t be agreed during that call. Mr W says he took the course of action he followed, because he feared for his safety and he notified UIA of his plans. UIA, on the other hand, say that no authorisation was granted to proceed with replacing the affected windows and when they were put on notice – Mr W had already arranged for the windows to be replaced. Ours is an evidence-based organisation, and when reaching my decision I have considered Mr W’s testimony - but memories can fade with the passage of time and I’m more persuaded by the contemporaneous call notes/internal records of UIA. Whilst I can understand Mr W’s sense of urgency in having his windows replaced, the contract of insurance between him and UIA required that he sought permission/approval to go ahead with the cost of the repair. Here, it seems UIA were loosely aware of the cost of boarding up the windows, but no approval was given to proceed with the replacement of the windows privately. I find that Mr W’s actions prejudiced UIA’s response to the claim. Of course, had the claim for the windows been accepted/approved, UIA would always have incurred a cost. UIA asked Mr W for information to help validate the claim (including a detailed breakdown of the costs) given their concerns about the very high price Mr W had been charged. They also made reasonable efforts to contact the window fitters themselves. I consider this reasonable – given the price Mr W paid was around five times the cost UIA estimated the work should cost.

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The policy terms state that the relevant limit of UIA’s indemnity here was the cost to carry out the repair themselves. They’ve shown evidence as to how the settlement was calculated and I’m satisfied they’ve done so fairly. Our Service recognises that an insurer may often be able to carry out a repair for less than the rates available to a consumer on the open market and when reaching my decision I’ve kept this in mind, whilst considering what is fair and reasonable in all the circumstances of the complaint. This difference can be for several reasons - including economies of scale, retention deals and insurers having their own network of contractors. In the specifics of this complaint, Mr W has not shown with any sufficiently persuasive evidence that the price he paid – notwithstanding the urgency of the situation, was competitive, or reflective of what he might expect to pay another company offering the same services. As already found, his actions prejudiced UIA’s position. In summary, although Mr W has said the settlement offered doesn’t indemnify him (relative to what he paid privately), he’s not shown with any persuasive evidence that the settlement UIA offered is unfair - relative to what the open market would’ve charged for the repair in question here. This point is particularly important here, as the contractor Mr W used has seemingly been found guilty of various trading standards breaches and received a suspended prison sentence, as well as being required to pay compensation to victims. Mr W was provided with this information by UIA to the same email address we held on file for him on 15 December 2023 and our Investigator shared that information again with Mr W on 13 October 2025. Mr W would need to take independent advice on any potential options available to recover any losses. This would not be the responsibility of UIA to pursue on Mr W’s behalf. In summary, whilst I have sympathy for the situation Mr W found himself in, I find that UIA’s settlement offer is fair and I don’t find that UIA need to increase their settlement offer to fully indemnify Mr W for the much higher private repair costs he incurred. The service provided UIA accepted that they let Mr W down with the service provided – particularly delays and communication. I find the £250 offered, when considered alongside our published guidelines to be broadly fair, reasonable and proportionate – relative to the impact on Mr W. But when reaching my overall outcome, I’ve also kept in mind that the largest impact here on Mr W has not been caused or influenced by the actions of UIA - but the inflated price he paid a contractor of his own choosing. My decision will disappoint Mr W, but it ends our Service’s involvement in this part of his dispute with UIA. My final decision My final decision is that UIA (Insurance) Limited made a fair offer to resolve the complaint prior to our Service’s involvement in the dispute. I don’t uphold the complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr W to accept or reject my decision before 20 May 2026. Daniel O'Shea Ombudsman

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