DRN-6227739

The complaint Ms W’s complaint is about a claim she made on her ARAG Legal Expenses Insurance Company Limited (‘ARAG’) legal expenses insurance policy, which ARAG declined. Ms W says ARAG treated her unfairly and should cover her claim, given her circumstances. What happened The details of this complaint are well known to both parties, so I won’t repeat them here in any great detail, save to say that Ms W made a claim on her ARAG policy for cover to bring Judicial Review challenges against the decisions of various police constabularies in relation to the investigation of offenses she says were committed against her. ARAG declined the claims on the basis that they thought there was no cover under the policy for this sort of action. Our investigator considered Ms W’s complaint, including her submissions about the policy engaging under the personal injury section of cover, but did not agree they extended to her claims. Because of this the investigator said ARAG did nothing wrong when declining cover. Ms W does not agree so the matter has been passed to me to determine. 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. Having done so, I don’t uphold Ms W’s complaint for broadly the same reasons set out by the investigator. Before I explain why, I wish to acknowledge both Ms W’s strength of feeling about her complaint and the very difficult circumstances underlying it. Whilst I’ve read everything she’s said, I won’t be addressing it all. That’s not intended to be disrespectful. Rather, it’s representative of the informal nature of the Financial Ombudsman Service. Instead, I’ll focus on the crux of Ms W’s complaint, namely whether ARAG did something wrong by declining her claim in the way that they did. The starting point is the policy terms. The provide cover for a range of matters, including employment disputes, personal injury, clinical negligence, consumer disputes, motor contracts disputes, property disputes, probate, personal identity fraud, vehicle cloning, tax investigation and jury service. Having considered the terms of all of the sections of cover carefully, I regret that I am not satisfied that the claim Ms W is seeking to bring falls within those sections. Ms W’s claim is for judicial review of the decisions of various police constabularies. It does not therefore meet the definition for any of the sections of cover afforded by the policy. So, although she might have a good claim in law, her insurance policy does not extend to funding bringing it. I appreciate that Ms W feels the personal injury section of cover engages in her case. But I

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don’t agree. That section of cover extends to “A specific or sudden accident that causes your death or bodily injury to you…” and it excludes a claim relating to “illness or bodily injury that happens gradually” or “psychological injury or mental illness unless the condition follows a specific or sudden accident that has caused physical bodily injury to you”. Ms W’s claim is not in relation to a sudden accident that caused bodily injury to her. Rather it is to challenge decisions of various police constabularies about their decisions that either no offenses had been committed against her or that they refused to investigate such offenses further. That is not a claim in relation to a sudden accident that caused bodily harm. I appreciate that Ms W considers the offenses she says were committed against her amounted to such harm. But it’s not my role to determine that issue. My role is to assess whether cover ought to have engaged in the legal claims she wanted to bring, not the matters underlying them. It follows that the policy exclusions in relation to this section of cover are largely academic because the cover available doesn’t encompass the type of claim Ms W was seeking to make in any event. I appreciate Ms W feels that ARAG should have covered her claim in her very difficult circumstances and given one of which needed to be brought earlier this year. Whilst I can understand why she feels this way, I don’t think it is fair for ARAG to offer cover for something they simply have not provided for in their policy and as such I cannot compel them to do so. Overall and for the reasons I’ve set out, I don’t think it was wrong for ARAG to decline Ms W’s claim in the way that they did. In light of the foregoing, I won’t be addressing the further detailed points Ms W has made in respect of her complaint as they make no difference to the outcome of it given there is simply no cover available for the type of claim she wishes to make. My final decision For the reasons set out above, I don’t uphold Ms W’s complaint against ARAG Legal Expenses Insurance Company Limited. Under the rules of the Financial Ombudsman Service, I’m required to ask Ms W to accept or reject my decision before 22 May 2026. Lale Hussein-Venn Ombudsman

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