DRN-6287978

The complaint Mrs K complains that AXA Insurance UK Plc (‘AXA’) unfairly declined an escape of water claim she made under her property insurance policy. Mrs K is professionally represented in this complaint, but for ease of reading, I have just referred to Mrs K and AXA as being involved in the activities of this complaint. What happened The details of this complaint are well known to both parties, so the following is a summary of key events only. Mrs K held a property insurance policy underwritten by AXA. She notified them of a claim in March 2025 and said a leak from pipework in an ensuite WC had caused damage. AXA considered the claim but ultimately declined to cover it. They said the damage was consistent with a gradual escape of water. And that the damage to the ceiling and walls had the appearance that it has been ongoing for some time and hadn’t been mitigated as there was evidence of salts forming down the wall causing damage. AXA said as this didn’t appear to be a one-off event, it was excluded by the policy’s terms. Mrs K was dissatisfied with AXA’s decline of the claim, so she raised a complaint. AXA issued a response in which they maintained their decline of the claim, so, Mrs K brought the complaint to this Service. An Investigator looked at what had happened but didn’t think AXA had unfairly declined the claim. He said the evidence demonstrated the damage had been caused over a period of time and was not a sudden, one-off event. The Investigator concluded AXA’s decline of the claim was fair. Mrs K didn’t accept the Investigator’s conclusions and asked for an Ombudsman to consider the complaint – so, 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. Having done so, I’ve reached the same overall conclusion as the Investigator, and I do not uphold this complaint. The crux of this complaint is whether AXA’s decision to decline Mrs K’s claim was done fairly and in line with the policy terms. The cover provided by Mrs K’s policy includes escape of water as an insured event. And I’m satisfied the evidence shows the damage being claimed for was caused by escape of water. But AXA’s position is that the damage was consistent with an ongoing issue and not a one-off event. So, they say this is excluded from cover. I can see the policy contains general exclusions; one of which says: “We will not pay for any loss, damage, liability, cost or expense caused by: 1. Gradual deterioration/maintenance

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Loss or damage caused gradually, or by wear and tear, depreciation, the effects of light or the atmosphere, mould, dry or wet rot or fungus and costs that arise from the normal use, maintenance and upkeep of your buildings and its contents.” AXA’s claim notes record that there was damage to the WC’s sink basin unit, as well as water marks on the wall behind it. And in the downstairs living room there was a large section of fallen ceiling and damage down the wall. There were also several contents items that were water damaged when the ceiling fell including the curtains, sofas, carpet, a free- standing TV stand, and some photo frames. And the notes record that the damage to the ceiling and walls had the appearance that it has been ongoing for some time, as there were salts forming down the wall which they said would have taken some time to happen. I've taken into account Mrs K’s submission that the affected room wasn't regularly used and that the leak was concealed. But even allowing for this, I find it unlikely that the extent of the damage, particularly to the living room ceiling and walls, wouldn't have been noticed earlier. The damage appears to be widespread rather than isolated, and more consistent with something that had developed over time. Looking at the photos that were taken during the claim validation, the damage looks to be extensive and the result of an ongoing issue. I’m not persuaded the photos support that this was a sudden escape of water. So, I’m satisfied that AXA’s conclusion, that the damage was ongoing for some time, was a reasonable one to reach, and supported by the available evidence. The basic premise of insurance is that it provides cover for damage caused by one-off fortuitous events. But taken in the round, I’m persuaded the available evidence demonstrates the damage being claimed for was the result of something that had been ongoing for a period of time instead. Taking all the above into account, I think AXA’s view is persuasive that the damage was caused by a known issue that had been ongoing for some time, resulting in gradual deterioration. I’ve also considered the further point Mrs K raised after the Investigator’s view, including that the pipe work itself was concealed, that a pressurised leak could result in a significant escape of water over a short period of time, and that salts may have formed as part of the drying process. I've considered those points carefully. While I acknowledge that these scenarios may be possible, my role is to decide what I think is most likely to have happened to, on the balance of probabilities and based on the available evidence. In this case, I'm satisfied the overall pattern of damage is more consistent with a prolonged exposure to moisture rather than a single one-off escape of water. So, in these circumstances, I’m satisfied that AXA’s conclusion that the claim would be excluded from cover was a reasonable one to reach. It therefore follows that I think AXA’s decision to decline the claim was fair. I understand that this won’t be the outcome that Mrs K was hoping for, but on balance, I’m satisfied AXA’s decision was fair and consistent with the policy terms. My final decision For the reasons I’ve set out above, my final decision is that I do not uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs K to accept or reject my decision before 20 May 2026.

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Stephen Howard Ombudsman

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