Fortegra Europe Insurance Company Ltd · DRN-6008091

The complaint Mrs A complains about Fortegra Europe Insurance Company Ltd’s (Fortegra) decision to decline a claim under a furniture insurance policy. What happened Mrs A bought a sofa in December 2023, which was delivered in late February 2024. She took out a furniture insurance policy (the policy) with Fortegra that included cover for accidental staining. In mid-May 2025, after discovering staining on one of the three sofa headrests, she made a claim. Fortegra inspected the sofa (through its technician) and declined the claim on the basis the staining was gradually occurring, and not the result of a single incident. It relied on exclusions for staining occurring at different times and general soiling, such as build-up of oil over an extended period of time. Mrs A complained to Fortegra. She didn’t know what the stain was from, but she denied it had occurred over a period of time. Fortegra issued a complaint response in June 2025. It relied on its technician’s report to say the damage was due to bodily oils built-up over time, which wasn’t covered under the policy. Mrs A referred her complaint to the Financial Ombudsman Service. She said the staining was not due to a build-up over time as it appeared suddenly and she’d not noticed it before. The Investigator upheld the complaint. They said they found Mrs A’s information more persuasive in the circumstances, and Fortegra hadn’t done enough to show the exclusions fairly applied. They recommended it cover Mrs A’s claim. Fortegra didn’t agree. It said it was entitled to rely on its technician’s conclusions, and it was satisfied the staining was the result of accumulation. 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. My role is to decide whether Fortegra acted fairly and reasonably in deciding the claim. And in doing so, I’ve considered the available evidence and the conclusions Fortegra reached. Given that Fortegra has relied on the policy exclusions to decline the claim, I consider the onus is on Fortegra to show an exclusion most likely applies. And I’m not persuaded that Fortegra has done this here. I’ll explain why. The policy covers individual incidents of accidental staining, from any substance, including, but not limited to, human and animal bodily fluid, ink and unidentifiable stains. And it excludes staining which has occurred at different times (and been allowed to

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accumulate/worsen) and deterioration as a result of general soiling, or a build-up of oil over an extended period of time. Fortegra’s technician inspected the staining and in June 2025, they reported the staining was “possibly body oils and grease which has built up over a period of time”. And on the face of it, Fortegra’s reliance on this seems reasonable. But the technician’s comments suggest the above to be a possibility, and I’ve not seen sufficient evidence to show it was most likely the cause. I consider it’s also a possibility the staining could have been the result of another “external source” that wasn’t excluded under the policy terms. The images I’ve seen show a distinct stain on the headrest area. I don’t consider this type of stain to be consistent with body oils and grease built up over time. And given the extent of the staining, I agree with Mrs A that she’d likely have noticed this damage much earlier than May 2025, had it been gradually occurring since the sofa was delivered in February 2024. I also think it’s worth noting that the stain appears to only be on one of three sofa headrests, despite Mrs A’s use of the sofa, along with her husband, and other guests in their home. The technician’s testing information, notes colour transfer in the claim area in wet conditions. And a change in the touch, smell and visual appearance of the area under heat. But I’ve not seen any explanation as to why this is more consistent with gradual staining over time, due to body oils and grease, than staining by other sudden external sources. For example, I’d consider colour transfer to be more likely in the instance of a recent sudden stain, than staining that had occurred gradually over time and been allowed to set. The testing also suggests the area of staining to be highly acidic. I’m not persuaded this is entirely consistent with the staining being caused by body oils and grease – body oils for example aren’t generally considered highly acidic. And again, there’s no explanation to outline why a very high acidic content is consistent with the conclusion of gradual staining over time due to body oils and grease. Overall, for the reasons outlined above, I don’t consider the technician’s suggestion of the possibility of body oils and grease causing the staining over a period of time, to be persuasive in the circumstances. It follows that I don’t consider it was fair for Fortegra to rely on this, and as a result, the policy exclusions outline above, to decline the claim. So I will direct Fortegra to accept Mrs A’s claim, subject to the remaining terms of the policy. Mrs A said she was left with a sofa that looks dreadful. And having seen the images of the staining, I’m persuaded that in unfairly declining Mrs A’s claim, Fortegra caused Mrs A to lose enjoyment in the use of her sofa. So I think it should pay her some compensation to recognise this. And in the circumstances, I think a payment of £75 is fair.

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My final decision For the reasons outlined above, my final decision is that I uphold this complaint. I require Fortegra Europe Insurance Company Ltd to: • Accepts Mrs A’s claim, subject to the remaining policy terms. • Pay Mrs A £75 compensation. Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs A to accept or reject my decision before 26 May 2026. Monjur Alam Ombudsman

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