Accredited Insurance (Europe) Ltd · DRN-6205443

The complaint Mrs H complains about the response of Accredited Insurance (Europe) Ltd to her buildings insurance claim and the service provided when responding to the claim. Any reference to Accredited as the underwriters (insurers) of this policy includes the actions of any agents acting on their behalf. Mrs H’s daughter has been helped by her daughter when bringing this complaint. In my decision, I’ll only refer to Mrs H. What happened The background to this complaint is well known to both parties and has occurred over a long period of time. I won’t repeat in detail what’s already known to both parties, instead, in my decision I’ll focus mainly on giving the reasons for reaching the outcome that I have. Mrs H had a buildings insurance policy with Accredited. In August 2024, Mrs H reported a leak affecting her property. Accredited arranged for investigative works to take place and initially said no leak had occurred. Mrs H got back in touch a month later as she said a leak was ongoing. Accredited approved further investigative works and said on 17 September the claim was declined due to the cause being rising damp. Mrs H disputed the declined claim and highlighted that she’d been without hot water and shower facilities for several weeks. Accredited approved a contractor of Mrs H’s choosing and on 18 November 2024, they concluded that water was coming into Mrs H’s property from the adjoining property next door. The claim was ultimately declined as Accredited said any escape of water was not coming from a fixed installation and was also excluded under the accidental damage section of cover. Unhappy, Mrs H raised several complaints about the service provided and claim decision. Accredited partially upheld one complaint and offered £750 compensation in a final response letter dated 18 November 2024. A further final response letter was sent on 27 January 2025, not upholding that complaint. Mrs H then referred her complaints to our Service for an independent review. Our Investigator explained that we couldn’t consider the earlier final response letter due to it being first referred to our Service outside of the six-month time limit that applied. The Investigator recommended that the second complaint be upheld. As Accredited didn’t accept the recommendations, the complaint was referred to me for a decision. The deadline for responses has now passed and I’ve considered the complaint 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.

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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 sorry to hear of the health issues Mrs H has faced. Responses to the provisional decision Mrs H responded to accept the decision. Accredited provided a detailed response, but not anything that materially impacts the outcome I’d intended to reach. For example, Accredited have said “Consumer Duty requires treating customers fairly, but the onus is on the consumer to show, on the balance of probabilities, that an insured event was the main cause of the damage they are claiming for.” But as already explained, there is an admission of liability from the next door neighbour and the evidence points towards the escape of water being from a supply pipe. Therefore, my previous findings form the basis of this, my final decision and are set out below. The scope of this decision I will focus on the parts of the complaint that remain in dispute. As it’s been accepted that the earlier final response letter (‘FRL 1’) dated 18 November 2025 was referred to our Service outside of the time limits that must apply, I won’t comment on that part of the complaint here. It’s not the role of our Service to determine the proximate cause of the damage to Mrs H’s property was. Instead, it’s our role to decide if Accredited have fairly responded to the claim before declining it in line with the policy terms. Usually, I’d only be considering events after FRL 1 (18 November 2024) until a second final response letter (‘FRL 2’) was issued on 27 January 2025. However, as Accredited have relied on a different reason to decline the claim in FRL 2, I will be considering the overall steps Accredited took to reach that claim decision. The claim consideration and decline The starting point with this insurance claim is for Mrs H to show - within reason, that an insured event covered by her policy has occurred. If she can, the responsibility then passes to Accredited to either accept the claim and settle it in line with the policy terms, or show that a policy limitation or exclusion applies that fairly allows them to decline the claim or limit their outlay. Accredited declined the claim and said that Mrs H had been unable to show there’d been an escape of water from a fixed domestic water or heating installation, drainage installation, washing machine, dishwasher, refrigerator, freezer of fixed fish tank. They also said the policy excluded water entering the home and any damage which had occurred over time. I’ve considered whether the decline was fair. Accredited were made aware on 11 November 2025 by a contractor chosen by Mrs H: “Our findings result in a leak that was caused by a neighbouring property… …It appears that next door had previously undergone renovation works and resulted in a new en-suite bathroom being installed against the party wall of [Mrs H’s] lounge. It appears that there has been a substantial amount of water ingress and due to the nature of the finished floor and membrane type underlay the water appears to have

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been pushed into the only places it can come out ie. All the edges of the inner and outer walls…. …Next door have admitted liability when inviting us into their property and suggested that they was aware their side of the damage but felt they contained it using drying equipment at the time.” Accredited have ultimately said the claim decline was due to Mrs H’s failure to provide evidence that the leak was caused by an insured peril. I’ve thought carefully about this. • Several different investigative surveys have taken place to try and establish the cause of the damage. The surveys reached different conclusions as to the proximate cause. But generally, the surveys agreed that whatever was causing the problem wasn’t originating from within Mrs H’s property. • Accredited’s own claim notes have recorded: “18/11/24 – Info received from LA - Water is coming through party wall from neighbours house - Neighbour had an en-suite bathroom installed but defective materials means that water is travelling into our insds property - Neighbour was aware of the issue but thought they were managing it with drying Equipment” • A private contractor on behalf of Mrs H also confirmed in a phone call with Accredited that next door had ‘accepted liability’ for a problem within their property. Neither Mrs H or Accredited can force entry into the next-door property, but Accredited have failed to take any action exploring this, and instead have put all the onus on Mrs H to provide this information. I consider this unreasonable and not in the interests of treating customers fairly, or in keeping with The Consumer Duty. • Accredited have referred to damage that’s occurred gradually being excluded under this policy. The evidence supports that although the water may have gradually affected Mrs H’s property, she notified Accredited when damage became apparent. I find it an unfair application of the policy terms to decline the claim for this reason. • Accredited also referred to the following term as a reason to decline the claim: o “What we don’t cover you for: - water coming into the home irrespective of how this may have occurred other than as stated under paragraphs 4, 5 and 6 of Section 1 – Buildings’. As the evidence suggests the damage originated from a pipe/fixed domestic water installation, again it is unfair an unreasonable of Accredited to rely on the above term as a reason to decline the claim. • I note Mrs H has home legal cover (underwritten by a different insurer) as part of this home insurance policy. This may be something Accredited can discuss with Mrs H. Details can be found on page six of the policy terms. In any case, where Mrs H has taken all reasonable steps to show an insured event

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covered by the policy has taken place, Accredited can explore the subrogation option to recover any claim outlay from any third party that may be responsible for the damage that’s occurred. To be clear, I’m not making any findings regarding liability, I’m simply pointing out the actions available to Accredited. • Mrs H has presented evidence (a further report) with our Service that we’ve recently shared with Accredited. I find this supports that Accredited unfairly declined the claim and Accredited’s recent response to our Service has been a continuation of their behaviour when responding to this claim – moving the end line further away when Mrs H has attempted to help validate her claim. The evidence here shows a plausible explanation for the proximate cause has been presented by Mrs H – seemingly with an admission of liability from her neighbour. Accredited have had sufficient opportunity to conduct their own investigations at Mrs H’s property but are now referring to findings of the independent third-party report Mrs H had completed to decline the claim. Yet, they didn’t carry out these investigations themselves when presented with the opportunity. It’s not the role of our Service to facilitate claims handling and any further claim consideration will need to be undertaken by Accredited outside of this complaint. • Overall, based on the available evidence, I find that Accredited have failed in their obligations under ICOBS 8.1.1: “An insurer must: (1) handle claims promptly and fairly… (3) not unreasonably reject a claim (including by terminating or avoiding a policy)…” The impact on Mrs H Our Investigator recommended that Accredited pay Mrs H an additional £350 to recognise the impact of their actions when responding to and declining this claim. Although I acknowledge Mrs H had her daughter’s help with the claim and complaint, avoidable distress and inconvenience has been caused here. When I’ve then factored in Mrs H’s medical vulnerabilities, the impact of a damp property on her (even if she wasn’t staying there all of the time) and considered our published guidelines on these types of awards, I find £350 to be broadly fair, reasonable and proportionate. Mrs H also commissioned a further report into the damage in February 2025 (now shared with Accredited). I find this was out of frustration with the lack of progress of her claim with Accredited and it was a reasonable course of action to take to try and mitigate against further damage to her property. I find if Accredited had carried out claim investigations as would be expected, Mrs H would not have needed to commission her own report. I’ve also kept in mind that alternative claim decline reasons (rising damp for example) were earlier relied on by Accredited and it was only Mrs H’s challenge and persistence that meant further investigative works were carried out. If Mrs H has incurred a cost for the report, Accredited will need to reimburse her for that cost. Putting things right I Accredited Insurance (Europe) Ltd to:

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• Pay Mrs H £350 compensation for service failings. This is separate to the earlier amount of £750 offered in a final response letter that I’m not considering here. • Reimburse Mrs H for any claim-related costs (including the cost of any report commissioned, temporary repairs or drying out). Subject to reasonable proof of her outlay, add 8% simple interest per annum* from the date she incurred any outlay until the date Accredited reimburse her. • Reopen and reconsider the claim in line with the remaining policy terms. As explained above, it is unreasonable to except Mrs H to do anything further to establish the proximate cause of the damage. Accredited have the option of contacting the third-party neighbour to obtain more details if wish to. *If Accredited considers that it’s required by HM Revenue & Customs to deduct income tax from that interest, it should tell Mrs H how much it’s taken off. It should also give her a tax deduction certificate if she asks for one, so she can reclaim the tax from HM Revenue & Customs, if appropriate. My final decision My final decision is that I uphold this complaint. Subject to Mrs H accepting the decision before the deadline set below, I direct Accredited Insurance (Europe) Ltd to follow my direction, as set out under the heading ‘Putting things right’. Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs H to accept or reject my decision before 7 April 2026. Daniel O'Shea Ombudsman

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