We know it’s distressing if your home or something you own has been damaged by accident. If you come to us with a complaint about an accidental damage claim, we’ll listen to both sides of the story and deal with it fairly.
Types of complaint we see
You might complain to us that your insurer has rejected a claim for accidental damage. The insurer might say:
- the damage wasn’t accidental
- your policy didn’t cover what happened
- you don’t have accidental damage cover at all
- there was no accident
- there was no damage
Some people complain that their insurer hasn’t given them enough information. This might happen if you paid extra for accidental damage cover but your claim is rejected. Or you might complain that you would have taken out accidental damage cover if you’d been given enough information when you bought the policy.
We sometimes see complaints where no-one has mentioned accidental damage cover. For example, your insurer rejects a storm damage claim but doesn’t check if you could claim under accidental damage cover.
How to complain
Talk to your insurer first so they have the chance to put things right. They have to respond within eight weeks. If they don’t respond, or you’re not happy with their response, let us know.
Bringing a complaint to us is straightforward and won’t cost you anything. We’ll check if your complaint is something we can deal with, and if it is, we’ll investigate.
What we look at
If your insurer has rejected a claim for accidental damage, we’ll usually look at:
- what cover you had
- which parts of your cover are relevant to your claim
- whether you had standard cover or accidental damage cover
- if your cover is for buildings, contents or both
- the policy’s terms and conditions
- what happened
- what evidence there is
- the definition of ‘accidental’ that applies to your claim
Here's what we consider, including definitions.
We’ll need to work out whether the damage was caused by an accident according to the policy definition. If we find it wasn’t, we’ll check to see if the damage is covered somewhere else in your policy. If it is, we’ll ask the insurer to deal with your claim.
We look at evidence to work out if the damage was caused accidentally. This could include:
- expert opinions
- photos of the damage
- a report, including photos, from a surveyor, loss adjuster or other expert
- customer testimony
We’ll weigh up all the evidence to make a fair decision.
If your policy doesn’t have a definition of accidental damage, we’ll apply our own. We say accidental damage is something that's:
- not just physical damage – it can also include loss of function
If your policy has a definition of accidental damage, we’ll check how the insurer explained this to you when you took out your policy. We’ll probably tell the insurer to reconsider your claim if:
- the policy defined accidental damage as something significantly different from its usual meaning
- the insurer didn’t draw your attention to an unusual definition of accidental damage
- you probably would have acted differently had you been aware of any limitations in the cover or unusual features
We’re likely to be satisfied that a definition of accidental damage was brought to your attention if it was:
- written in plain, clear language
- given prominence when you bought the policy or when the definition was introduced
You might see any of these terms in your policy.
Sometimes the policy definition includes the word ‘sudden’ but you can’t pinpoint exactly when the damage happened. This doesn’t mean the damage wasn’t sudden.
The damage can be sudden even if it’s caused by a long-term problem. We’ll take this into account in each case. We’ll also consider the nature and extent of the damage.
Some policies talk about ‘breakage’ instead of damage. This is often used in cover for underground pipes, glass or ceramic items. Breakage can mean:
- smashed glass
- shattered ceramics
- cracked pipes
In most cases, it’s unlikely that the difference between breakage and damage will affect the outcome of your complaint.
Loss of function
Sometimes damage results in a loss of function – for example, a blocked drain. Even if there’s no physical break, we can still consider the drain damaged because it can’t do what it’s designed for.
Some cases of accidental damage are caused by some kind of external action or force. For example, a hole in a pipe behind a wall could be caused by a nail being accidentally hammered into it.
Policy exclusions are things your policy doesn’t cover. Accidental damage cover doesn’t usually include damage caused by:
- wear and tear
- gradual deterioration with age
- deliberate acts
- defective workmanship
If your insurer rejects a claim because of a policy exclusion, we’ll consider whether the exclusion is significant or unusual. If it is, we’ll check how the insurer told you about this. We're likely to uphold, or agree with, your complaint if:
- the insurer didn’t draw your attention to the exclusion properly
- you probably would have acted differently if you’d understood the exclusion
We’ll probably agree that an exclusion was properly brought to your attention if it was:
- written in plain, clear language
- given prominence when you bought the policy or when the exclusion was introduced
Putting things right
If we think your insurer has treated you unfairly or made a mistake, we’ll ask them to put things right. We’d expect them to put you in the position you would have been in if the problem hadn’t happened. How we ask them to do this will depend on the case. For example, we might ask your insurer to:
- deal with a claim they’ve rejected
- add interest to any claim you should have been paid
- pay for more work to be done if you’ve complained about repairs
We may also ask the insurer to pay you compensation for any distress or inconvenience you’ve experienced as a result of the problem.
Damage to laminate flooring not covered by Karim's contents insurance
Buildings insurance Contents insurance
Accidental paint damage claim deemed ‘foreseeable’ by insurer
Claim about cracking in a garage rejected due to questions about the definition of 'sudden'
Insurer unfairly points to policy exclusion for damaged jewellery
Information for financial businesses
You can read more information about accidental damage in the business section of our website. This includes technical details and information to help you resolve complaints.