Lanisha raised a complaint against her home insurance provider as they declined her claim for damage caused by her ex-partner.
Lanisha’s ex-partner had been abusive towards her for several years and had recently left the property as their relationship had ended. Lanisha had the locks to the property changed. However, he later returned to the property, broke in, trashed the house and set fire to one of the bedrooms.
As the ex-partner was a joint policy holder, the insurer relied on the exclusion within the terms and conditions of the policy. It told Lanisha that deliberate acts caused by the policy holder were excluded and declined her claim.
Lanisha felt this was unfair and raised a complaint. The insurer said in its final response that it won’t change their decision about her claim. Unhappy with the outcome, Lanisha contacted us to investigate her complaint.
What we said
There was no dispute that Lanisha’s ex-partner, as a policy holder, had started the fire. Following the incident, he was arrested and later convicted for arson.
The terms and conditions were also clear that it didn’t cover for any loss or damage that “You or your household do on purpose or that is against the law.” And as a principle of law, a wrongdoer can’t benefit from their own wrongdoing.
However, we also considered that there was nothing Lanisha could have done to prevent her ex-partner’s actions and that she had caused no damage to the property herself. We also considered that Lanisha had changed the locks and we didn’t consider that the ex-partner remained part of the “household”.
So we recommended, on further discussion with the insurer, that they award Lanisha 50% of the claim that would have been payable but for the exclusion.
The insurer and Lanisha both agreed to the recommendation, bringing a fair and reasonable resolution to the complaint.
Related case studies
Consumer complains when insurer reduces claim settlement on her home insurance
Consumer says insurer unfairly cancelled policy because of incorrect information