Admiral Insurance (Gibraltar) Limited · DRN-6131859

The complaint Mr B complains that Admiral Insurance (Gibraltar) Limited unfairly declined a claim under his motor legal protection insurance policy. Where I refer to Admiral, this includes the actions of its agents and claims handlers for which it takes responsibility. What happened The detailed background to this complaint is well known to both parties, so I’ll only summarise the key events here. In 2021, Mr B was involved in a road traffic accident which caused damage to his car. He made a claim on his motor insurance policy. Mr B’s insurers accepted the claim and agreed to pay the cost of repairs. Whilst the car was with the repairers, Mr B asked them to carry out some additional works including installing some parts to bring the engine up to date and an MOT. He paid for this work privately. In 2024, shortly after the repairs had been completed, Mr B’s car broke down. He contacted his roadside assistance provider who attended and diagnosed the fault as a leak from one of the radiator pipes that was rubbing against the alternator belt. Mr B made a claim on his motor legal protection insurance policy to pursue action against the repairers for breach of contract and/or negligence. Admiral instructed its panel solicitors to assess whether the claim enjoyed reasonable prospects of success and was proportionate to pursue – which are requirements for cover under the policy. The solicitors were satisfied there was a fault with Mr B’s car. But they said there wasn’t enough evidence to determine who was responsible for it. This is because the repairers had undertaken two sets of work to the car – works to repair the accident damage under the motor insurance policy and works carried out for Mr B privately – and it wasn’t clear what set of work the fault arose from. The solicitors concluded that, due to a lack of expert evidence, they were unable to confirm which party was responsible for the fault and therefore they were unable to establish reasonable prospects of success against the repairers. They said Mr B would need to get an expert report to determine the responsible party. Based on this advice, Admiral declined cover as it said the claim didn’t enjoy reasonable prospects of success. It said if Mr B didn’t agree, he could submit further evidence for the panel solicitors to consider or he could obtain a legal challenge in the form of a prospects assessment from a solicitor of his own choice.

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Mr B raised a complaint, which he brought to our Service. But our Investigator didn’t uphold it. He was satisfied Admiral had handled the claim in accordance with the policy’s terms and conditions and hadn’t treated him unfairly. Mr B didn’t agree with our Investigator. He said the solicitor’s assessment couldn’t be relied upon as the process they’d followed was procedurally unfair, material evidence hadn’t been substantively considered, and they’d relied on an incorrect factual premise. He’s told us the solicitors have only recently agreed to reopen his claim and consider the evidence he’d previously provided which he believes clearly shows which works were the cause of the fault. As Mr B didn’t agree with our Investigator, the complaint has 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 conclusion as our Investigator and for broadly the same reasons. Before I explain why, I wish to acknowledge the parties’ submissions in respect of this complaint. Whilst I’ve read them all, I won’t comment in detail on every single point that has been made. Instead, I’ll focus on the key points that are relevant to the outcome I’ve reached. That’s in line with our remit, which is to resolve complaints promptly and with minimal formality. When making a claim under an insurance policy, the onus is on the policyholder to prove they have a valid claim. If they do, the insurer should cover the claim unless it can prove that a policy condition or exclusion applies. Mr B’s motor legal protection policy says it will cover “motoring contract disputes” to “pursue or defend contractual disputes over the sale or purchase of goods or services for the insured vehicle. This includes the sale or purchase of the insured vehicle”. The claim Mr B wishes to make is for breach of contract / negligence against the repairers. So, he needs to show he had a contract with the repairers for the work which caused the fault to his car in order for a valid claim to be made under the policy. According to the solicitors, the information provided didn’t satisfy this requirement. So, they couldn’t confirm there was a valid claim against the repairers and whether there was any merit to it. I appreciate Mr B didn’t agree with the legal advice. He’s told us there was enough evidence to show which party was responsible for the fault. But it isn’t for us to evaluate the merits of the underlying claim. Instead, we look at whether the insurer has acted fairly. As long as Admiral obtained a reasoned legal opinion from suitably qualified lawyers, we won’t generally question its reliance on that advice, unless we think it was obviously wrong or based on factual mistakes. Having considered the legal assessment, I’m satisfied its properly written, well-reasoned, and not obviously wrong. And it’s been obtained from a suitably qualified lawyer. It’s clear the repairers carried out work in or around the area of the fault for both the accident damage repair works and the works they did for Mr B privately. So, without an expert’s opinion on what work caused the fault, I’m not persuaded that an insured event against the repairers directly has been established. Overall, I haven’t seen anything to persuade me that Admiral shouldn’t have relied on the legal advice it obtained. Rather, it was up to Mr B to obtain a contrary legal opinion on the

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merits of his claim, at his own cost, if he’d wanted to challenge this further. Alternatively, he could’ve obtained an opinion from an expert on who was responsible for the fault in line with the panel solicitor’s advice. I can’t see that he did either. Based on the information available to Admiral at the time of its final response letter, I’m not persuaded that Mr B had shown he had a valid claim under his policy. And because of that, the solicitors were unable to confirm the claim enjoyed reasonable prospects of success. For this reason, I’m satisfied Admiral acted fairly and reasonably when it declined Mr B’s claim. I understand the situation has moved on since Mr B brought his complaint to our Service. I can’t consider anything which has happened since Admiral issued its final response to this complaint, but I’m pleased to hear that the solicitors are reconsidering further evidence on the claim. If Mr B is unhappy with the outcome of this, he can raise a new complaint to Admiral which he can bring to our Service in the same way he did this one. My final decision For the reasons I’ve explained, I don’t uphold the complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr B to accept or reject my decision before 3 April 2026. Sheryl Sibley Ombudsman

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