AXA Insurance UK Plc · DRN-6255752

The complaint Mr S2 and Mrs M complain on behalf of the estate of Mr S that AXA Insurance UK Plc unfairly declined Mr S’s home insurance claim. Mrs M is the wife of the late Mr S and is the executor of his estate. Mr S2 is the son of Mr S and Mrs M and has been given authority by Mrs M to represent the estate of Mr S in this complaint. AXA is the underwriter of this policy i.e. the insurer. Part of this complaint concerns the actions of its agents. As AXA has accepted it is accountable for the actions of the agents, in my decision, any reference to AXA includes the actions of the agents. What happened In August 2022, Mr S’s house was burgled so he made a claim under his home insurance policy with AXA. AXA instructed loss adjusters (“G”) to validate the claim. A loss adjuster visited the property in February 2023. During the visit, she spoke to Mrs M who described the circumstances of the burglary. A couple of months later, AXA said it was declining the claim on the basis that policy endorsements relating to property security hadn’t been complied with. It said the alarm wasn’t in operation at the time of the theft and the lock of the door at the point of entry didn’t meet requirements. Mrs M said the lock did comply with requirements and the alarm was on at the time of the burglary. AXA arranged for another loss adjusting company (“C”) to deal with the claim. C attempted to arrange a recorded interview with Mr S, but Mr S declined to attend. He raised a complaint which was considered by the Financial Ombudsman Service. Our investigator didn’t think AXA’s request for an interview was unreasonable. Mr S2 then informed C that Mr S had dementia. C said it would like to interview Mrs M as she was present at the initial loss adjuster’s visit and the discovery of the theft. Mr S2 said Mrs M wasn’t available for a recorded interview. He suggested that he be interviewed instead as he was there when the theft was discovered. C said it could conduct an interview with Mr S2 as long as Mrs M was also present. After some further back and forth, it was agreed that C would interview Mr S2 and Mrs M via Teams. This interview took place in January 2025. In July 2025, AXA said it was maintaining its decision to decline the claim. It was satisfied that the lock installed at the time of the theft was compliant with the policy endorsement. However, it was repudiating the claim because there was no evidence to confirm the alarm was activated on the date of the theft incident.

-- 1 of 6 --

By this stage Mr S had sadly passed away a few months before. Mr S2 was unhappy with the claim outcome and the way AXA had handled it. So, he raised a complaint. AXA apologised for some poor communication and avoidable delay, but it maintained its position to decline the claim. So, Mr S2 asked the Financial Ombudsman Service to consider the matter. I issued a provisional decision on 12 March 2026, where I explained why I intended to uphold the complaint. In that decision I said: “I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. Based on what I’ve seen so far, I intend to uphold this complaint. I’ll explain why. I’ve considered everything Mr S2 has told our service, but I’ll be keeping my findings to what I believe to be the crux of his complaint. I wish to reassure Mr S2 I’ve read and considered everything he’s sent in, but if I haven’t mentioned a particular point or piece of evidence, it isn’t because I haven’t seen it or thought about it. It’s just that I don’t feel I need to reference it to explain my decision. This isn’t intended as a discourtesy and is a reflection of the informal nature of our service. When a policyholder makes a claim, the onus is on them to show that an insured event caused the loss or damage. If it’s established that an insured event caused the damage, an insurer can decline a claim if it can show an exclusion applies or a condition has been breached. Mr S’s policy schedule includes the following wording: “Your endorsements An endorsement is a separate term, condition or extension of cover that applies to your policy. An endorsement supersedes any of the terms within your policy booklet. 1. Protection clause For any claim caused by theft or attempted theft, no cover is provided under Buildings (Section 1) or Contents (Section 2) unless all security features listed within your statement of fact are: - maintained in good working order; and - In full operation , whenever You are away from the Home.” One of the endorsements listed beneath this is: “Property Security – Alarms Fitting security measures, such as alarms, can reduce the risk of theft from the property.” AXA says it’s declined the claim because there is no evidence to confirm that the alarm was active when the theft occurred. However, Mr S2 says the alarm was activated by himself prior to him, his father and his mother leaving the house. The report from the loss adjuster from company G who visited the property in February 2023 says:

-- 2 of 6 --

“The house was secured, the electric gates were locked, but the alarm was not set on leaving; this was because the dog was in the house although the dog was kept in an animal crate in the kitchen.” After AXA informed Mr S of its initial decision to decline his claim in April 2023, Mrs M said the following in an email to the loss adjuster. “It is unclear to us where the information has been obtained that the alarm was off. My son has informed myself that the alarm was in operation at the time of the theft. He is the one who turns the alarm on and off as I am not very good with technology and he has confirmed the alarm was in fact on when we left the house on the day of the theft. He was not present at our meeting on 28th February to tell you this information.” In response to Mrs M’s email, the loss adjuster said it was confirmed in her visit that the alarm was not set at the time of the loss as the dog was in the kitchen. She questioned why the neighbour’s son said he heard a loud bang when the door was forced but didn’t hear the alarm. She said it was also confirmed at the time of her visit that workmen down the road were interviewed by the police and they saw and heard nothing. In response, Mrs M said: “With regards to the alarm, we cannot account for what others heard or saw. All we are able to confirm is that there was considerable amount of banging noise happening all day due to builders works on the road. Home and car alarms are continuously going off on and around our road and unfortunately nothing is ever queried by anybody. Our alarm was on as the dog was in his cage. When we returned home, we noticed the alarm but thought nothing of it as we assumed the dog has set it off as he has previously done before. It was once we were inside that we noticed this wasn’t the case and the home was broken into.” In a subsequent email, Mrs M said she was under a lot of stress and anxiety as she was grieving the loss of both her parents very soon after the burglary. She said she was confused at the time, and it was only when her son returned home and confirmed the alarm was on that she realised this must be relayed. AXA has provided a transcript of the interview that took place in January 2025. In that interview, Mrs M was asked some questions to clarify what she’d said at the February 2023 meeting. Mrs M said she didn’t think she said the alarm wasn’t set. She said: “I don’t think I would have said that because I heard the alarm when we came back from the supermarket. I think there’s been some miscommunication or maybe I didn’t explain myself properly to that lady.” Mrs M doesn’t appear to have been given the opportunity to review what the initial loss adjuster noted when she visited in February 2023. She wasn’t given anything to sign to confirm it was a true and accurate representation of what she said. In the January 2025 interview, Mr S2 said they put the dog in a cage because he had sometimes set the alarm off. It is noted in the February 2023 report that Mrs M said the dog was in a crate at the time of the burglary. So, I think this would support there being some sort of misunderstanding as to what Mrs M said at the time of the February 2023 interview. I’ve also kept in mind that the February 2023 interview was around six months after the burglary. At that time, Mrs M had recently suffered the loss of both parents and her husband had dementia. So, given the distress she was experiencing at the time, I think it’s possible that she didn’t express herself clearly enough in the interview.

-- 3 of 6 --

Mr S2 has confirmed multiple times in writing and in the recorded interview that the alarm was set when the burglary occurred. I appreciate that this was after AXA gave the alarm not being set as one of the reasons for declining the claim. But I can’t see that Mr S2 had the opportunity to provide information about this earlier. AXA says the police report failed to confirm the alarm had been activated. However, there’s nothing to suggest that the police asked about an alarm. So, I don’t think the absence of any information about an alarm in the police report is enough to show it wasn’t activated. I can see from AXA’s notes that there were also concerns that the neighbour’s son who heard a noise at the time of the incident didn’t mention the alarm. However, the neighbour’s son doesn’t appear to have been interviewed by the police or AXA. According to the February 2023 report, Mrs M told the loss adjuster the neighbour’s son heard a loud bang around the time of the theft. In the January 2025 interview, Mr S2 said it was he who had spoken to the neighbour’s son and had just discussed the loud banging from workers drilling the concrete. So, I haven’t seen anything to show that the neighbour’s son said that no alarm was sounding. The February 2023 report says Mrs M said workers two houses down were questioned by police but had not noticed any unusual behaviour. There’s no mention of the workers in the police report, so there’s nothing to show me what they might have said to the police if they were interviewed by them. In the January 2025 interview, Mr S2 said it wasn’t correct that the police interviewed the workers. It was his mother who spoke to the workmen and asked if they saw the burglars. So, I think what was said in February 2023 might have been misunderstood by the loss adjuster or noted down incorrectly. AXA’s notes also suggest the fact that Mrs M and Mr S2 were unable to evidence that the alarm had been activated with any assistance from their alarm company was also a factor in its decision to decline the claim. However, the policy documents confirm that the alarm was audible only and not monitored by a central station. So, they wouldn’t have been able to provide such evidence. Keeping in mind that the onus on the insurer to show that a policy condition has been breached, I’m not persuaded that it has. I don’t think it’s enough for AXA to rely on Mrs M supposedly changing the circumstances in her account of what happened, particularly when she wasn’t given the opportunity to confirm that the initial loss adjuster had noted what she said in the first interview accurately. In its submission to our service, AXA said multiple concerns have been raised about the claim. However, one of the concerns it mentioned was regarding the lock. And AXA has accepted that the lock was compliant with the endorsement. The only reason its given for declining the claim is the alarm not being activated. AXA has had around three and a half years to assess the claim which I think was ample opportunity to explore any other concerns it might have about the claim. So, I think the fairest way to resolve the complaint at this stage is to tell AXA to settle the claim, in line with the remaining terms and conditions of the policy. Given the conflicting information, I can understand why AXA wanted to conduct the recorded interview before making a decision on the claim. But I think it should have accepted the claim shortly after the interview. I think one month after the interview would be a reasonable timeframe for it to have settled the claim. So, I intend to direct AXA to add compensatory interest to the settlement at 8% simple per year from 13 February 2025 until the date the settlement is paid.”

-- 4 of 6 --

I set out what I intended to direct AXA to do to put things right. And I gave both parties the opportunity to send me any further information or comments they wanted me to consider before I issued my final decision. Responses AXA said it would be happy to accept a final decision in line with what I’d said in my provisional decision. Mr S2 said he and Mrs M agreed with my conclusion that AXA had not demonstrated a breach of the alarm condition and that the claim should therefore be settled. He said they considered this to be a fair and just outcome. However, he asked that I consider further points in relation to the proposed remedies. Mr S2 gave reasons why he felt the start date of the interest applying to the settlement should be September 2023. He also gave reasons why he felt an award should be made for the distress and inconvenience experienced by his late father. 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. I appreciate Mr S2 feels that AXA had sufficient information to accept the claim in September 2023. However, Mr S previously brought a complaint to our service which was considered by an investigator in April 2024. The investigator concluded that AXA’s requirement for Mr S to attend a formal recorded interview so it could validate the claim was reasonable. The investigator explained that Mr S could have his complaint considered by an ombudsman if he disagreed with her outcome. But this wasn’t requested so the case was closed. It wouldn’t be appropriate for me to revisit a complaint that has already been considered by our service. So, I can’t consider what happened prior to April 2024. I can see that Mr S2 made AXA aware of his father’s dementia in April 2024, and AXA proposed that his mother attend the recorded interview instead. Mr S2 initially told AXA Mrs M was unavailable for the interview and she had no obligation to attend. He later agreed that she would attend but said she couldn’t do it at the time due to illness. AXA followed this up with Mr S2 several more times before a date for an interview was agreed I acknowledge what Mr S2 has said about his mother’s vulnerability. However, I think it was reasonable for AXA to want to interview Mrs M to help clarify the conflicting information it had received. While I think AXA’s concerns should have been alleviated during the interview, I’m not persuaded this interview wasn’t necessary to validate the claim. So, I remain of the opinion that it would be fair to start the interest from one month after the interview. I understand Mr S2 feels that AXA should pay compensation for the distress and inconvenience experienced by his father. However, as I’ve explained, I can’t consider what happened prior to April 2024. Shortly after Mr S’s previous complaint about the claim was closed by the service Mr S2 explained that Mr S had dementia and started to deal with the claim on his behalf. While I appreciate Mr S may have experienced some further frustration following this, I don’t think AXA was responsible for most of the delay in the progression of the claim up until Mr S sadly passed away in April 2025.

-- 5 of 6 --

Having carefully considered Mr S2’s comments, I think the redress I proposed in my provisional decision is fair and reasonable. So, I’m not persuaded to award any additional compensation. Putting things right AXA should: • Settle the estate of Mr S’s claim in line with the remaining terms and conditions of the policy and • Add interest to the above at 8% simple per year from 13 February 2025 until the date the settlement is paid. My final decision For the reasons I’ve explained, I uphold the estate of Mr S’s claim and direct AXA Insurance UK Plc to put things right by doing as I’ve said above. Under the rules of the Financial Ombudsman Service, I’m required to ask the estate of Mr S to accept or reject my decision before 23 April 2026. Anne Muscroft Ombudsman

-- 6 of 6 --