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Rejection of fire insurance claim


FSPO – Decision Ref: 2018-0083 – fire insurance claim

Background

The Complainants made a claim under their home insurance policy for damage due to their heating system as a result of a fire.

The Complainant’s Case

The Complainants state that the damage was caused due to fire therefore its covered under the fire section of their insurance policy.

The Insurer’s Case

Insurers state that the damage is due to a mouse/mice coming into contact with a microchip in the heating system. Which caused the chip to burn out and damage the heating system, therefore  the Insurer states that the damage resulted from ‘Accidental Damage’ and not a fire insurance claim.

The Insurer states that the policy under ‘Accidental loss or Damage to your building’ excludes accidental loss or damage by vermin, insects, fungus, wet or dry rot. The Insurer doesn’t accept that the loss was as a result of a fire insurance claims and refers to the engineer’s report in which it states that the microchip was burnt out but there was no fire event.

Decision

The FSPO point out what is not covered under the ‘Accidental loss or damage to Your building’ of the policy,

We will not cover accidental loss or damage:

  1. Specifically excluded under the building section
  2. By frost
  3. By wear or tear or anything which happens gradually
  4. By vermin, insects, fungus, wet or dry rot
  5. By chewing, scratching, tearing or fouling by domestic animals

The FSPO accepts that mice are vermin and that a dead mouse was found in the heating unit.

The Complainant stated in a phone conversation with Insurer when reporting the claim that mouse may have caused problems/damage with the electrical board. Recordings of telephone calls has been supplied in evidence.

Insurer engineer stated that the microchip burnt out but did not go on fire. Insurer contacted the engineer to confirm the meaning of ‘burnt out’ in the report.

The FSPO have provided dictionary definition of ‘burnt out’ which is “cease to function as a result of excessive heat or friction.” And a definition of “fire” which is “ a process in which substances combine chemically with oxygen from air and typically give out bright light, heat, and smoke; combustion or burning.” The FSPO notes that from the photos of the unit it’s not black or burnt and there is no evidence of a fire insurance claim.

With the evidence of the engineer’s report and the photos FSPO accepts that the damage was caused by a mouse or mice who caused the microchip to short circuit and cease to function. Therefore accidental damage caused by vermin is not covered by the policy and the Insurer was not obliged to pay the claim.