Admiral Insurance (Gibraltar) Limited · DRN-6090258

The complaint Mr A and Mrs A complain that Admiral Insurance (Gibraltar) Limited hasn’t agreed to settle part of their home insurance claim. Admiral is the underwriter of this policy i.e. the insurer. Part of this complaint concerns the actions of its agents. As Admiral has accepted it is accountable for the actions of the agents, in my decision, any reference to Admiral includes the actions of the agents. Mr A and Mrs A are joint policyholders, but most of the communication regarding the complaint has been from Mr A. So, I’ll refer mainly to him in my decision. What happened In February 2025, Mr A and Mrs A made a claim for storm damage to their property under their home insurance policy with Admiral. Admiral arranged for a surveyor to attend. The surveyor concluded that the damage wasn’t caused by a storm. So, Admiral declined Mr A and Mrs A’s claim. Mr A disagreed with Admiral’s decision. Admiral suggested he provide a cause of damage report for its consideration. Mr A provided a report from a roofer, but Admiral maintained its position regarding the decline of the claim. After Mr A raised a complaint, Admiral said it would cover the cost of replacing damaged fascias and guttering. It also paid Mr A £200 for distress and inconvenience. Mr A thought Admiral should also accept his claim for the side of the roof and roof tiles and the related structure as well as scaffolding and a skip for debris. So, he asked the Financial Ombudsman Service to consider the matter. Our investigator asked Admiral if it would contribute to or pay for a skip and scaffolding as it was covering the replacement of the fascias. Admiral said the settlement it had paid Mr A included the costs of supplying scaffolding and an allowance for the disposal of fascia, but it did not include an allowance for separate waste disposal. It said it would contact Mr A and raise a payment for the costs of additional waste removal. Our investigator thought Admiral’s offer was fair. She wasn’t persuaded Admiral was liable for the other damage Mr A was claiming for. Mr A disagreed with our investigator’s opinion. He said the storm that caused the damage took place in January 2025, not February 2025. He didn’t agree that google maps images supplied by Admiral were relevant to his claim. He felt the evidence he’d provided from the roofer had been disregarded. He said the homebuyer report from before he’d purchased the property indicated the roof and walls were in good condition, but Admiral had said this wouldn’t be considered. He said missing mortar from one tile had nothing to do with water

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going in and causing damage to the whole roof. So, 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 broadly the same conclusions as our investigator. I’ll explain why. I’ve considered everything Mr A 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 A I’ve read and considered everything he has 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. Mr A’s policy provides cover for loss or damage caused by an event listed in it. For Mr A’s loss to be covered, it would need to fall under one of those events. If it doesn’t – then the claim isn’t covered and won’t be settled. So, I’ve needed to consider whether Mr A has shown that an event listed in the policy caused the damage. Mr A says the damage to his property was caused by a storm, which is one of the insured events listed in the buildings section of the policy’s terms and conditions. So, I’ve considered if the damage was likely to have been caused by this peril. When our service looks at storm damage claims, we ask three questions. These are: • Do we agree that storm conditions occurred on or around the date the damage is said to have happened? • If so, is the damage being claimed for consistent with damage that a storm typically causes? • Were storm conditions the main or dominant cause of the damage? If the answer to these questions is ‘yes’, then the claim is likely to succeed. But, if the answer to any of the above questions is ‘no’ – the claim for storm damage is unlikely to be covered. The policy’s terms and conditions define “storm” as follows: “For weather to be classed as a storm, one or more of the following must be present: • Wind with gusts of at least 55mph • Heavy rainfall at a rate of at least 25mm per hour • Snow to a depth of at least 30cm in 24 hours • Hail that causes damage to hard surfaces or breaks glass These extreme weather conditions can cause damage to even well-maintained homes. However, damage caused to homes that have not been well-maintained, or caused by normal weather or wear and tear, is not covered…” Admiral has accepted that there were storm conditions shortly before Mr A made the claim in February 2025. Mr A says he believes the storm damage he is claiming for happened in January 2025, rather than the February 2025 date in Admiral’s surveyor’s report. So, I’ve

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kept this in mind when considering the second question which is whether the damage being claimed for is consistent with damage that a storm typically causes. When Mr A made his claim, he said the roof fascia and a section of the gutter was falling down. He believed some roof tiles shifted as they didn’t look aligned. The ceiling and wall in the bedroom had water ingress and were cracked. Admiral has agreed to settle the damage to the fascias and guttering. So, I’ve only needed to consider the other damage Mr A is claiming for in this decision. Admiral’s surveyor noted that verges on the gable-end of the house had deteriorated mortar works along both elevations. The surveyor’s report says the external damage was caused by deteriorated mortar works and the internal damage to the ceiling was caused by rainwater ingress over time. Mr A has provided a copy of his homebuyer report dated August 2022. He’s commented that this has rated the roof and walls as ‘1’ which is the top grade. I can see that the roof is graded as 1. However, the homebuyer report says: “The Inspection is a general surface examination of those parts of the Property which are accessible: in other words, visible and readily available for examination from ground and floor levels, without risk of causing damage to the Property or injury to the Surveyor.” The report also says: “Roofs are prone to water penetration during adverse weather but it is not always possible for surveyors to identify this likelihood in good or dry weather. All roofs should be inspected and repaired by reputable tradesmen on an annual basis and especially after storms.” So, while the roof was graded as 1 which means “no immediate action or repair is needed”, I’m not persuaded the report is evidence that the roof was watertight immediately prior to the storm events of early 2025, particularly as the survey was carried out around two and a half years earlier. The homebuyer report also says “gable verge tiles require pointing repairs particularly at the apex of the roof.” So, I think this supports what Admiral has said about the deteriorating mortar on the verges of the gable-end of the house. This can also be seen in photographs in a google maps image from 2024 as well as in Admiral’s surveyor’s report. Admiral has also provided images of the property from August 2019, October 2020, April 2021 and May 2024 which show raised and misaligned roof tiles above a window at the front of the house. Admiral says this would allow rainwater to penetrate below and behind the first row of tiles damaging over time the fascia board / soffits and sub-fascia wood causing it to rot. I think it’s clear from photographs in the surveyor’s report that the wood underneath the fascia that had come off in the storm a few days prior to the visit was rotting. This suggests water had been entering for some time before the storm event. Mr A has commented that the google map pictures show the side of the building which was visible from the road and this was not involved in the damage that occurred. However, having reviewed Admiral’s surveyor’s photographs and google maps, I’m satisfied that the fascia fell off the side of the house which was in view of the road. I’ve reviewed the cause of damage report Mr A has provided from the roofer he instructed to inspect his roof. This refers to ridge tiles being dislodged and several front and back first-row tiles being visibly broken or displaced. However, there are no photographs of the outside of the house to support this. Nor is there any evidence of damaged or dislodged tiles in the

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photographs taken by Admiral’s surveyor. So, I’m not persuaded the roofer’s report is evidence of storm damage to the roof. I appreciate my answer will be disappointing for Mr A and Mrs A, but I haven’t seen evidence to persuade me that there was storm damage to the side of the roof, roof tiles or roof structure. Based on what I’ve seen, I think the internal damage to the loft and bedroom is likely to have been caused by water ingress because of a pre-existing issue with the roof, rather than being due to a one-off storm event. So, I’m not persuaded that the storm events were the main cause of the damage Mr A and Mrs A are claiming for. Admiral appears to have accepted the damage to the fascias and guttering is covered by the policy because it’s likely these were blown off during the storm. It’s also agreed to add the cost of additional waste removal to the claim settlement. I think this is fair and reasonable in the circumstances. Putting things right Admiral should pay Mr A and Mrs A the cost of the additional waste removal it has agreed to. My final decision For the reasons I’ve explained, I uphold Mr A and Mrs A’s complaint and direct Admiral Insurance (Gibraltar) Limited to put things right by doing as I’ve said above. Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs A and Mr A to accept or reject my decision before 22 April 2026. Anne Muscroft Ombudsman

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