Liverpool Victoria Insurance Company Limited · DRN-6182112

The complaint Mr G is unhappy that Liverpool Victoria Insurance Company Limited (“LV”) declined his home emergency claim when his boiler stopped working. What happened The background to this complaint is well-known to both parties, so I’ve summarised what I think are the key events. Mr G had home insurance underwritten by LV. He also bought the optional home emergency cover. In April 2025, Mr G’s boiler developed a fault and, being without heating and hot water, he claimed under the home emergency policy. LV sent an engineer the same day who diagnosed a faulty pump. The following day, LV declined to offer any further service under the policy because its engineer had noted that the pump was not a manufacturer’s approved pump and it was faulty. Mr G said the pump was replaced some weeks earlier for maintenance purposes, but his boiler hadn’t stopped working then. He asked LV to show where in the policy it excluded cover for the reasons it had given. Mr G said it was unable to find any such exclusion, but LV maintained its decision to decline the claim. It said the policy excluded faulty workmanship and it was a matter for Mr G’s own engineer to fix. Unhappy with LV’s decision, Mr G complained. He said LV had treated his claim as if it were under an extended or manufacturer warranty, and also as if it was a home insurance claim. He said it was neither of those and should have been treated as an emergency claim, which is what it was. LV issued a final response to Mr G on 29 April 2025 in which it said: Unfortunately, we were unable to move forward with repairs as this part had been very recently replaced by a third party. As we were not contacted when the part initially failed, we would be unable to perform any rectification work for repairs completed by a third party. Mr G had the pump replaced, at no cost, by his own engineer who told him that it was a faulty part, which can happen. Mr G’s heating and hot water was restored. When Mr G brought his complaint to us, our investigator upheld his complaint. She said LV had reasonably concluded that Mr G’s own engineer was responsible for the repair. However, our investigator agreed LV had failed to handle his claim appropriately, in particular during calls. She thought LV should pay £100 compensation for the poor customer service which caused Mr G to be without heating and hot water for longer than he reasonably expected.

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Mr G didn’t agree. He asked for an explanation of why the pump was not suitable, and how a fault with a part might be considered poor workmanship. Our investigator responded with LV’s comments but Mr G remained unconvinced that the pump was incompatible with his boiler. I issued a provisional decision in February 2026 explaining that I was intending to uphold Mr G’s complaint, but for different reasons to those set out by our investigator. Here’s what I said: provisional findings The Financial Conduct Authority’s rules (ICOBS 8.1.1) say that insurers must handle claims promptly and fairly. And that they mustn’t turn down claims unreasonably. The policy sets out the detail of the contract between Mr G and LV and, having looked carefully at the terms and conditions, I don’t think LV’s reasons for declining to offer emergency assistance were in line with the policy. Mr G had an engineer carry out maintenance work on his boiler due to it not working as well as it should. As part of the work the engineer replaced the pump. The pump was faulty and Mr G’s boiler stopped working. So, simply put, Mr G made a claim under his home emergency policy when his boiler broke leaving him without heating and hot water. Being without heating and hot water is classed as an emergency under the policy terms and conditions. Looking at the policy, LV’s responsibility was to: organise and pay for an approved repairer to provide emergency assistance, up to a maximum of £1,000 (including call out, parts, labour and VAT) for any one emergency Emergency assistance is defined in the policy as follows: work carried out by an approved repairer to resolve the immediate emergency. This may involve a temporary or permanent repair. On the face of it, then, LV ought to have carried out at least a temporary repair so that Mr G could arrange and pay for a permanent repair if necessary. Instead, LV declined further cover because its engineer said the wrong pump was installed; it wasn’t compatible with a boiler, and it was faulty. But the policy Mr G had was to provide emergency assistance – a temporary repair - it was not necessarily required to pay for a replacement pump. However, Mr G was unaware that LV would not be offering further assistance until later the following day. I think that if LV’s engineer concluded that the wrong pump had been installed, then that could’ve been explained to Mr G on the day and he could’ve arranged for his own engineer to replace it. Instead, LV went on to say that the policy didn’t provide cover because Mr G had not contacted it first before arranging for his pump to be replaced; that there was third-party interference, and that the parts were not genuine manufacturer’s parts meaning the boiler’s warranty would be invalidated. When Mr G asked where the policy excluded cover for the reasons it gave, LV was unable to find anything. I’ve considered the reasons LV gave for not providing assistance but I have not seen evidence that there are any such exclusions relating to the home emergency claim Mr G made. • The boiler warranty is not relevant to the claim, and the use of non-branded parts is not excluded in the policy. Indeed the policy provides for LV using other compatible

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parts if they are unable to source the manufacturer’s parts. • LV was unable to point to where in the policy there was an exclusion for third-party interference. • Mr G had not needed to contact LV before having work done on his boiler because it wasn’t an emergency. The original work was routine and wouldn’t have been covered under the policy anyway. Ultimately, LV’s final response was that Mr G hadn’t contacted it before having work done by a third party so the claim was excluded. Given that the work done by the third party wasn’t in response to an emergency, and routine work is clearly set out in the section for repairs not covered under the policy, I don’t think LV fairly sought to rely on this policy exclusion. Further, cover is provided on the condition that a boiler is maintained, so it’s reasonable to expect that a third-party would’ve worked on it at some point. Turning to the matter of whether the pump was compatible, I can understand that LV relied on its engineer’s view that it was not compatible with Mr G’s boiler. LV did not provide a photo of the pump in place to evidence that it was incorrect for the type of boiler. I asked Mr G to provide information about the pump that his engineer installed and the one that it was replaced with. He said his engineer replaced the faulty pump with the same type and since then his boiler has worked. He provided a photo of the box in which the pump was packaged prior to installation. Not unreasonably, Mr G did not have any photo evidence of the original pump, the faulty replacement, or the current one in situ. I’ve thought carefully about this point and I think that if LV’s engineer had told Mr G during the visit that the pump was incompatible, Mr G might’ve been in a position to challenge or question the facts and restore his heating sooner. Whether or not he agreed with LV’s engineer, Mr G could’ve asked his own engineer to return and the faulty pump might’ve been replaced sooner. Having listened to the subsequent calls between Mr G and LV, I think matters have become complicated when LV has tried to provide answers to Mr G’s questions about why the pump installed was not correct. It’s evident that the technical specification of the pump and whether it was compatible with the boiler has become a drawn-out dispute, and to the extent that the main issue of complaint has been lost. The key issue is that LV did not provide emergency assistance when Mr G made his claim and, in the circumstances, I think it relied on irrelevant or non-existent policy terms and conditions. Because of this, Mr G was without heating and hot water for two days. Mr G raised further concerns about the way LV handled his complaint. While complaint handling itself is not a regulated activity, I have considered how this affected the overall claim. The home emergency insurance is a regulated activity, and in trying to find out why LV was not accepting his claim, he made a complaint. Therefore I think it’s appropriate to address Mr G’s concerns here. I’ve listened to the calls in which Mr G tried to raise a complaint about how LV handled his claim. My overriding observation was that LV seemed to be providing a timeline of the complaint process repeatedly, but failing to hear or respond to what Mr G was saying. That is, he wanted to understand where the quoted exclusion was shown in his policy and he complained because no one could direct him to it. But LV’s response was about making a complaint and that it could take up to eight weeks to resolve. Given that Mr G was without heating and hot water at the time, I don’t think it was helpful to focus on the complaint process and timeline rather than Mr G’s need for clarification about why LV wasn’t providing emergency assistance. I will mention here that Mr G’s frustration was evident and LV felt it necessary to terminate a

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call when it became heated on Mr G’s part. I don’t find LV’s action in respect of this particular call unreasonable in the circumstances. In summary, I think that LV unfairly declined Mr G’s emergency assistance claim based on the reasons it gave. His heating and hot water was restored but, more likely than not, it took longer than it would’ve done had LV completed a temporary or permanent repair in line with the policy. The final repair carried out by Mr G’s own engineer was at no further cost to him, so I don’t think there’s any direct financial detriment that LV needs to put right. However, in recognition of the avoidable delay in restoring his heating and hot water, I think compensation is warranted. I also think compensation is warranted for LV’s shortfall in handling Mr G’s overall claim and his subsequent questions about the cover available to him under the policy. Our investigator proposed £100 compensation. While I realise Mr G’s level of frustration was significant, LV issued its final response to Mr G’s complaint and its final claim decision within a week. So I can’t justify increasing the award based on the circumstances presented. I asked both parties to send me any further comments and information they might want me to consider before I reached a final decision. Responses LV did not make any further comment or submission. Mr G said he appreciated the recognition that it was a home emergency policy and that LV relied on non-existent exclusions. However, he felt the decision was incomplete and requested consideration of the following: • issuing its final response within a week did not amount to proper complaint handling and he repeated this request for £200 compensation along with £100 for the time he invested in preparing his complaint referral to this service. • What he considered to be LV’s untruthful and factually incorrect responses regarding the policy cover and complaints process, for which he repeated his request for £200 compensation. • LV’s reliance on an outdated energy standard that did not exist in respect of his claim. • The wider implications of LV’s conduct. 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 remain of the view that the outcome I proposed is fair and reasonable in the circumstances. In my provisional decision, I explained that I thought LV’s reason for turning down Mr G’s claim was not in line with the policy. Therefore, I was persuaded that LV had not acted fairly or reasonably. However, I see no reason to award separate compensation for each listed element of shortfall in its claim handling. That’s because, when looking at the complaint as a whole, LV’s failure to handle the claim appropriately caused a delay of two days in Mr G’s hot water and heating being restored. And given that it was Mr G’s own engineer who unknowingly installed a faulty pump, I think it’s reasonable that the same engineer replaced it.

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Thinking about LV’s reliance on its own engineer’s assessment of the third-party pump installation being faulty, I’m satisfied that it was reasonable in the circumstances. But LV’s responsibility was to handle the emergency – the loss of heating and hot water - which might have been, for example, providing heaters until Mr G could arrange a permanent fix. It is for this shortfall along with LV’s delay in communicating the outcome of the visit that I considered £100 compensation was warranted. I’ve considered the points Mr G raised in his response and the matters which he thinks have not been considered sufficiently or at all. My remit is to look at Mr G’s complaint about how LV handled his claim and, where appropriate, require action of LV to put matters right. Any wider implication across LV’s customers is not within my remit to address in my direct response to Mr G’s complaint. LV responded to Mr G’s complaint and issued its final position promptly. While Mr G did not agree with its position, I do not consider that providing clarity promptly amounts to a failure to consider matters. Overall, I find that LV should’ve handled the emergency situation and communication with Mr G better than it did, and its failure to do so caused him an avoidable, albeit minimal, delay in restoring heating and hot water. However, I see no reason to increase the compensation to £700, which is what Mr G requested, and I’m satisfied that £100 by way of apology for the service shortfalls is fair and reasonable in the circumstances. My final decision For the reasons I’ve explained above, and in my provisional decision, my final decision is that I uphold Mr G’s complaint and Liverpool Victoria Insurance Company Limited must: • pay £100 compensation for the distress and frustration caused by the shortfall in service which caused Mr G to be without heating and hot water for longer than reasonably expected. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr G to accept or reject my decision before 14 April 2026. Debra Vaughan Ombudsman

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