AXA Insurance UK Plc · DRN-5996385

The complaint Mr K and Mrs S complain they were given incorrect information during a phone call with AXA Insurance UK Plc (AXA) when discussing the purchase of a legal expenses insurance policy. While Mr K and Mrs S refer the complaint jointly as joint policyholders, the telephone call in question to AXA was made by Mr K, and he’s corresponded with AXA and our service throughout the complaint. I'll therefore mainly refer to him but this should be taken to include Mrs S where appropriate. What happened Mr K was in the process of renewing a home insurance policy and phoned AXA to discuss this, including that there were building works at the property. During the course of this phone call, the potential cover for a claim made against building contractors for the work was discussed. Mr K renewed the policy online, including in the cover an add-on for legal expenses insurance. That cover was provided by a different insurer, A. Mr K subsequently made a claim on the legal expenses insurance cover against the building contractor. This claim was declined as the contract the claim related to had been entered into before the policy cover started, which was the subject of a policy exclusion. Mr K made a complaint to A, and then our service. We thought the decision to decline cover was fair given the relevant exclusion. A new complaint was then made about AXA which was referred to our service when AXA rejected it. Our investigator thought that while the content of the phone call could have been clearer, she didn’t think Mr K had suffered any meaningful loss. Given the circumstances, she didn’t think it was likely his decision to take out the cover was solely based on the advice given around a potential claim against the contractor. She also thought it was unlikely he’d have been able to secure relevant cover for what he subsequently sought to claim. She didn’t believe it was reasonable to ask AXA to effectively pick up the claim and act as if it was covered. Mr K disagreed and asked for an ombudsman’s decision. 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’m aware Mr K believes AXA should be liable for a claim which would be advanced against the building contractor. I assume by this he means that the claim would be subject to the same terms and conditions as the legal expenses insurance policy with A, except for the exclusion for claims relating to contracts entered into before the policy cover started. I don’t think this would be a reasonable outcome. Firstly, while it was suggested that a claim

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against the contractor would be covered on the legal expenses insurance during the call, I think it’s fair to say that there had been various points discussed within the call relating to the building works, insurance cover and the extent of liability in both the legal expenses cover and home insurance. I also don’t think it’s reasonable to expect AXA to pick up a claim based on one piece of incorrect advice from its advisor. It’s also important to note that Mr K was speaking with a sales advisor, having contacted AXA to discuss the renewal and changes to a policy. He wasn’t speaking with, and could have no reasonable expectation that he was speaking with, a claims advisor who could indicate whether a claim would be successful. It isn’t reasonable to expect that a sales advisor can say whether a hypothetical claim would be covered. Any claim will be subject to the terms and conditions, and the application of those terms and conditions to the actual circumstances. This was a non-advised sale, which means that AXA weren’t recommending a policy based on Mr K’s specific demands and needs. Rather, they were obliged to make a fair presentation of the terms of cover and I’m satisfied this occurred here. Furthermore, it’s also evident that both during the call and prior to the policy being purchased, Mr K had access to the policy documents including the terms and conditions. The relevant exclusion is suitably prominent in the documents given its limitation on cover. Legal expenses insurance policies typically exclude from cover disputes arising from matters which occurred before the cover started, and this is no different. The condition didn’t require particular attention to be drawn to it beyond what was provided prior to the policy being purchased. I’m also not persuaded by a suggestion that Mr K only took out the legal expenses cover on the basis of the advice that a claim against the building contractor would be covered. The legal expenses cover is wider than contract disputes. In any case, if Mr K suggests that the reason for taking out the cover was because he already anticipated making a claim on the policy, then it would seem inevitable that such a claim would be unsuccessful. The intention of the legal expenses policy he held with A was to provide cover for unexpected events. Taking out a policy with the knowledge a claim would be made is the opposite of that. While I appreciate that it was frustrating to be told by A that his claim was unsuccessful based on the previous call with AXA, I don’t think there was a material difference in what happened here in contrast to what should have happened. AXA’s advisor should either have said they couldn’t comment on the cover provided by the legal expenses insurance and to refer to the policy documents, or alternatively said that based on the information from Mr K that it was unlikely that a claim would be successful. In either scenario, Mr K would have needed to submit the claim to A in order to establish whether cover was provided, which is what happened. Finally, I’ve considered whether Mr K’s decision to take out the legal expenses cover was done on the basis of the incorrect advice, as opposed to obtaining alternative cover elsewhere which would have provided the cover he seeks. As I’ve said above, these types of exclusions are common on legal expenses insurance policies. Where an event giving rise to a claim occurs before the policy is taken out, most insurers won’t provide cover. Specialist cover taken out after the event is available but no evidence has been provided that Mr K would have been able to obtain such cover at the time, or since. There’s nothing to suggest he’d obtained advice about any such specialist cover at the time of his phone call with AXA. I can’t conclude that Mr K has lost the opportunity to obtain that specialist cover because of the incorrect advice given by AXA.

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My final decision I don’t uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr K and Mrs S to accept or reject my decision before 27 April 2026. Ben Williams Ombudsman

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