Admiral Insurance (Gibraltar) Limited · DRN-6229011

The complaint Mr M and Mrs Z have complained about the amount Admiral Insurance (Gibraltar) Limited offered them as compensation for the handling of their buildings insurance claim. What happened In June 2024 Mr M and Mrs Z claimed for damage caused to their home following a water leak. Admiral appointed a loss adjuster to handle the claim on its behalf. Mr M and Mrs Z arranged for the leak to be repaired and towards the end of 2024 parts of the kitchen were stripped out and drying works started. A drying certificate was later issued, indicating that the property had dried out (so that repair works could start). In March 2025 Mr M and Mrs Z complained to Admiral. They said thick mould had been discovered under the floor. Admiral considered the complaint and wrote to Mr M and Mrs Z with its final response. It broke the complaint into five parts: Complaint part Admiral’s response The loss adjuster confirmed the property was dry when it wasn’t, which caused significant distress, particularly as there were vulnerable adults and a newborn baby in the home It was clear the loss adjuster’s assessment that the property was dry was incorrect; the loss adjuster failed to remove the flooring, which resulted in prolonged exposure to harmful mould spores and created unacceptable living conditions The loss adjuster said Mr M and Mrs Z weren’t entitled to alternative accommodation as he felt the property was liveable Mr M and Mrs Z should have been offered alternative accommodation sooner (it paid for Mr M and Mrs Z to live elsewhere from the end of March 2025) Overall poor service and complaint handling The loss adjuster’s handling of the claim fell below the standard Mr M and Mrs Z should have expected Mr M’s lost earnings This wasn’t covered by the policy A Subject Access Request (“SAR”) wasn’t actioned The original SAR wasn’t actioned due to an IT error Admiral apologised for the distress and inconvenience caused and offered Mr M and Mrs Z £700 compensation. It later increased the offer to £1,500 after Mr M and Mrs Z referred the complaint to us. What I provisionally decided – and why I issued a provisional decision which explained why I thought the complaint should be upheld. The relevant parts of my provisional decision are outlined below and form part of my final decision. • As Admiral had accepted Mr M and Mrs Z’s claim was poorly handled by the loss adjuster – including that the property wasn’t properly dried and that Mr M and Mrs Z should have been placed in alternative accommodation – I didn’t dwell too much on this

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part of the complaint. This was because the main outstanding area of dispute concerned the appropriate level of compensation, rather than Admiral’s liability to pay it. • I thought there were two potential elements to Mr M and Mrs Z’s compensation claim. Compensation for non-financial loss • This is often referred to as compensation for distress and inconvenience but it also includes pain and suffering. Awards I make are to compensate a complainant if a business’s mistake has caused things like: o embarrassment, anxiety, disappointment, loss of expectation, upset, stress (distress) o time, extra effort or trouble they've been put to (inconvenience). • But they also cover more serious issues such as distress making someone ill or resulting in a diagnosed mental health condition. • I don’t make awards for distress, inconvenience etc that was inevitable. I thought that was important in this case because, although it was nine months or so into the claim before Admiral provided alternative accommodation, even if the claim ran smoothly I thought Mr M and Mrs Z were always going to suffer some distress and inconvenience due to the nature of the damage caused and the time it would take to assess and repair the damage – although I appreciated both could have been reduced had Admiral paid for Mr M and Mrs Z to live elsewhere. I also don’t make awards for the distress, inconvenience etc that wasn’t suffered ie I only look at what did happen; I don’t consider what might have happened had the circumstances been different. • I usually consider that compensation between £750 and £1,500 is likely to be fair where a business caused a consumer substantial distress, upset and worry – including serious disruption to daily life over a sustained period, with the impact being felt for many months. Admiral’s offer was at the upper end of this range. • I usually consider that compensation over £1,500 is likely to be appropriate where a business caused sustained distress, potentially affecting someone’s health – typically lasting more than a year. • I didn’t think there was any doubt that Mr M and Mrs Z suffered more than they ought to have – something, as outlined above, Admiral had accepted. For example, even though they didn’t know precisely what was causing the suffering, Mr M and Mrs Z had to live with mould under the floor for longer than they should have. Mr M and Mrs Z further told us that Mr M suffered from asthma and that his breathing worsened due to the mould (particularly as he spent a lot of time in the kitchen). They also told us their newborn baby suffered similar difficulties. They were particularly concerned for their baby’s health going forward given the exposure to the mould spores. • I acknowledged Mr M and Mrs Z’s comments about their suffering. But I was persuaded that Admiral’s offer was fair. I didn’t think there were sufficient grounds for me to make Admiral increase the offer further without any independent (eg medical) evidence showing the increased suffering and linking it to Admiral’s poor handling of the claim. Compensation for financial loss

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• Both Admiral and our investigator dismissed this part of Mr M and Mrs Z’s complaint on the basis that the policy didn’t cover lost earnings. I didn’t think that approach was fair or correct. That was because although it was true the policy didn’t cover lost earnings, Mr M and Mrs Z’s claim for lost earnings wasn’t made under the terms and conditions of the policy – it was made as compensation because, in essence, Mr M and Mrs Z said that were it not for Admiral’s poor handling of the claim it wouldn’t have been necessary for Mr M to have taken time off work. In effect, this claim was no different to the claims for distress, inconvenience and suffering (which weren’t covered by the policy either). • For me to make Admiral pay any compensation in this respect Mr M and Mrs Z needed to show/evidence (a) that it was necessary for Mr M to take the time off work and (b) the financial loss they suffered. • For (a), Mr M told me he was effectively left to project manage the outstanding repairs – including finding and liaising with the contractors. He said he was receiving numerous calls a day from the contractors to discuss and oversee the repairs – which took him away from his work. He also said it was a one hour round trip between the alternative accommodation and his home. Mr M felt his actions resulted in the repairs being completed quicker than they would have been (which in turn meant Admiral paid less overall than it would have done to re-home him and Mrs Z) had he not taken the time off. • Given the problems Mr M and Mrs Z had encountered with the claim and the loss adjuster, and Mr M being left to sort out the outstanding repairs, I didn’t think it was unreasonable for Mr M to have chosen to take time off work with a view to moving things forward and getting the repairs done quicker. The other option would have been to leave the repairs in Admiral’s hands or for Mr M to only take calls from the contractors outside of work hours. I didn’t think either would have been practical or would have resulted in the repairs being completed any quicker than they were. Accordingly, I concluded it was necessary and fair in the circumstances for Mr M to have taken time off work. • For (b), Mr M’s losses were twofold – lost wages and lost bonuses. Mr M provided us with a copy of a calendar which showed a total of 18 days “Unpaid Leave” in April and May. He also provided his payslips from April and May which showed total deductions of £1,350.65 for “Unpaid hours/days”. I was therefore satisfied that Mr M had showed that he lost £1,350.65 in lost wages due to the time he took off work in April and May to project manage the claim. • The lost bonuses were a little trickier to calculate because the bonus Mr M earned each month fluctuated. He told me the lowest he received was around £300 and the highest was around £700 – with an average around £450. Mr M’s payslip from April showed a bonus of £405 (from sales in March). His payslips from May and June showed a bonus of £0 (from sales in April and May). At the higher end, a screenshot I’d seen showed a bonus of £757 for last month. • Based on what I’d seen I thought the fairest way to calculate the lost bonuses was to assume that the bonus Mr M would have earned in April and May had he not taken the time off would have been similar to the bonus he earned in March. Accordingly, I thought it was fair to conclude that Mr M lost £810 in bonuses due to the time he took off work in April and May to project manage the claim. • That brought Mr M’s total lost earnings for April and May to £2,160.65 Responses to my provisional decision

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I haven’t received any further comments or evidence from either party in respect of my provisional conclusions. 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. As there is nothing more for me to consider, my final decision remains as outlined in my provisional decision – for the same reasons. Putting things right For the reasons outlined above, I conclude that Admiral should pay Mr M and Mrs Z: • a total of £1,500 compensation for non-financial loss (ie £1,500 less what it has paid already) • £2,160.65 compensation for financial loss, plus interest at a rate of 8% simple calculated from 31 May 2025 to the date of payment. My final decision I uphold this complaint. I require Admiral Insurance (Gibraltar) Limited to settle the matter as outlined under the ‘Putting things right’ heading above. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr M and Mrs Z to accept or reject my decision before 14 April 2026. Paul Daniel Ombudsman

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