Aviva Insurance Limited · DRN-6209427

The complaint C, a limited company, complains about the way Aviva Insurance Limited has handled several claims under their legal expenses insurance (“LEI”) policy. Where I refer to Aviva, this includes the actions of its agents and claims handlers for which it takes responsibility. What happened The detailed background to this complaint is well known to both parties, so I’ll only summarise the key events here. • In 2016, C made a claim under their LEI policy to pursue legal action for breach of contract against their bank regarding a transaction on their account. • Aviva instructed its panel firm of solicitors, who were of the opinion the claim didn’t enjoy reasonable prospects of success. As this was a requirement for cover under the policy, Aviva declined the claim. • In 2023, C made a claim under their policy for professional negligence against the panel firm. They said the panel firm had reached an opinion on prospects without taking advice from counsel. • Aviva couldn’t locate another solicitor on its panel willing to take on the case. So it allowed C freedom to choose their own solicitor. C asked to appoint a solicitor who I’ll refer to as ‘S’. • S initially submitted a claims management report to Aviva which confirmed they didn’t know if the claim enjoyed reasonable prospects of success. They said they’d need the panel firm’s file and advice from counsel. Subsequently, S confirmed there were reasonable prospects. • Aviva raised concerns. It said it wasn’t clear how S had reached this opinion because the panel firm’s file had been destroyed due to the length of time which had passed since the original claim – so there were no documents to base an opinion on. It said S hadn’t cited any case law nor had it addressed limitation. • Aviva informed C it wasn’t prepared to appoint S under the policy. It said it had concerns over S’ prospects assessment, as well as S’ conduct on other claims they were representing C on under the policy. In addition, it said as C was still pursuing legal action against their bank, any losses against the panel firm hadn’t yet crystalised and they should wait until that matter had resolved. • C raised a complaint. They said they were struggling to find another law firm and wanted S to act for them.

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• In response to the complaint, Aviva said it was now prepared to instruct S under the policy, but S had declined to act until Aviva has settled their costs bill on other claims. It said C would need to find another law firm. It acknowledged there’d been some poor customer service and delays during the claim, and it offered £250 compensation to put things right. • C was unhappy with this response and brought their complaint to our Service. • Whilst the complaint was with us, S agreed to act on this claim under the policy. Aviva sent its terms of appointment to S in February 2025, agreeing to S’ hourly rate and the cost of obtaining counsel’s advice. But S didn’t respond, so Aviva closed its file. • Our Investigator looked into what had happened. And he was satisfied Aviva had acted in line with the policy terms and hadn’t treated C unfairly. As C didn’t agree with our Investigator, the complaint was passed to me to decide. And I issued the following provisional decision. My provisional decision I’ve reached the same outcome as our Investigator, but for different reasons. Before I explain why, I wish to acknowledge the parties’ submissions in respect of this complaint. Whilst I’ve read them all, I won’t comment in detail on every single point that has been made. Instead, I’ll focus on the key points that are relevant to the outcome I’ve reached. That’s in line with our remit, which is to resolve complaints promptly and with minimal formality. The terms and conditions of C’s LEI policy say: “2. Claims – legal representation a) On acceptance of a claim, if appropriate, We will appoint an Appointed Representative. b) If it is necessary to start court proceedings or there is a conflict of interest, an Insured Person is free to nominate an Appointed Representative by sending to Us the name and address of the suitably qualified person. c) If We do not agree to the Insured Person’s choice of Appointed Representative under condition 2(b) above, an Insured Person may choose another suitably qualified person. d) If there is still a disagreement with regard to the Appointed Representative, We will ask the president of a relevant national law society to choose a suitably qualified person to represent an Insured Person. We and the Insured Person must accept such choice. e) In all other circumstances We will be free to choose an Appointed Representative. f) An Appointed Representative will be appointed by Us and represent an Insured Person according to Our standard terms of appointment.” Aviva couldn’t find a panel firm willing to take on C’s claim for professional negligence. So it allowed C freedom of choice – which I agree was appropriate. C wanted to use S, but Aviva didn’t agree, so in line with 2(c) above, Aviva asked C to choose another firm. I don’t think this was unreasonable. The policy terms allow Aviva to refuse a nominated solicitor. And I’m satisfied it had valid reasons to do so, given S had

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provided an unreasoned opinion on prospects based on insufficient evidence and were refusing to cooperate in a cost assessment on other claims. In any event, Aviva subsequently agreed to S’ appointment so this complaint point falls away. At the time of the complaint, it was S who had declined to act. And, as it stands today, there is cover available under the policy for S to act and costs to obtain counsel’s advice have been approved. So if C wants to utilise their policy and be represented by S, they need to arrange for S to cooperate with Aviva. Alternatively, C can appoint another law firm. C says Aviva were unfair to suggest this claim should be placed on hold until the claim against their bank had resolved. They say liability and breach could be investigated without their losses being crystallised, and to delay things could cause issues with limitation. Whilst I agree with the point C is making, Aviva didn’t decline the claim on this basis or insist the matter be placed on hold. I can’t see on file that Aviva refused to progress the claim for this reason. It merely raised a suggestion that, without the panel firm’s file or sufficient evidence to base an opinion on prospects, it might be worth waiting to see what the outcome of the appeal against the bank brought to determine whether a claim for negligence had merit. This didn’t impact the progression of C’s claim, so I don’t think the suggestion Aviva made – whether appropriate or not – caused any detriment here. And finally, Aviva identified that its communication could’ve been clearer at times and there had been delays in processing the claim. I don’t disagree that Aviva could’ve responded sooner on occasions. But I’m mindful that much of the time spent on this case was determining C’s legal representation and, as I’ve explained above, I’m not persuaded Aviva acted unfairly in this regard. Overall, I’m satisfied the £250 compensation which Aviva has already paid sufficiently reflects the impact its actions had on C. So, I’m not persuaded it needs to do anything more. Responses to my provisional decision Whilst C has responded to my provisional decision, their points appear to relate to different complaints which I’ve already issued final decisions on, and these matters can’t be revisited. I haven’t identified any submissions relevant to the subject matter of this decision. Aviva didn’t respond. 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 neither party had any further submissions for my consideration, I see no reason to deviate from the outcome explained in my provisional decision. My final decision For the reasons I’ve explained, I don’t uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask C to accept or reject my decision before 6 April 2026. Sheryl Sibley Ombudsman

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