Intact Insurance UK Limited · DRN-6238393

The complaint Mrs S has complained that Intact Insurance UK Limited (Intact) unfairly declined a claim under her home insurance policy. References to Intact include companies acting on its behalf. What happened Mrs S made a claim when a retaining wall collapsed in three stages at her property. UKI assessed the claim, including by sending a surveyor, and declined it. It said the damage was because tree roots had destabilised the wall, which wasn’t covered by the policy. When Mrs S complained, UKI maintained its decision to decline the claim. About seven months later, a retaining wall at the back of the house collapsed following heavy rain. UKI assessed the claim, including sending a surveyor, and declined it. When Mrs S complained, UKI maintained its decision to decline the claim. It said the damage was due to a natural breakdown of materials. It said the wall was built many years ago and these types of walls fail slowly over time, as they’re not designed to take the pressures put open them. When Mrs S complained to this Service, our Investigator told Mrs S that her first complaint wasn’t one this Service could consider as it was submitted to this Service too late. However, we could consider the complaint about the wall collapse at the back of the house. When our Investigator looked at that complaint, she didn’t uphold it. She said she considered it in line with how we would normally look at storm complaints. She said there weren’t strong winds around the time the wall collapsed. But, there was heavy rainfall, which she said was exceptional enough for her to say it was a rainstorm. However, she said a boundary wall should generally be able to withstand a storm. She said she was more persuaded there had been a build-up of rainfall over a prolonged time. She said it was unlikely a storm was the main or underlying cause of the damage. She said she agreed with the insurer that it was more likely a breakdown of materials over many years. She said the wall showed general signs of deterioration. So, it was reasonable for Intact to decline the storm claim. As Mrs S didn’t agree, the complaint was referred to me. I issued my provisional decision on 6 March 2026. In my provisional decision, I explained the reasons why I was planning to uphold the complaint. I said: My decision is only looking at the second claim and complaint. The first complaint was submitted to this Service too late for us to consider it. When we look at a storm claim complaint, there are three main issues we consider: 1. do we agree that storm conditions occurred on or around the date the damage is said to have happened? 2. is the damage claimed for consistent with damage a storm typically causes? 3. were the storm conditions the main cause of the damage?

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We’re only likely to uphold a complaint where the answer to all three questions is yes. I’ve looked at the weather conditions around the time the wall collapsed, which was on 24 November 2024. The day before the wall collapsed, there were peak gusts of 56mph and a daily rainfall total of 49.2mm. The day the wall collapsed, the peak gust was 51mph and the daily rainfall total was 56.8mm. These would be considered storm strength winds, combined with a significant amount of rain in a short period of time. I also think the damage is consistent with damage that could be caused by a storm. I think a storm could cause a wall to collapse, particularly where there is a combination of storm strength winds and significant rainfall. So, I think the answer to the first two questions is yes. So, I’ve also thought about whether the storm conditions were the main cause of the damage. I’ve looked at the Intact’s surveyor report, including the photos. This said: “When the surveyor inspected the garden/boundary wall he observed that the damage was caused by Natural breakdown of materials”. Intact also provided some further comments from the surveyor that he had sent in an email. This said: “I have been to this property twice now to look at two different sections of the wall. Both sections of the wall have collapsed after its has been said heavy periods of rain. The walls in question were built many years ago and as retaining walls up to a standard that was standard practice then. The issue I have is that these types of walls will and, as we can see, fail slowly over time as they are not really designed to take the pressure put upon them unlike more modern and more highly engineered retaining walls.” (As original) I thought the surveyor’s assessment lacked detail. So, I asked Intact for further details of the surveyor’s assessment. It provided the same email, along with the surveyor’s audio notes from the visit. One of the audio recordings said: “…This retaining wall here … it’s enormous. It’s nearly as tall as the house. You can see historical movement within the wall itself over time. This must have been built around the same time as the house due to retaining it, the ground behind it. There is a small section which has now collapsed. It’s just loose fill really a lot of this. The stones over the years the in-fill starts to wash out, dirt gets into the middle of it and eventually the weight behind it can start pushing it and we can see that is occurring along the wall due to bows and historical distortions. I have to say this is, unfortunately, an age-related issue.” Following the claim decline, Mrs S provided Intact with a report from her own engineer. Intact later emailed Mrs S and said: “I have reviewed the engineers structural report and looked through the claim with my technical team and we are not changing the decision”. I asked Intact to provide its technical team’s assessment of Mrs S’s report to show why this hadn’t changed its view about the claim decline. It replied and said the technical experts’ comments weren’t available because it had been an internal discussion. It said it had no reason to think the technical experts hadn’t taken Mrs S’s expert report into account when making the claim decision. I found it difficult to form a view on Intact’s assessment of the claim. I think it lacked detail and I don’t think it was clear from the photos where the issues identified by the surveyor were on the wall or why issues were considered to be historic. I also think it wasn’t possible for me to understand how it had formed its view on Mrs S’s expert reports and why, following this, it had reached its decision to continue to decline the claim. Overall, I didn’t find Intact’s position particularly persuasive.

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I also read Mrs S’s expert report, which was prepared by a structural engineer. The report assessed both claims. However, I should note that I am only considering the second claim, even though I have included some references to the first claim. The engineer’s first report was written shortly after Intact’s surveyor had visited. It said: "Having inspected the state of the wall behind the house as it stands and photos of the wall by the drive leading to the house of it before the major collapse and a Google Street view of the wall before any collapse, I am at a loss to understand why the loss adjuster has declared that both collapses are not insurable perils. My reasoning is that the condition of both the wall behind the house and the wall by the drive leading up to the house were in a good condition before any collapse occurred. There is no sign of any significant lean or bulging or deterioration to the wall then would indicate that the walls were in imminent danger of collapse or that they were badly maintained. There are quite a few drainage holes through the wall to relieved pressure from behind due to the possible build up of any water. It is understood that both wall collapses occurred as a result of heavy rainfall in the period just before the collapses … There are quite a few drainage holes through the wall to relieved pressure from behind due to the possible build up of any water. It is understood that both wall collapses occurred as a result of heavy rainfall in the period just before the collapses.” A couple of weeks later, the structural engineer wrote a further report. This was because Mrs S had told him Intact had been in contact to say it had declined the claim “due to the age of the wall”. The structural engineer’s report said: “Let me firstly say that having looked through the insurance document from [Intact] that you sent me there is no exclusion of any building or structure due solely to the age of the structure. A typical exclusion of any structure is if it has not been maintained and the damage or collapse is due to wear and tear. I spent a considerable amount of time with photographic evidence in my previous letter to show that the walls that collapsed were all in a good state of repair considering their age and that there is nothing to show that the walls were about to collapse.” The structural engineer also provided Mrs S with a document that explained about retaining wall collapses, including some case studies. He also commented on the level of rainfall for the second claim, which he said was 6.5 times the average rainfall. He suggested Mrs S put his report to Intact to consider the claim further. About six months later, Mrs S’s structural engineer provided a further report. I should note that this was shortly after Intact responded to Mrs S’s complaint. I later asked Intact some questions, including asking it to consider this report, which it did. References to paragraphs are to those in Intact’s complaint response and the structural engineer’s report said: “In the fifth paragraph it says “[The loss adjusters] carried out an inspection and advised the cause of the damage to the recent claim to be historical movement over time”. This is not what [the loss adjusters] said to you and that the wall collapsed due to it being an old wall. There is a complete inconsistence between what [the loss adjusters] said to you and what they have [later] said to [Intact]. This is very unprofessional. [The loss adjusters] provided no evidence to show how they can know if there was historical movement and this is simply because there had not been any significant movement. My letter of 17/12/24 showed that the wall, from Google street views was in a good condition and with no signs of any lean or disturbance.

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The fifth paragraph also says “A small section had collapsed but the surveyor could see this was just loose fill, whereby dirt gets in and starts pushing the wall. This is something that would happen to all of the wall and would be age related. The claim was declined, due to a natural breakdown of materials.” This is simply a mind-boggling statement as it seems that the … surveyor has no idea how retaining walls work. All walls support fill or whatever material is behind and it pushes against the wall and the weight of the wall prevents it from falling over. In periods of storm this load is increased and this is what causes collapse. I [am] also at a loss to determine what is meant by “a natural breakdown of materials”. [The loss adjusters] have never said that to you and they do not appear to provide any photographic evidence to show this. I attach two photographs of the revealed side/cross section of the remaining wall after one section collapsed. You can clearly see that the wall has NOT broken down and therefore it is just an invented cause of collapse by [the loss adjusters]. The [eighth] paragraph is another curious statement showing again that the … surveyor does not understand how old stone retaining walls work. Old stone walls will only fail over time [if] they are not maintained and looked after. My letter of 17/12/24 established quite clearly that the stone retaining wall was in good condition and had been pointed over time. It was therefore NOT failing over time and it is spurious and without any evidence for [the loss adjusters] to say so.” It is irrelevant for [the loss adjusters] to say that old walls were not designed to take the pressures put upon them as this wall had done so for over a 100 years as have many old stone retaining walls in [this area].” When Intact replied to my questions about the claim and the structural engineer’s reports, it maintained its view that it was fair for it to rely on its own surveyor’s report that the damage wasn’t caused by an insured event. It also said: “I disagree that there are inconsistencies with our surveyors explanation. As the dictation included with the report from [surveyor] states, they have said the policy would not respond due to the historical distortions of the wall and the age of the wall. He observes that there are a lot of historical problems with the wall. This is not inconsistent with the damage that he observed and the comments regarding the loose fill. Furthermore, where the insureds own surveyor … refers to the google images, these refer to the sections of the wall that were the subject of the previous claim, not the damage to the wall at the rear of the property.” I think Intact has misunderstood what the structural engineer said. It’s my understanding that he was commenting that the written reasons given to Mrs S to tell her the claim had been declined were different to the written explanation she was given in the complaint response. I note that the reasons for the claim decline did seem to change and were more detailed in the complaint response. I am also aware that the google images seemed to be of the sections of wall that were part of the first claim. I also asked Intact to show what specific evidence there was of a natural breakdown of materials. Intact said: “The surveyor inspected the wall and observed distortion in the wall due to age. He comments that a lot of this was loose fill and over the years the infill starts to wash out and eventually the weight behind it starts to push out. He observed that this was starting to happen with bowing and that it was an age related issue.” I also asked Intact to provide the evidence to show there was historical movement. Intact said:

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“The surveyor visited the property and made a number of observations including bowing along the wall.” I don’t find either of these explanations particularly persuasive. I was already aware this was what the surveyor said he saw. But, for example, I haven’t seen evidence that showed it was more likely than not that any distortion was due to age or that the observations about loose fill should be relied on to show there was an issue, rather than just how these types of walls were constructed. I asked Intact to provide the specific reason why it had declined the clam and, if possible, to show how this was supported by the photos. It said: “The specific reason for declining the claim is that the damage has not been caused by an insured event. The surveyor explained to the insured in her presence that this was due to historical distortions and the age of the wall and it has simply collapsed from these deteriorations over time. We remain of the view that this is not damaged by substantial rainfall over a two day period although it may have contributed to it. However, it seems unlikely that the rainfall over the two days mentioned would have been sufficient to increase the hydrostatic pressure to the point where it would overwhelm the wall and cause its collapse. Rather, it is far more likely that the wall has become weakened over time.” I note that Intact has said the surveyor explained to Mrs S the reasons why the claim was declined. Having listened to the two recordings, which I take to be the basis for Intact saying this, I’m not clear whether Mrs S would have heard what was said and whether the majority of it was directed to her. The surveyor was recording his claim assessment. He was softly spoken and quite difficult to understand in places. In both recordings, the surveyor spoke to Mrs S, but he raised his voice when he did so to ask her a direct question. I also note that Intact provided the same photos it had previously sent, but didn’t highlight the issues the surveyor had identified. I accept this was likely a simple misunderstanding of what I was asking. But, I remain unclear how, for example, the photos supported that the wall was bowed, as I’m not sure where this is shown in the photos, or that how the photos showed this was more likely to be historic, rather than a consequence of the storm. I also asked Intact to consider the document about retaining walls that included the case studies. When it replied, it said there was nothing in this document that would overturn its decision. It said the guidance strongly reported its conclusion that no insured peril operated. It also said the document explained that prolonged rainfall didn’t constitute a storm and couldn’t on its own establish a peril. It also commented: “Scenario guidance confirms that collapses linked to, inadequate drainage, weep-hole blockage, or groundwater accumulation are not storm or flood and are typically excluded due to deterioration or maintenance issues. This matches the likely cause here, given the visible condition and lack of maintenance history.” However, I’m not clear why Intact is suggesting there were issues with inadequate drainage, weep-hole blockage or ground water accumulation. I’m not aware that these were identified as the likely causes for the wall’s collapse. At the end if its comments, Intact also said the document confirmed that: "  the observed conditions indicate long-term deterioration  heavy/persistent rainfall does not constitute storm  and that well-maintained retaining walls should not collapse solely due to rainfall."

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So, from what I can see, Intact didn’t fully assess the weather conditions at the time of the incident. There wasn’t just heavy/ persistent rainfall. There were also storm strength winds. So, I think this suggests that Intact hasn’t assessed this claim with the correct weather information in mind. Based on what I’ve seen, I’m not currently persuaded that Intact has fairly assessed this claim. From what I can see, it hasn’t understood the weather conditions at the time of the incident for the second claim. It also seems to have been inconsistent in its reasons for the wall collapsing and now seems to be suggesting reasons that I can’t see have been previously raised. Although it is often reasonable for an insurer to rely on their expert’s findings, I haven’t seen photo evidence of the issues the surveyor identified or received what I consider to be persuasive evidence of why the collapse was more likely due to historic issues. As a result, I currently intend to say that Intact needs to continue to assess this claim. As part of that, it needs to ensure that it has taken into account the full weather conditions when the wall collapsed. It also needs to fully assess all the evidence, including Mrs S’s expert evidence. It needs to provide Mrs S with an outcome to the claim and, if it still maintains its decision to decline the claim, it needs to provide a clear and detailed explanation of this, including why it doesn’t accept the structural engineer’s expert evidence. I’ve also thought about compensation. I think Mrs S’s claim and complaint has been poorly handled. Intact has been inconsistent and unhelpful in its explanations to Mrs S. I think this has caused her distress and inconvenience. As a result, I currently intend to require Intact to pay Mrs S £200 compensation to reflect the impact on her because of how it has dealt with the claim. I asked both parties to send me any more information or evidence they wanted me to look at by 20 March 2026. Both parties replied before that date. Intact said it accepted my decision. Mrs S, in summary:  queried whether the first claim was covered by the second complaint response as it had been referred to.  agreed with my observations on Intact’s surveyor’s assessment and the photos.  confirmed again her engineer’s opinion that the retaining wall had been in good condition and that the heavy rainfall immediately before the incident was the likely cause of the failure.  said she didn’t think Intact had properly addressed the expert evidence or explained why it had been rejected. She also agreed the full weather conditions, which was heavy rainfall and storm-strength winds, didn’t appear to have been considered.  she said she agreed with my view on the second claim and hoped the first claim could also be reconsidered. 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 uphold this complaint and for the reasons given in my provisional decision. I have looked again at whether the first claim can be considered as part of this complaint. I considered this before I issued my provisional decision and concluded that it couldn’t. I remain of that view.

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The second complaint response explained that the complaint was about the second claim decline. Although it referred to the first claim, I don’t think that meant Intact was revisiting that claim or its decision on it. My reading of this was that it was mainly noting what had previously happened. The complaint response was about the reasons for the second claim being declined. However, if Mrs S has new or additional information or evidence in relation to the first claim that she wants Intact to consider, this doesn’t prevent her from providing it with that information or evidence. If Mrs S then disagrees with Intact’s conclusions on it, she can raise a new complaint. My final decision For the reasons I’ve given above and in my provisional decision, my final decision is that this complaint is upheld. I require Intact Insurance UK Limited to:  Continue to consider the claim in line with the policy terms and conditions.  If it continues to decline the claim, it must provide Mrs S with a clear and detailed explanation of why it has done so, including why it doesn’t accept her structural engineer’s evidence.  Pay Mrs S £200 compensation. Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs S to accept or reject my decision before 17 April 2026. Louise O'Sullivan Ombudsman

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