SoL · DRN-6191972

The complaint Mr T complains that SoL unfairly declined a claim he made on a business protection insurance policy. Both Mr T and SoL have been represented during the course of the claim, and (in Mr T’s case) submissions to our service. Where I refer to either Mr T or SoL within this decision, this should be taken to include their respective representatives where relevant. What happened The background to this complaint is well known to both parties, and for the purposes of my decision, a detailed timeline isn’t necessary. I’ve summarised what happened. • Mr T held an insurance policy with SoL which provided cover for, among other things, liabilities to third parties in respect of his worker as a roofer. • Mr T was contracted by a third party contracted him to carried out repairs to a roof. After completing the work, a fire occurred at the premises he’d been working at. • Insurers for the building held Mr T liable for the damage, saying his works had caused the fire. • Mr T approached SoL as his insurer, seeking cover for the claim made against him. • After examination of the damage, SoL’s position was that the fire had started in the eaves of part of the roof (hereafter referred to as Roof C, in line with the terminology used throughout the claim) after Mr T used a gas torch to apply felt. • SoL concluded that the policy didn’t cover what had happened. It concluded Mr T hadn’t complied with conditions relating to the use of heat, and that use of heat was the cause of the fire. • After extensive correspondence between SoL and Mr T, he referred his complaint about this decision to our service. SoL had maintained its decision to decline cover but offered £300 compensation to recognise there had been delays in its assessment of the claim. • Our investigator thought Mr T’s complaint should be upheld as SoL hadn’t acted reasonably in declining the claim. SoL didn’t agree and asked for an ombudsman’s decision. On reviewing the information available, I didn’t think SoL’s decision to decline the claim had been unfair. I was therefore of the opinion that the complaint shouldn’t be upheld. In my provisional decision, I My provisional decision In the findings of my provisional decision, I explained I was minded not to uphold Mr T’s complaint, and outlined my reasons for this: When it declined cover for the claim, and throughout correspondence with Mr T and our service, the “Use of heat condition” outlined in the terms and conditions of the policy has been the focus of attention. Although not every section has been relied on or referred to, I’ve reproduced it in full below:

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“It is a condition precedent to liability that in respect of use away from your premises of blow lamps blow torches flame guns hot air guns hot air strippers electric oxy-acetylene or other welding or cutting equipment and angle grinders (in circumstances where sparks are emitted) or tar bitumen or asphalt boilers or pitch heaters the undernoted precautions will be complied with on each occasion. a) the immediate area in which work is to be carried out must be examined and combustible property within the vicinity of the work either removed to a distance of not less than 6 metres from the point of work or as far as practicable covered by noncombustible materials, blankets or screens. b) adequate and suitable fire extinguishers in full working order must be kept available for immediate use at each area of work and used immediately where smoke smouldering or flames are detected. c) heat equipment will be lift for as short a time as possible before use and extinguished immediately after use and will not be left unattended while hot lit or switched on. d) upon completion of each period of work a thorough fire safety check must be carried out in and around the vicinity of the work (including spaces behind walls screens or partitions and above false ceilings). The fire safety check must be undertaken at regular intervals for a period of at least 30 minutes after completion. e) the area in which the work is to be carried out including adjoining shafts or openings and the area on the other side of any wall or partition must be inspected to see whether any combustible property other than the property to be worked upon is in danger of ignition either directly or by conduction of heat f) all combustible property must be removed to a distance of not less than 6 metres from the point of work and property which cannot be moved must be covered and fully protected by overlapping sheets of non-combustible material or equivalent protection g) you must arrange for a person who is competent in the use of fire extinguishing appliances to work in conjunction with the operative using the equipment to act as a fire watcher and to remain in attendance at all times until lighted flame equipment is extinguished h) gas cylinders not in use must be kept outside the building in which the work is taking place where practicable but in any event at least 15 metres from the point of application of the heat i) any tar bitumen or asphalt boiler must not be left unattended j) the heating of asphalt bitumen tar or pitch must be carried out in the open in a vessel designed for that purpose placed on a noncombustible surface” SoL’s position is that Mr T, when he carried out the works breached clauses (d), (e) and (f). In submissions to our service, it said that, in essence, the decision here is considering two questions: • Did Mr T breach the use of heat condition? • Has Mr T shown that the breached condition could not have increased the risk of the fire that occurred? I agree with this position, and think it helpfully distils the matters I need to decide. The “Use of Heat” condition is explicitly stated to be a “condition precedent to liability.” What this means is that if the condition is breached, then cover can be declined, irrespective of whether that breach directly caused the loss being claimed. However, section 11 of the Insurance Act 2015 says that non-compliance with a policy condition cannot be used to decline cover if that non-compliance could not have increased the risk of the loss which occurred. In other words, there needs to be a link between the breach of the condition and an increase in the risk of the relevant loss.

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This is what the two questions SoL has referred to are seeking to establish – whether there was a breach of the condition and whether there was a link between that breach and the risk of the loss claimed (ie the fire). While there’s some overlap between the conditions SoL has referred to, I think it’s worth considering each individually. The nature of the conditions is such that, if I’m satisfied that Mr T didn’t comply with any of them, and that non-compliance represented an increased risk of fire, then it follows that SoL’s decision to decline cover was fair. Only if I conclude that none of them have been breached (or alternatively that non-compliance didn’t increase the risk of the fire which occurred) would I look to uphold the complaint and require SoL to reconsider the claim. Separately from this, Mr T believes that the compensation paid by SoL for delays during the claim to have been inadequate. He says the £300 offered doesn’t properly reflect the impact of unfairly declining cover on his mental and physical health. He’s said that if cover is declined, then he’s likely to be made bankrupt and that is having a significant effect on his wellbeing. He’s also incurred legal fees through his ongoing correspondence with SoL about the claim. I’ll consider whether SoL’s offer of compensation is suitable once I’ve looked at the decision regarding cover, and also address the legal fees and SoL’s liability for those after looking at the policy cover question. There has been a large amount of correspondence between Mr T, SoL and our service. I’ve tried to summarise their respective positions below, before going on to consider each of the relevant conditions in turn. SoL says: - An external check of the roof is insufficient to discharge the obligations of the use of heat condition. - The fire safety check after the work was completed was inadequate in that it didn’t examine the eaves / voids around roof C. - The check before work was carried out was inadequate. - Mr T failed to remove or cover combustible items - If the conditions had been complied with, the fire wouldn’t have occurred - The requirements of clause (d) in the use of heat condition are absolute, not what is reasonably practical. - The requirements of clause (e) implied that the eaves of roof C should be checked before the works. - The requirement to cover combustible items in clause (f) is absolute, and not qualified in any way. - Hot works should have been avoided in the area around roof C. - If it wasn’t practicable to carry out checks which complied with the conditions, then an alternative method of works should have been carried out. - Torch free methods of work were available. In contrast, Mr T says: - The fire safety check carried out after the completion of works was adequate and reasonable. - The checks carried out before the works were started were reasonable. - He couldn’t remove the combustible property that was identified. - It wasn’t possible or practical to cover the combustible property that was identified. - There was no evidence of any combustible material in roof C. - Clause (a) of the use of heat condition (and other wording in the policy) says that combustible property should be covered as far as is practicable.

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- He couldn’t have used a torch free method to carry out the works. Any alternative would have incurred additional costs - Reasonable steps were taken to mitigate the risk of fire. - SoL is failing to apply any reasonable interpretation to the policy conditions. - SoL’s expectations on him in respect of checks are unreasonable. - It isn’t SoL’s role to tell Mr T he should use other methods. - Any non-torch alternative would still have required the use of a heat gun, which would fall within the use of heat condition and so the same restrictions would apply Cause and source of the fire Before I go further and consider the various clauses of the use of heat condition, I think it’s important for me to outline my thoughts on SoL’s conclusions regarding the source of the fire. I’m aware there was, in correspondence, between SoL and Mr T, some dispute about where and how the fire started. My role here isn’t to say how the fire occurred, or what the source was. Rather, I need to determine whether it was reasonable in the circumstances for SoL to conclude that the gas torch used by Mr T was the source of the fire. A forensic expert (Dr S), who examined the premises after the fire, said “On the day of the fire Mr T had been using a gas torch to apply felt to the flat roof. The gas torch was last used two hours prior to the discovery of the fire. On this occasion, it was used to apply a strip if felt in a narrow gap between the skylight in the southeast corner of the flat roof and the upstand with Roof C. Given the coincidence in timing and location of the fire, its cause was very probably associated with this activity.” Dr S went on to conclude, “Overall, it is far more likely than not that the fire was caused by Mr T inadvertently ignited combustible materials within the eaves of Roof C with the gas torch” [sic]. I’m aware that Mr T has also engaged a chartered surveyor who cast doubt on this conclusion, commenting that they’d have expected more damage in the area where SoL’s expert identified as the source of the fire. However, the surveyor also notes that they haven’t inspected the roof in question, and are reliant on the report and photos of SoL’s expert in assessing what had happened. I also note that no other location for the fire starting has been suggested or identified. On balance, therefore, I conclude that SoL’s position that the fire started in the eaves of roof C and was caused by Mr T’s use of the gas torch in that area as part of the works is reasonable. I say this because I think it was fair to rely on Dr S’ report as the sole expert who had inspected the location. Dr S was suitably qualified to make that assessment, and no alternative source of the fire has been identified. Clause (d) Clause (d) concerns the checks carried out after the completion of hot works, to ensure that there is no fire or signs of a fire starting. It requires Mr T (as the policyholder) to carry out a check in the “vicinity” of the area worked in. However, “vicinity” isn’t given any definition, but it’s clear from the wording of the clause that checking the exterior and/or visible areas isn’t sufficient. I say this because, after saying that a check of the vicinity needs to be carried out, the clause says this “includes….” These would be beyond the scope of a check of the exterior. I note that the vicinity to be checked “includes” a number of specific spaces, and so I’m satisfied that this isn’t intended to be an exhaustive list of the areas which need to be checked. It seems to me that a reasonable interpretation of this is any space or item which could pose a fire risk should be examined as part of this check. The crucial question,

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therefore, is whether the “vicinity” mentioned in the clause included the roof eaves and void space of Roof C. If it did, it follows that a check of these should have been carried out. The case of Financial Conduct Authority v Arch considered the issue of “vicinity” and has been referred to in correspondence. That case involved the extent of cover for businesses forced to close by the COVID-19 pandemic, and so any discussion of “vicinity” as part of that is of limited benefit to the facts of this case. In that case, there was discussion of whether “vicinity” referred to locality of neighbourhood or UK-wide. That isn’t relevant to my considerations here. It's inevitable that “vicinity” will have different meanings across different insurance policies, but I need to think about its application to this policy, and Mr T’s circumstances. I accept (and SoL hasn’t disputed) that Mr T took the actions of a reasonable roofer, but that it isn’t necessarily sufficient here. An insurer is free to impose restrictions on cover which go beyond the actions a reasonable roofer would take. That doesn’t render the conditions unfair, as long as they’re suitably clear and prominent in the terms and conditions. I think the condition is clear in that it requires a fire safety check to go beyond an external examination limited to the area in which hot works were carried out. The question is the extent of the required check, and whether the areas in which SoL reasonably concluded the fire started were included in that. It seems to be accepted that the area in question was within six metres of the location where hot works were being carried out. I say this because in submissions, it’s been argued by Mr T (and SoL accepts) that it wasn’t possible to remove the combustible items which were in this area outside of that distance (as required by clause (f)). I think the six metre distance is relevant here when it comes to assessing what is meant by “vicinity.” It’s evident that other clauses (specifically clauses (a) and (f)) make reference to a distance of six metres, and so I've considered whether the “vicinity” (in the absence of any other definition) is the same, less or more than this distance. I think it’s fair to say that the six metre distance should be considered analogous to the “vicinity,” as both that specified distance and the more general “vicinity” are related to the safe distance away from hot works which would usually be at a much lower risk of fire. I think that if an area is within six metres of the area where hot works were performed, then that should be included in the post-work fire safety check. That safety check, as I’ve detailed above, needs to be more than an external check. Therefore, I conclude that the area in which it’s been concluded the fire started should have been included in the fire safety check. I take Mr T’s point that in order to carry out a check of this part of the roof, slate and felt would have needed to be removed, potentially causing further damage. However, I also note that if that was the case, as part of the pre-work checks, Mr T should have been aware that a post-work safety check of a required area wouldn’t be possible. In that case, I agree with SoL that Mr T could have considered alternative methods to avoid the use of heat in that area. I also note Mr T’s position that a reasonable roofer wouldn’t carry out a check which involved the removal of slate and felt. I accept that position, but the relevant test here is whether it’s reasonable to say that in order to comply with the condition of the policy, he should carry out a check of that nature. The term, in my opinion, is worded in a way that is suitably clear and it has suitable prominence within the terms and conditions. On balance therefore, I think that

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SoL has demonstrated that Mr T’s fire safety check wasn’t in line with the requirements of clause (d). I’m also mindful of the requirements of clause (f) (which I’ll come onto consider in due course) which require the removal or covering of any combustible property. Mr T’s position with regards to this is that relevant items in and around roof C couldn’t be removed or properly covered. If I accept that position, then it also follows that the area near those items should be the subject of particular attention as part of the fire-safety check. And so if it was neither possible to remove the combustible items, nor carry out a check in line with clause (d), then it similarly follows that an alternative method for the works should have been adopted, avoiding the use of heat in this area. I think the second part of the question I need to answer, whether there was any link between the non-compliance and the risk of a fire is fairly straightforward. I can’t see any way in which a check which didn’t meet the requirements of the clause didn’t increase the risk of fire. While I note the fire was discovered some time after Mr T ended the fire-safety check (and it’s accepted that the period of time that Mr T carried out the check was longer than required by the policy), the fact that areas which should have been checked weren’t, and that those areas presented a risk of fire means that SoL could reasonably conclude there was a direct link between the non-compliance with the clause and an increased risk of fire. For these reasons, I’m satisfied that Mr T’s fire-safety check wasn’t compliant with clause (d) of the use of heat condition. As such, that means it’s fair for SoL to have relied on the condition and decline cover. Notwithstanding this, and my earlier point that if SoL could rely on any of the clauses as a reasonable justification to decline the claim, I have also considered clauses (e) and (f), and their applicability to the circumstances of the claim. Clause (e) This clause relates to checks carried out before hot works are undertaken. The relevant part that I need to consider is whether the eaves and area behind roof C fall within the scope of the area to be checked. The clause states that the inspection must cover “the area in which the work is to be carried out including adjoining shafts or openings and the area on the other side of any wall or partition.” Similarly to clause (d), this clause details the area to be inspected, and then lists a number of specific areas as part of this. Again, in line with clause (d), I don’t think this is intended to be an exhaustive list, as it states “including.” The clear intention, in my opinion, of the clause is that the area needs to be checked for combustible property. There’s no doubt that Mr T did identify potentially combustible property as part of his pre- works inspection, as this is indicated on a checklist completed at the time. However, it also seems to be accepted that he didn’t check behind roof C. This was for the same reason as given for the post-work checks not being carried out in these areas – namely that to do so would have required the removal of slates and felt, and potentially caused further damage to the roof. Given the similarity of the clause, and the arguments around whether the relevant areas should have been checked and the practicality of doing so, my findings on this point are broadly similar to what I’ve said with regards to clause (d). I’m satisfied that the intention of the policy was for all areas where there is a risk of combustion to be checked prior to work being carried out. On balance, that includes the area

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around roof C, including the void and eaves. If I accept that to carry out a check of those areas would require the removal of parts of the roof and/or further damage, rendering that impractical, then it follows that an alternative method should be used to avoid the use of heat in those areas. It isn’t sufficient to say that because a check can’t be practically carried out of those areas then the requirements of the condition don’t apply. I’m satisfied that there’s evidence a suitable alternative method could have been used which wouldn’t have involved the risk assumed by Mr T, and which he now seeks to have SoL provide cover for. Clause (f) Like clause (e), clause (f) relates to actions taken before carrying out hot works. It requires the removal or covering of any combustible property within six metres of the area to be worked on. I’ve addressed it in part in my discussion of clause (d), but the main point of contention here is whether provisions outlined in clause (a) also apply to clause (f). Mr T seems to accept that there was combustible property in the relevant area, and maintains that it wasn’t possible to remove these items and it similarly wasn’t possible to properly cover them. SoL accepts that point, but says this was an absolute requirement and so if the items couldn’t be removed or covered, then heat shouldn’t have been used. Mr T’s says that clause (a) is worded in a similar way to clause (f) but has a qualification to it that items which can’t be removed should be covered “as far as practicable.” There are two ways of looking at this. The first would be to say that the intentions of clauses (a) and (f) are similar, in that they require the removal or covering of combustible property before carrying out hot works, and so it would follow that the “as far as practicable “ requirement should also extent to clause (f). The alternative is to say that clauses (a) and (f) are separate, and that clause (f) explicitly requires the removal or covering, without any qualification I agree there’s merit in both parties’ positions on this point, but I also think there’s a lack of clarity here. There’s no obvious reason why clause (a) has the qualification which is lacking from clause (f). The two have a similar effect and relate to combustible property. The distance in both that property needs to be removed to is six metres, and if the items can’t be removed they should be covered. As that’s the case, I can’t see why one clause has the qualification around covering items “as far as practicable,” if that doesn’t similarly apply to the provisions of clause (f). Where there are two similarly worded clauses, and one has the qualification, I think it’s reasonable to say that qualification applies to the other, even if the wording doesn’t explicitly say this. Notwithstanding this, however, if the items couldn’t be covered or removed then it follows that they would remain in situ during the course of the works and would be the subject of the pre-works checks addressed by clause (e) and the post-work fire safety checks required by clause (f). It seems to be accepted that the combustible property which applies to clause (f) was checked before and after the works, with no obvious issues. The areas of concern with regards to clauses (d) and (e) were in voids and eaves. On balance, therefore, I don’t believe that it was reasonable for SoL to rely on a breach of clause (f) when it declined the claim. I’m aware this will be of limited effect to the overall outcome of the complaint, and Mr T’s claim, given my findings about the applicability and compliance with clauses (d) and (e). Claim handling

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Mr T’s complaint also includes concerns about the way in which SoL handled the claim. He’s referred to the impact on his health of being told that the claim wasn’t covered, given the likely financial impact of this on him if his insurance doesn’t cover his liability. While I understand that, as I’ve outlined above, I think SoL’s decision to decline cover for the claim is fair, and so I can’t require it to pay compensation to recognise the impact of that decision on him. Mr T’s also incurred significant legal costs in the course of his dispute with SoL. I understand why he’s done so, as SoL has similarly received legal advice over the course of the claim, but there was no obligation on him to do so. Similarly, while his complaint has been submitted to both SoL us with the assistance of legal representation, that would seem to me to have been his choice to do so. There’s no requirement in either the policy or in using our service that legal representation be engaged to make submissions. On that basis, and as I’ve also concluded that the decision to decline cover was reasonable, I can’t ask SoL to make any contribution towards Mr T’s legal costs. However, SoL has acknowledged there were unnecessary delays to the claim. Considering their duty to handle claims promptly and effectively, it’s right that this is recognised. The delays, it seems to me, arose because of the complexity of the issues to be addressed and the need to obtain advice from a number of sources. That’s acceptable, but at the same time there doesn’t seem to have been sufficient efforts made to update Mr T, set timescales for the completion of enquiries and work to those deadlines. As a result, it seems to me that Mr T could have been better informed about SoL’s actions and the status of the claim over a period of several months. While the outcome of the claim wouldn’t have been different, the extended periods with a lack of clarity would have been distressing, especially given the likely consequences if the claim was declined. SoL has offered £300 compensation to recognise the impact of its poor handling of the claim. I think this is a fair amount, taking into account the length and extent of the delays, but also being mindful that it wasn’t the primary reason for the distress Mr T has suffered. I want to finish by making some general points, which it seems to me apply to all of the clauses addressed above. One of the points made by Mr T is that if he was to carry out the checks that SoL says were required in order to comply with the various clauses of the use of heat condition, he would have incurred additional costs. I understand that position, but an increase in costs isn’t a reason to say that various clauses of the use of heat condition aren’t enforceable. It seems to me that in such a scenario, a policyholder has a choice whether to accept the increased costs (and either absorb these or pass them onto their customer) or assume the risk related to the use of heat at a lower cost. Furthermore, I’m aware of the Safe2Torch guidance, published by the National Federation of Roofing Contractors (NFRC). I’m aware that compliance with this guidance isn’t a condition of the policy, and that Mr T isn’t a member of the NFRC. Notwithstanding this, I’m satisfied the guidance does give useful insight into the use of heat, and the steps available which can mitigate the risk. Thie guidance notes a number of scenarios relevant to the circumstances of this claim, including where combustible property can’t be removed or covered, and also where checks can’t be carried out without invasive examinations or further damage caused. In those situations, the guidance says that alternative methods should be explored. What this shows, for me, is that there’s an acceptance that the use of heat can pose significant risks, and that there are alternatives to its use. Unfortunately, the evidence I have is that Mr T either didn’t consider alternative methods, or of if he did, he preferred the use of heat even though, as I’ve outlined in doing so he wasn’t compliant with the relevant clauses of the use of heat condition.

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I accept that SoL can’t tell Mr T what methods to use to carry out roof repairs. However, insurance cover is based on the level of risk an insurer is willing to assume, and so if Mr T wants to benefit from the cover provided by the policy then he needs to comply with the relevant conditions. SoL has evidently taken the view that the risk of a fire leading to a claim is significant, and so has placed strict conditions on the use of heat to mitigate this risk and limit its exposure to claims where steps which may go beyond what would normally be expected by a reasonable roofer. If that means Mr T has to change his ways of working, then that’s an consequence of having the insurance cover, rather than SoL dictating how he carries out his work. I’m conscious as well that Mr T may consider the policy to be of limited benefit, as it would prevent him from going about his normal business in a commercially viable manner. If that’s the case, it would be separate to this complaint. That would be a concern that the policy wasn’t fit for purpose at the time of sale, and that the clauses he considers to be restrictive should have been discussed at that stage. My decision here is about whether SoL could reasonably rely on the policy terms and conditions and whether the claim was declined fairly. I can’t, and am not in a position to, comment on the advice given to Mr T or sale of the policy. The responses to my provisional decision Both SoL and Mr T were provided with copies of my provisional decision, and offered the opportunity to make any further points in response to my findings. They both responded, although only Mr T made additional points or comment on my findings. SoL accepted my provisional decision, but Mr T, as will become clear, didn’t. In summary, he says: - He was given no opportunity to discuss and negotiate the terms of the policy when he took out the cover. - When he took out the policy, it wasn’t explained that the use of heat condition would be applied in the way SoL did. - Our service’s position in previous decisions is that there needs to be a causal link between the alleged breach of a condition and the loss which resulted in the claim (as opposed to an increased risk of that loss). - In order to decline cover, SoL needs to prove Mr T breached a condition “contained in” the use of heat of condition. - None of the requirements of the use of heat condition expressly required Mr T to dismantle parts of the roof in order to gain access to areas of it. - SoL can’t refuse cover because of suggested requirements that aren’t “contained in” the use of heat condition, but are instead implied as being included. - The NFRC Safe2Torch guidance is irrelevant as a prohibition on the use of heat, or a requirement to comply with the Safe2Torch guidance, could have been included in the policy. - The wording of the policy should be given a reasonable and business-like interpretation, with any ambiguity construed in Mr T’s favour. Terms of the contract of insurance need to be transparent and expressed in plain language. - Agreements should be read as a whole, for example with the similarities between clauses (a) and (f) which could lead to inconsistent outcomes if considered separately. - Any interpretation of the policy which included that the intention for inaccessible areas to be dismantled is something that has to be inferred, as it isn’t expressed anywhere explicitly.

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- Any implied term has to be necessary to give that policy business efficacy, or because it can be properly be inferred that if both parties had addressed the particular facts which arise, it would have been expressly stated. - It’s neither reasonable nor necessary for additional requirements (ie the dismantling to allow access to inaccessible areas) to be implied where they could easily have been expressly included. - SoL couldn’t impose unexpected, unreasonable and uncommercial interpretations of the conditions of the policy which aren’t clearly expressed. - Mr T agreed with my position that SoL couldn’t rely on a breach of clause (f), given its similarity to clause (a). - Mr T believed the list of areas or parts of a roof to be included in the checks detailed in clauses (d) and (e) was exhaustive. - Neither clause (d) or (e) make any reference to needing to dismantle parts of a roof to allow access as part of the checks, or that this is a requirement of the policy. - The areas and parts mentioned as needing to be checked in clause (e) refer, on the face of it, to accessible areas open for inspection. - The policy makes no stipulation that if an area can’t be inspected without dismantling part of the roof, then an alternative to the use of heat should be used. - He disagreed with my contention that where clause (d) referred to the “vicinity,” this should be considered analogous to the 6 metre distance expressed in clauses (a) and (f). - Previous decisions of our service had said that where an area was inaccessible, there was no obligation on policyholders to dismantle the roof in order to benefit from cover. - He continues to dispute Dr S’ conclusion around the cause and source of the fire, given his own expert’s comments. - For these reasons, Mr T contended that I should uphold the complaint, and require SoL to indemnify him for the claims made in respect of the fire, including reimbursement plus interest of the costs he’d incurred to date. - SoL should be required to pay compensation to reflect the distress caused by its flawed decision to decline cover. - He also believed his legal fees should be covered by SoL, as it was reasonable and necessary to obtain professional advice. He noted SoL had recommended he do so when it first intimated it wouldn’t cover the claim. He said professional advice had been necessary to put him on an equal footing during the claim and complaint process. 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 understand the strength of feeling on all sides of this complaint. The implications for Mr T, in particular, of having his claim declined are very significant. While my decision will no doubt come as a disappointment to him, I have the utmost sympathy for his position. Nothing I say here is intended to criticise the arguments which have been advanced on his behalf by his representatives. Those have been made coherently, courteously and with an understanding of the role of our service. I’m also grateful to both SoL and Mr T for their patience while we’ve considered the complaint. As I observed in the provisional decision both SoL and Mr T have made detailed submissions to our service and in correspondence with each other. Similarly, Mr T provided a detailed rebuttal to the provisional decision. The findings of the provisional decision are outlined above and form part of this final decision.

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My findings remain substantively unaltered from what I outlined previously. I don’t intend to repeat every point made previously, but will seek to address the points made by Mr T in response to the provisional decision which are relevant to the main question I need to answer – which is whether SoL acted reasonably when it declined cover for the claim. That means I may not address every point that has been made, but I have carefully considered all of the submissions and evidence in making this decision. Comment has been made in Mr T’s response to my provisional decision to the legal position of how policy conditions should be interpreted and my obligations to explain my reasoning from departing from the law if I believe it’s fair and reasonable to do so. I acknowledge, and agree, with many of the points Mr T makes in respect of the legal position regarding interpretation of contracts. However, I can’t agree that my provisional findings decision depart from the points of law he’s raised. My view is that a logical interpretation of the use of heat condition, particularly clauses (d) and (e), means that it’s both necessary and reasonable to include the various inferences that I’ve set out. I say this because it’s logical to say that if an area can’t be inspected, then consideration has to be given to either finding access (potentially by dismantling part of a roof) or using another method. I can’t see how it’s reasonable to suggest that because an area is inaccessible, the obligation to reduce as far as possible the risk of ignition is effectively discarded. I agree that SoL could have expressly included wording to say that parts of a roof needed to be dismantled if necessary, or mandate alternative methods if an area requiring inspection was inaccessible. However, I don’t take the view that it’s reasonable to uphold the complaint simply because it didn’t. I think the average layperson would anticipate that if a condition requires an inspection of an area that’s otherwise inaccessible, they would show that they’d either considered alternative methods or sought to gain access through dismantling the required area. I can’t say that it’s reasonable to recognise that an inspection of an area is required (although I note Mr T’s position is that inspections of the relevant area weren’t needed by the nature of the policy wording) but not do this, or consider alternatives, on the basis that it’s inaccessible. It’s also important consider that it wouldn’t be practical to expect an insurer to include within its policy terms and conditions every conceivable scenario and how the policy would respond to it. There will always be elements of the terms and conditions which require interpretation and application to the circumstances of a claim. That will, necessarily, include inferring what is intended to be covered, or what a policyholder needs to do in order to avoid breaching the conditions of cover. Clauses (d) and (e) are different from clause (a), in that they relate to checks of the area, rather than the removal of combustible material. The “as far as practicable” element of clause (a) is noticeably absent from these clauses, and so I think it’s clear that the requirements for relevant areas to be inspected is absolute, and so arguments around accessibility are of limited benefit – either access should be gained, based on the wording of the clauses, or alternative methods explored. I’m conscious an argument could be made that the “as far as practicable” element of clause (a) should also be read into clauses (d) and (e) – after all, I’ve essentially said that with regards to clause (f). I’m satisfied that clauses (a) and (f) are similar enough in nature, with both relating to the removal or covering of combustible material. Clauses (d) and (e) are distinct from clauses (a) and (f) as they relate to checks of areas which could pose a fire risk. I’m therefore satisfied that it isn’t reasonable to infer or insert that the checks should be carried out as far as practicable – the requirement to carry out the checks of areas included in the clauses is absolute.

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I’ve noted Mr T’s points about the advice, and apparent lack of discussion or negotiation, given when he took out the policy. However, as I said previously, my decision here is solely about whether the claim has been reasonably declined by SoL as the insurer. Any concerns about the advice given at the point of sale would need to be addressed separately. I’ve also considered Mr T’s position regarding the cause of the fire. In disputing that the fire was caused by any alleged breach of the use of heat condition (although of course he denies any such breach), he refers to his appointed expert’s opinion, including that the level of damage seen in the area in question was inconsistent with it being the location where the fire started. I addressed this in my provisional decision, explaining why I believed it was reasonable for SoL to rely on Dr S’ conclusion, and I’ve seen nothing to change my mind on that point. The only forensic examination of the roof identified the eaves of roof C as the most likely location for the fire starting, with the cause being Mr T’s use of a torch in that area causing ignition of combustible materials. No other source or cause has been identified (beyond Mr T’s surveyor who conceded they hadn’t inspected the roof themselves) and I don’t think it’s reasonable to expect SoL to carry out further enquiries or question that conclusion without further evidence or explanation for how the fire could have started elsewhere. This is connected to the need, as Mr T puts it, to establish a causal link between the alleged breach of the condition and Mr T’s actions. I’m satisfied SoL could rely on the finding that Mr T’s use of heat caused the ignition of combustible material in the roof void. The use of heat condition required him to carry out a check of that area (as I’ve previously addressed and still believe to be the case, which I’ll come onto below). It seems fair to say that if the check had been done, then the material would have been identified and either removed or the risk mitigated. I think it’s fair for SoL to say that there’s a causal link between the breach of the condition and the fire. I’ve also considered the point made with regards to the Safe2Torch guidance. Mr T observes that if SoL wanted to rely on this, specific reference could have been included in the policy wording to adherence to the guidance. However, it’s never been SoL’s position that compliance with the guidance is a requirement of the policy. What has been said, and I agreed with, is that the guidance identifies situations where the use of heat by a gas torch would be unsuitable because of the risk of fire, and that alternative methods are available and should be preferred. That demonstrates that there’s an awareness and acceptance of the risk of fire in various scenarios, and that where that risk can’t be properly assessed or mitigated, then an alternative should be looked at. I don’t think it was unreasonable for SoL to refer to the guidance as evidence to that effect – to demonstrate that Mr T should have carried out checks as have been outlined, or used an alternative method. The guidance supports a position, in my view, that not carrying out the checks but using heat could be a breach of the use of heat condition. Moving onto the specific application of the three clauses SoL referred to when it declined the claim, SoL now seems to accept that it can’t reasonably rely on a breach of clause (f) to decline cover. I don’t intend to repeat myself on that point. I remain satisfied that because of the similarity between clauses (a) and (f) the element of it being necessary as far as practicable to cover or remove combustible items was applicable to clause (f) despite its absence from the specific wording. As it’s accepted that it wasn’t practicable to do so here, then clause (f) didn’t apply. Mr T also disagrees with my conclusion that the areas stated as needing to be inspected in the checks covered by Clauses (d) and (e) aren’t exhaustive lists. As I set out in the

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provisional decision, it’s clear that the areas need to be inspected, and that those checks need to “include” specified types of spaces and items. I can’t see any logical argument whereby a clause says a check needs to “include” specified parts of a roof could only be said to cover those parts. A fair interpretation of these clauses is that the area as a whole needs to be checked, and that regardless of whether a specific area falls within the inclusive list, it still falls to be inspected. Either the whole area is to be inspected, or only the parts in that area which fall within the specified list – plainly the wording of the policy intends the whole area to be checked. If parts of the area to be checked are inaccessible, then it follows that either access should be gained, or an alternative method pursued. That’s where the Safe2Torch guidance has relevance, as it identifies such a scenario and suggests alternatives. The guidance supports the idea that an inaccessible part of a roof isn’t to effectively be accepted as a risk without any mitigation being taken. I don’t accept the position taken by Mr T that the areas mentioned specifically in clause (e) are “open for inspection.” He contends that the condition anticipates the inspection of “the reverse side of walls or partitions from adjacent accessible spaces.” I’m not sure where that suggestion arises. The clause says the areas to be checked include the “area on the other side of any wall or partition.” I can’t see how that could reasonably be interpreted to only cover an accessible area. I assume, on the basis that it’s not expressly stated, that Mr T invites me to infer that this is the case, I don’t agree. A far more reasonable interpretation, in my view, is that this check needs to include the area on the other side of a wall or partition, and that accessibility to that space isn’t relevant to the need to carry it out. As I’ve said previously, if the relevant area isn’t accessible, there are three choices available to the policyholder – to gain access, with the associated consequences of doing so including dismantling the necessary parts to do so; to carry out the work using heat or torch free methods; or to not carry out the check and assume the risk that this entails. I’m also conscious Mr T thinks it’s unreasonable to draw an analogy between the 6 metre distance required by clauses (a) and (f) and the “vicinity” expressed in clause (d). Referring back to the provisional decision, I drew that analogy as providing a fair definition of “vicinity,” and I remain satisfied that this is the case. It’s clear that a distance of 6 metres is considered important in terms of the protection of combustible materials, so I think it follows that a similar distance would be applicable for fire safety checks. Mr T hasn’t offered a separate, reasonable definition of “vicinity” that would mean the relevant parts of the roof didn’t fall within the area to be checked. It seems heat was applied directly in areas close to the void and near the eaves of roof C where (SoL reasonably concluded) the fire started .Even if I were to be persuaded the distance meant by “vicinity” was less than the previously stated six metres, I’d need to see something very persuasive to suggest that the roof void didn’t fall in any reasonable definition of “vicinity.” The lack of a formal definition doesn’t render that word ineffective. An ordinary and normal meaning would be “close,” and I’m satisfied that the void was close to the area in which work was to be, and indeed was, carried out. I also note Mr T’s view that my provisional findings differ from those of previous decisions issued by our service. Our decisions aren’t binding in terms of precedent, but we do seek to be consistent in our approach to similar complaints. Two decisions have been highlighted where, in particular, inaccessible areas which could have been considered necessary to check weren’t, but relevant clauses weren’t considered to fairly apply. However, SoL has

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previously pointed to other decisions from our service about use of heat conditions which supported its position. What this shows is that our service doesn’t have a uniform approach to insurers’ application of use of heat conditions. Different insurers will have different conditions, which will be worded individually. The decisions referred to by Mr T were about different insurers. The conditions in those cases were similarly worded to the SoL condition, but not identical. I think it’s also important to consider that every case will have different circumstances leading to the claim and the complaint. What I’ve done here is consider the specific wording of Mr T’s policy, and how it applies to the specific circumstances of his claim. In doing so, I may have reached a different outcome to other decisions which, on the face of it, appear similar. However, those cases aren’t identical, given that differently worded conditions applied, and were about their own unique set of circumstances. I’ve reached what I consider to be a fair outcome for Mr T’s complaint alone, and make no comment on any other decisions issued by our service. I agree with Mr T that SoL can’t impose unexpected, unreasonable or uncommercial interpretations of policy conditions when assessing claims. No insurer could fairly do so. However, I can’t say that the conclusion reached by SoL relied on such an interpretation. My provisional decision and this final decision, in my opinion, explain why this is the case. I’ll finally address the points made around suggested redress by Mr T. Clearly, as I don’t consider SoL acted unreasonably when it declined cover for the claim, I can’t ask it to indemnify Mr T in respect of the losses he’s incurred in defending claims from third parties, or provide cover on an ongoing basis for the claim. I’ve noted the comments around Mr T needing professional assistance in order to pursue the claim and complaint. Ultimately, as I can’t conclude that SoL’s actions in declining the claim were unreasonable, then I can’t say that the costs incurred by Mr T in disputing that are something SoL should be liable for. If the claim had been declined unfairly, I might be minded to look at this differently, but as that isn’t the case, I can’t ask SoL to make any contribution towards Mr L’s legal costs. On balance, therefore, I conclude that SoL’s decision to decline cover for Mr T’s claim was fair in the circumstances. I’m satisfied that his actions were in breach of clauses (d) and (e) of the use of heat condition, and that there was a causal link between the breach and the fire which led to the claim. Finally, in terms of compensation for the poor handling of the complaint, I note Mr T’s position that SoL should be asked to recognise the distress and inconvenience caused by its decision to decline cover for the claim. As I set out in the provisional decision, the £300 SoL offered to recognise delays and poor communication during its assessment of the claim was fair. I can’t ask it to pay additional compensation for the distress caused to Mr T because the claim has been declined. Put simply, this is because I’ve concluded that decision was reasonable. I can’t ask SoL to pay compensation for making what I consider to be a justified decision, even though I understand the level of upset and distress that decision has caused. My final decision I don’t uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr T to accept or reject my decision before 7 April 2026. Ben Williams Ombudsman

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