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When the Insurer Does Not Find the Leak Properly

The Ombudsman has held an insurer responsible for the consequences of not investigating (DRN-5745749), has declined to blame an engineer for missing a fault that was not yet visible (DRN-3331206), and has split the cost where an insurer wrongly refused trace and access and the policyholder then overspent (DRN-4562672). Each turns on its own wording and facts and creates no precedent.

Leak Fix LondonLast updated

Thermal imaging survey being carried out to trace a hidden leak

The diagnosis is part of the claim

Most insurance disputes about leaks are argued as coverage disputes. A smaller and more interesting group are about competence: the insurer or its contractor decided where the water was coming from, got it wrong, and the policyholder lived with the consequences. Three published decisions show how the service handles that, and they do not all go the same way.

The regulatory backdrop is the same in all of them. FCA rule ICOBS 8.1 requires an insurer to handle claims promptly and fairly, to provide reasonable guidance to help a policyholder make a claim and appropriate information on its progress, and not to unreasonably reject a claim. The decisions quote it directly.

DRN-5745749: two years waiting for the wrong repair

A landlord reported water ingress into a rental flat in January 2022 after storm conditions. The claim had originated from another flat, and the owners there told the loss adjuster the roof was the cause. Ageas accepted that, declined the external damage as poor maintenance rather than storm, and covered the internal damage under accidental damage.

The flat did not dry out after the roof was repaired. The policyholder said so, repeatedly, and asked for further investigation. Nothing happened. He eventually arranged a trace and access himself, which found a leaking pipe. That was repaired and the problem stopped. By then the tenant had given notice because of the damp conditions and moved out.

The Ombudsman upheld the complaint, and the reasoning is squarely about the failure to investigate. Ageas "made a mistake here when it didn’t investigate further" once concerns were raised. It could either have allowed the policyholder to instruct his own contractor for a trace and access, or carried one out itself, to establish whether the roof really was the cause. And under ICOBS it had a duty to give reasonable guidance: the decision records that the policyholder was a layperson who did not know the roof was not the cause, because the loss adjuster had presented it as settled.

The consequences followed the failure. Ageas was directed to pay the loss of rent from June to November 2023 at £900 a month with 8% simple interest, to reimburse the trace and access costs on production of a breakdown, also with interest, and its existing £100 for delays stood.

Two details are worth extracting. The insurer argued that neither the landlord nor his agents had raised concerns about another cause, and the Ombudsman found on the evidence that he had been seeking guidance from the loss adjuster about those very issues. And the insurer argued the tenant left out of frustration with the pace of repairs rather than because of the insured event, which the decision rejected: the frustration was with the condition of the property, and the condition was a direct result of the insured event.

DRN-3331206: the crack that was not visible yet

The counterweight. A household lost water pressure and suspected a leak. An RSA engineer attended under home emergency cover, inspected the boiler, found no visible leak, and advised that trace and access would be needed to locate it. The policy did not include trace and access, so the household paid a third party £750 to investigate. That engineer found no leak in the system but noticed water dripping from the boiler. The RSA engineer returned, agreed there was a leak in the boiler, and the manufacturer replaced the heat exchanger.

The complaint was that the crack in the heat exchanger was very visible, and a few more minutes of work on the first visit would have found it and saved the £750.

The Ombudsman did not uphold it. Home emergency cover is designed for a rapid response to an emergency affecting essential services, and it was not unreasonable for the insurer to say locating a hidden leak is not what it is for. There were no signs of limescale or staining to work from, the boiler was working when the engineer left, and there was no visible leak at that point. The third party did not identify the boiler leak until about eleven days later, and the Ombudsman thought it fair to conclude the leak had worsened in between, which made it easier to find on the second visit.

The decision accepts that with hindsight it would have been better had the engineer done more. Hindsight is not the test.

DRN-4562672: refused first, then argued about the bill

The third one is uncomfortable reading for everybody involved, including our trade. A plumber detected a leak on a central heating system in January 2023. The policyholder called Aviva. The call handler confirmed the policy included trace and access cover but said there was no insured event yet because there was no visible water damage. The plumber explained the heating was partly under a concrete floor beneath floorboards, that damage was likely already occurring, and that turning the system back on would make it worse before it became visible.

The claim was not accepted. The policyholder asked whether she could instruct her own contractors, have them trace the leak, and claim if damage was found. The call handler agreed Aviva would assess that. The contractors ran a pressure test, thermal imaging, moisture readings and a tracer gas test, found the leak under the kitchen floor, and invoiced over £11,000.

The Ombudsman dealt with two questions. On cover, the decision is emphatic: there is no reference to visible damage in the wording, damage can be present without being visible, and an expert had told the policyholder water was escaping and likely causing damage. The Ombudsman also noted that if she had waited for visible damage, the insurer might reasonably have asked why she let the leak worsen after it was detected. Aviva’s positions were described as at times contradictory, including offering a figure for reasonable trace and access costs while arguing there was no cover for tracing.

On cost, the decision goes the other way. The policy pays "the reasonable cost" of finding a leak, defined in the booklet as costs for goods and services competitive in the relevant marketplace. Aviva’s own estimate of eight hours was unsupported by anything in its notes. But the invoices showed 66.5 hours of labour with no breakdown, the detection report recorded 1.5 hours spent carrying out repairs, and the Ombudsman could not reconcile the two. The outcome was a 50/50 split less the £600 excess, coming to £4,596.12, plus interest and £200 compensation.

What these three have in common

The service is not asking whether the investigation was perfect. It is asking whether the insurer did something a competent insurer would not have done, and what followed from it.

  • Failing to investigate at all after the policyholder raised a concern was unfair, and the insurer carried the downstream losses including lost rent.
  • Failing to spot a fault that was not yet showing symptoms was not unfair, even though it later turned out to be obvious.
  • Wrongly refusing cover and pushing the policyholder into the market did not hand her a blank cheque. Reasonable cost still had to be evidenced, and 66.5 hours against a 1.5-hour repair was not.

The part that is ours to get right

That last decision is a warning to every leak detection firm in London, and we have taken it as one. If an invoice cannot be reconciled with the report, it does not matter how good the work was. Hours have to map to activities, the report has to show which test found what, and the detection, access, repair and reinstatement lines have to be separable so an insurer can see what belongs under which heading.

That is why we quote at £150 per hour agreed before we attend and itemise the output, and it is set out on why leak detection is charged by the hour and in what an insurer-ready report contains. If you are about to instruct anyone, what to ask a trace and access plumber is the checklist.

Read this properly

All three were decided on their own policy wordings and their own facts. They set no precedent and they do not tell you what your insurer must do. If you think your claim has been mishandled, ask for a final response in writing, then take it to the Financial Ombudsman Service, which is free and allows six months from the date of that response.

When not to call us

If your insurer has accepted the claim and its contractor is actively investigating, let them finish. If you are within a home emergency policy and the problem is an emergency rather than a hidden leak, use it, because that is what it is for, and DRN-3331206 is a reminder that it is not a detection service. Call us when a leak has been looked for and not found, or when the explanation you have been given does not match what the building is doing.

Frequently asked

Can I claim the cost of a trace and access I arranged myself?
It depends on the wording and on what you were told. In DRN-5745749 the insurer was directed to reimburse trace and access costs on production of a breakdown, because it should have investigated or told the policyholder his reasonable costs would be covered. In DRN-4562672 cover was confirmed but only half the invoice was allowed, because the cost could not be shown to be reasonable.
My insurer says there is no claim until there is visible damage. Is that right?
In DRN-4562672 the Ombudsman rejected that argument on the wording in front of it, noting there was no reference to visible damage in the policy and that damage can be present without being visible. Whether the same applies to your policy depends on your own wording.
What if the insurer blamed the wrong cause and the repair did not fix it?
That is the situation in DRN-5745749, where a roof was repaired over two years before a trace and access found a leaking pipe. The insurer was held to have made a mistake by not investigating further once concerns were raised, and was directed to cover lost rent and the trace and access costs with interest.
Will the Ombudsman pay whatever my contractor charged?
No. Trace and access wordings typically pay reasonable costs, and DRN-4562672 shows what that means in practice: invoices showing 66.5 hours of labour with no breakdown, against a report recording 1.5 hours of repairs, were not accepted, and the cost was split.
Should my detection invoice be itemised?
Yes, and it should reconcile with the report. Separate lines for detection, access, pipe repair and reinstatement let an insurer allocate each part to the right section of the policy, and an hours figure that matches the report is what stops a reasonable-cost argument before it starts.

Sources

No find, no fee · £150 per hour. The rate is fixed before we attend and does not rise for a difficult property, an awkward access or an evening visit. The total depends on how long the job takes; the rate cannot change.