The High Court has declined to set aside a Financial Services and Pensions Ombudsman decision that upheld RSA Insurance Ireland Limited’s refusal of a burglary claim by John and Deirdre Billane.
Mr Justice Max Barrett, in a judgment delivered on 23 November 2021, found no significant and serious error in the Ombudsman’s determination, reasoning or process. The Billanes’ appeal under the Central Bank Act sought an order setting aside the Ombudsman’s binding finding of 15 November 2017. The court refused that relief and said it would hear the parties on costs.
The dispute concerned a one-year home insurance policy arranged online through broker 123.ie, which began on 17 August 2014. The Billanes’ cottage was burgled in February 2015. RSA declined their claim in July 2015 and treated the policy as void, citing non-disclosure of a previous insurance claim and the property’s history of flood damage.
The judgment records that the Billanes had made a flood damage claim in October 2011. During the online application, they selected “three years” in response to a claims-free-period question. The court said they had not been claims-free for that period. It also found that the cottage was within 100 metres of the River Dodder, contrary to an insurance assumption concerning proximity to water. The judge stressed that no one alleged the Billanes had deliberately given false answers.
The Ombudsman had found that the policy documents clearly set out the assumptions and warned that inaccuracies could affect cover. The Ombudsman concluded that the prior claim and flood damage were material to assessing the risk, and that the Billanes had not contacted RSA to correct the information after receiving the documents. The judge considered the prior claim sufficient to support the Ombudsman’s finding, even if the flood damage itself was not material because flood damage was excluded from cover.
The Billanes argued, among other points, that the relevant documents arrived after the policy began, that the online questions differed from the later assumptions, and that RSA had not shown the non-disclosure was material. They also challenged the Ombudsman’s decision not to hold an oral hearing. The judge rejected those arguments, finding no deficiency in the process and no good reason why an oral hearing would have resolved a material factual dispute.
The court noted that the Ombudsman had not addressed an argument about “OTC insurance”, but held that omission made no practical difference: this policy was not OTC insurance as the term was used in the cited case law, and selling insurance online did not make it so. The court’s decision concerned the appeal from the Ombudsman; it did not order RSA to pay the burglary claim.