AmTrust Specialty Limited · DRN-6083119

The complaint Mr M complains AmTrust Specialty Limited has unfairly declined a claim he made on a legal expenses insurance policy. What happened The details of the complaint are known to both parties, so I won't repeat them in full again here. Instead, I'll focus on providing my reasons for my decision. 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. • The policy terms and conditions exclude claims where the insured incident happened before the policy started. The policy defines insured incident as “..the incident or the first of a series of incidents which may lead to a claim under this insurance. Only one insured incident shall be deemed to have arisen from all causes of action, incidents or events that are related by cause or time.... • Mr M's policy started on 8th of August 2024. In his submissions supporting his employment tribunal claim, Mr M referred to regular weekly meetings which took place from June 2024. He also referred to specific meetings that took place in late July 2024 and referred to them as “the beginning of a hostile work environment”. • Having reviewed the policy terms and conditions, I'm satisfied AmTrust has fairly declined the claim as the first of the series of incidents started before the policy was in force. No cover is therefore available for the claim Mr M wishes to make under the policy. • Mr M has said he telephoned the legal advice helpline and was incorrectly told his claim was not covered, which led a delay in him registering it. Neither party has been able to identify the date this call was made. While I appreciate Mr M wants AmTrust to conduct further searches of its telephone systems I don't think it needs to do this. Mr M says he was told the claim was not covered and, as I've set out above, I've found that to be the case. While it is possible different reasoning or explanation was given, ultimately Mr M’s position was not prejudiced by this. • When declining his claim AmTrust also made Mr M aware the policy included a 90- day exclusion period, which applied to employment dispute claims. Mr M was unhappy about this as he didn't think it would apply to his claim. To confirm I'm satisfied the 90-day exclusion is clearly set out in the terms and conditions under the heading “Employment Disputes”. However, as I've already found the claim was not covered, I don't need to decide whether this exclusion would also have been fairly applied to the claim. For the reasons set out above I do not uphold this complaint.

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My final decision My final decision is that I do not uphold Mr M's complaint against AmTrust Specialty Limited. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr M to accept or reject my decision before 20 April 2026. Alison Gore Ombudsman

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