Arch Insurance (UK) Limited · DRN-6239675

The complaint Mr P is unhappy with how Arch Insurance (UK) Limited handled a claim on his income protection policy. What happened Mr P has an income protection policy underwritten by Arch. He submitted a claim for unemployment cover. Mr P is unhappy with how his claim was handled. He said Arch asked for three pieces of evidence per month to show he was actively looking for work. But he wasn’t aware of the need for this much evidence. He thinks the policy should be clearer and more specific about the evidence required. Arch also extended the waiting period under his policy and concluded there was a termination in his job seekers agreement when he spent five days abroad. Mr P doesn’t think the policy terms allow them to do this, so he referred a complaint to this service. Our investigator looked at everything and said Arch had acted reasonably based on the policy terms. Mr P disagreed. In summary he said the policy terms don’t allow Arch to extend the waiting period. And he explained his jobseeker’s agreement wasn’t terminated - there was just a short non payable period when he was abroad for five days The case has been passed to me to decide. 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 may not respond to every point that has been raised, but I want to reassure both parties that I’ve considered everything that’s been submitted. The informal nature of this service enables me to do that so I can resolve complaints with minimal formality. The relevant rules and industry guidelines say an insurer has a responsibility to handle claims promptly and fairly and shouldn’t reject a claim unreasonably. To make a successful unemployment claim under this policy the terms state Mr P must show he is: ‘continually available for work and actively looking for work.’ I note Mr P’s comments about the policy wording regarding evidence to show he is actively looking for work. I accept that the policy terms could be more specific about the monthly evidence required. But I don’t think this has caused any significant impact in this case.

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I can see Arch made adjustments to their usual threshold for the start of the claim because Mr P said he wasn’t aware three pieces of third party evidence was required per month, so I don’t think I need to ask them to do anything further here. I also don’t consider the amount of evidence they have asked for to be unreasonable. Jobseeker Agreement The policy terms also state a claimant must have a Jobseekers agreement. This is defined in the policy as: “Registered as unemployed at the Jobcentre and have a valid Jobseekers agreement for the duration of your claim.” The policy terms also state: “Proof that you have a Jobseekers agreement. Thís could be evidenced by the award letter issued by the Jobcentre detailing when your claim started and, if applicable, the amount of benefit you have been awarded” Mr P has confirmed that his Jobseekers award (JSA) was suspended during the five days he was abroad. But his Jobseekers agreement was never terminated. I’ve thought carefully about this, but as his JSA was suspended, Mr P would be unable to evidence an award letter or any benefit amount of benefit being received during this period. So, based on the above policy wording, I don’t think it was unreasonable for Arch to conclude Mr P was unable to provide the proof that he had a valid jobseekers agreement in place during this period of his claim. Extension of the waiting period Mr P is unhappy Arch extended the waiting period of his policy for five days to reflect that he wasn’t receiving his JSA during this time. The policy terms confirm: “There are a number of requirements you must satisfy for you to be able to claim….. You have to satisfy these requirements for a period of days greater than the waiting period before any claim can be considered. Once the requirements have been satisfied your first payment of one monthly benefit will become due on the day following the expiry of the waiting period. This will be paid as soon as our investigations into your claim have been completed.” I think it was fair for Arch to conclude Mr P didn’t satisfy the requirements for benefit for five days, because he wasn’t receiving JSA during this time. The policy term above is clear that Mr P must satisfy the benefit requirements for 60 days before the claim can be considered. So I don’t think it was unreasonable for Arch to update the timeline in the circumstances to reflect the five days Mr P didn’t meet the policy requirements. I know this will be disappointing to Mr P but having carefully considered the policy terms and how they’ve been applied to his claim, I don’t think Arch have treated him unfairly.

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My final decision I don’t uphold this complaint for the reasons I’ve explained. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr P to accept or reject my decision before 28 April 2026. Georgina Gill Ombudsman

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