Covea Insurance plc · DRN-5986254

The complaint Mr M’s complaint is about the handling of a claim he made on his Covea Insurance plc (‘Covea’) pet insurance policy. Mr M says Covea treated him unfairly. What happened The details of this complaint are well known to both parties, so I won’t repeat them 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. Having done so, I uphold Mr M’s complaint for the same reasons set out by the investigator. Before I explain why, I wish to acknowledge the considerable submissions Mr M has made. Whilst I’ve considered everything he’s said, I won’t be addressing it all. That’s not intended to be disrespectful. Rather it’s representative of the informal nature of the Financial Ombudsman Service. Instead, I’ll focus on the crux of Mr M’s complaint, namely whether Covea treated him unfairly and what they need to do to put things right. These are the reasons for my decision: • Covea have accepted that the service they provided Mr M with fell short of their own expectations. So, this matter is not in dispute. In particular, Covea accept that they closed Mr M’s claim in error in July 2025 when they should have been assessing the information they received from Mr M’s vet and they could assess the claim. I agree that this was not how matters ought to have unfolded but I have also taken into account that Mr M contacted Covea the same day and complained about this. In response Covea settled his claim 2 days later. So, although Covea were in receipt of the information they needed to assess Mr M’s claim 12 days before closing it, I’m not satisfied that a very considerable delay was caused in this case, beyond two weeks. • Looking at how things unfolded before the claim was closed, there is nothing in the communications between Covea and Mr M or his pet’s vet that makes me think that Covea did anything wrong here or that there were any delays on their part. Rather the way in which the claim was handled does look to me to be entirely in line with Covea’s own service standards and that matters were dealt with reasonably. • Mr M is unhappy that Covea deducted £3.35 from his claim for kitten food. From what I’ve seen that food was included on the invoice sent to Covea and was being claimed for. The policy excludes “Any food (including food prescribed by a vet and/or complementary therapist)” subject to some exceptions that don’t apply in Mr M’s case. So, I think this deduction was reasonable. If Mr M has already funded that food himself as he suggests, that makes no difference to his claim because this sum did form part of it. Rather he should contact his vet for double accounting for it if what he says is correct. My view is that Covea were entitled to deduct this cost in line with their policy terms.

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• Mr M is unhappy that Covea settled his claim 3 days after he raised his complaint. He feels this was contradictory. I don’t agree. Covea had 8 weeks to respond to Mr M’s complaint which was about various issues, not just his claim being paid. I would be more concerned if Covea didn’t settle Mr M’s claim promptly if they had no concerns about it. In this case I think they acted as I would expect them to by dealing with Mr M’s complaint and claim separately and within usual timeframes. • Mr M feels Covea didn’t make reasonable adjustments given his health condition. Looking at the timeline applicable here, Mr M didn’t notify Covea of his health condition until 31 July 2025, which was a month or so after the claim was made. This was also after Mr M complained to Covea. From what I’ve seen Covea noted this on his records after the final response letter was issued. I can see why this was. In my view it’s most likely this occurred because Covea were in the process of reviewing Mr M’s complaint at that time. And given a great deal didn’t appear to happen in the intervening period, I’m not satisfied that Mr M was prejudiced in any way by Covea updating his records when they did. So, I don’t think they did anything wrong here. Like the investigator however, I agree that it is preferable for businesses to act on such information soon after it is received to prevent prejudice to their customers. So Covea are advised to reflect on this. Overall however I’m not satisfied that Covea’s actions resulted in Mr M being prevented from engaging with them in any way. • Mr M says he requested full disclosure of the internal handling of his claim but instead Covea dealt with this as a Subject Access Request. When Mr M complained about this Covea did agree to raise this request separately with their relevant department. I appreciate this might have been frustrating for Mr M, but I don’t think that he was caused considerable inconvenience as a result of this. • Covea initially offered Mr M £75 for the poor handling of his claim and the service he received generally. Since making his complaint to this Service, Covea have increased that offer to a global amount of £200. I think this is reasonable and in line with awards we’d make in similar circumstances. I appreciate that Mr M had a health condition which caused him difficulty and that he found dealing with Covea stressful. I also understand that he has raised complaints about the way in which Covea have handled his claims in the past. But I’m not considering those here. I’m only considering the matters set out in this decision and their impact on Mr M. And though I can see he feels an award of significantly more is appropriate, I’m not persuaded that the impact Covea’s conduct on him warrants this in his circumstances. Rather I think £200 is adequate compensation for Covea’s errors in dealing with his claim, taking into account the distress and inconvenience caused to him. Putting things right Covea should pay Mr M £200 in compensation for the distress and inconvenience caused to him if they have not already done so.

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My final decision For the reasons set out above, I uphold Mr M’s complaint against Covea Insurance plc and direct them to put things right as noted within this decision. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr M to accept or reject my decision before 22 April 2026. Lale Hussein-Venn Ombudsman

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