Covea Insurance plc · DRN-6121066

The complaint Ms K complains Covea Insurance plc has refused to meet a claim she made on a pet insurance policy. It has instead cancelled the policy and has refunded the premiums. What happened The details of the complaint are well known to both parties, so I won't repeat them in full again here. Instead, I'll provide a summary and then focus on providing my reasons for my decision. In summary, while it considered a claim Ms K made, Covea noticed discrepancies with the date of birth recorded for her dog between the policy documentation, its adoption advert and paperwork that was completed at the time. It says her dog is older than she disclosed. Covea took over the policy based on the date of birth declared to a previous insurer. It has taken the stance that Ms K recklessly provided an incorrect date of birth when setting up the policy and failed to correct this when it sent her policy documentation listing the incorrect birth date, It says, based on this, under the relevant legislation it is entitled to cancel the policy and keep the premiums paid. But it instead chose to refund the premiums. 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 relevant law I need to consider here is The Consumer Insurance (Disclosure Representations) Act 2012 (CIDRA). This sets out that where a consumer provides incorrect information when applying for a policy, and an Insurer can show it would have done something differently had it known the correct information, the Insurer can take that action as a remedy. • Covea has shown that the age of a pet influences how much it may charge for a policy. So I’m satisfied here that, if the date of birth is demonstrated to be incorrect, a qualifying misrepresentation had taken place and Covea would be entitled to remedy the situation as set out in CIDRA. • The issue here is Covea thinks Ms K acted recklessly which means it can cancel the policy and keep the premiums charged (even though it chose to refund them). Whereas Ms K said it was an oversight as no one was certain exactly how old the dog was. In such a case under CIDRA as Covea has said it would still have offered a policy but at a higher premium, the appropriate remedy would be for the policy to stay in force and Covea proportionately settle the claim. • Ms K put the date of birth for her dog as 1 January 2017 (it would have been seven years old), whereas it’s adoption certificate states 10 March 2015 (eight years old). An adoption advert for the dog in 2023 also referred to it as being eight years old but Ms K has said conversations held at the time with the adoption agency was that they weren’t

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sure of the dogs exact age as it had been rescued from roaming the streets of a different county. Ms K said she was told it was possible the dog was only six or seven years old. • Ms K took out the policy in April 2024 and declared her dog was seven years old. • To consider if the misrepresentation was reckless, I need to consider whether Ms K knew the information she was providing was untrue or misleading or did not care whether it was untrue or misleading. • Based on the information available to me, I don’t think it was a reckless misrepresentation, but I am satisfied it was careless. I say this because this was a rescue dog, I accept Ms K’s statement about no one being completely sure about the dog’s date of birth at the time she adopted it, but she was given a rough estimate which is what she went with. I think the fact she chose the date of 1 January demonstrates the uncertainty about the exact date. I’m not persuaded by Covea’s arguments that Ms K likely did so knowingly in order to benefit from cover under the policy which wouldn’t have been available to an older dog, this is a speculative argument that is not supported. Ms K has not gone on to make any such claims. • I’ve considered the fact the adoption paperwork Ms K received stated her dogs date of birth, but it was some weeks later when she originally took the policy out with the previous insurer. Ms K said she relied more on what she was told about the dog rather than referring back to the paperwork. I do therefore think Ms K’s misrepresentation was careless as she could have double checked that information. • Covea has referenced that Ms K came into possession of the dog’s pet passport later which also had the older date of birth so she would have been in the position to correct the information on the previous policy and more crucially, at the subsequent renewal which it became the insurer for, but she did not do so. It again suggests this was a reckless action by her. However, I disagree, given what Ms K has explained, I don’t see why receiving the passport would have prompted her to check the information she had given. • I do however accept that the date of birth was clearly set out on the policy documentation Covea sent to her. And it set out her obligation to check the information contained within it was correct and let it know if it wasn’t. • Overall, I’m satisfied there was a misrepresentation in the information given, it was a qualifying one as Covea would have offered a policy on different terms and I’m persuaded based on the information available to me it should be classed as a careless misrepresentation. Under CIDRA the only remedy available to Covea is to proportionately settle the claim made based against the premium Ms K should have been charged for the policy in that policy year. So, it should now reinstate Ms K’s policy, she would need to repay the premium to Covea for it to reconsider her claim. • Covea has also mentioned there was also a discrepancy noted in the breed of the dog, it being recorded as cross breed on the policy but mixed breed in the veterinary records. However, Covea hasn’t shown it would have done anything differently because of this. In any event, the adoption paper records the dog as being a mixed cross, so I don’t think Ms K made an unreasonable selection here, so no misrepresentation occurred. • I do think Ms K was caused a degree of distress and inconvenience by the way Covea dealt with her claim. She has explained it has caused her anxiety about how she will afford the treatment her dog needs and her expectations about the claim being paid were

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raised in a phone call with an agent of Covea, before she was then told the policy was cancelled. Covea offered £70 compensation, I think this is reasonable in the circumstances. For the reasons above, I uphold this complaint. Putting things right To put things right Covea should do the following: • Reinstate the policy and remove any cancellation markers, providing a letter to Ms K confirming this has been done. • Arrange with Ms K a way of repaying the premiums to it. • Reconsider the claim in line with the remaining policy terms and limits. • If the claim is to be paid, Covea should proportionally settle the claim in line with the premium Ms K has been paying to what she should have paid had the correct date of birth been provided. • If there are claim related costs being reimbursed to Ms K, 8% simple interest per year should be paid on these from 30 days after the claim was registered until the date the costs are reimbursed. • Pay Ms K £70 compensation. My final decision My final decision is that I uphold Ms K’s complaint against Covea Insurance plc. I direct it to put things right as I have set out in the section above. Under the rules of the Financial Ombudsman Service, I’m required to ask Ms K to accept or reject my decision before 24 April 2026. Alison Gore Ombudsman

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