HDI Global Specialty SE · DRN-6005411

The complaint Mr K’s complaint is about a claim he made on his HDI Global Specialty SE (‘HDI’) pet insurance policy which HDI declined to cover. Mr K says HDI 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 concentrate 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 don’t uphold Mr K’s complaint. This is why. Mr K’s claim is for veterinary costs associated with the investigation and treatment of neuritis. Neuritis is the inflammation of one or more peripheral nerves, causing pain, tingling, numbness, weakness, or muscle atrophy. Mr K says this occurred a result of his pet falling off the bed. On the other hand, HDI say neuritis is an illness and this is not covered because Mr K’s policy only provides cover for accidents. The issue for me to determine is therefore whether Mr K has established he has a claim capable of cover under the type of policy he purchased. It’s right that Mr K’s policy only provides cover for “vet fees for treatments arising from an accident, from when it is first noted by you or your vet.” So, in order for Mr K’s claim to be covered I need to be satisfied that his pet’s condition was caused by an accident. Mr K has said the problem was caused by the pet falling off the bed. HDI asked Mr K’s pet’s vet if the condition could be caused by an injury. They said: “l am not able to confirm that this condition has been a result of injury Neuritis is a condition that may be triggered by a trauma, but l am unfortunately unable to state this to be the case confidently, as it is a condition that can come about spontaneously”. So, the vet wasn’t able to support what Mr K says. Having reviewed the pet’s clinical notes, I am satisfied that there is nothing in them to support that Mr K reported an accident as the cause of the problem his pet was experiencing. As HDI have said, that is something that one would expect to see as part of the clinical notes as vets do have an obligation to document everything relevant to the pet’s state of health. Despite this there is nothing recording this anywhere in the pet’s clinical notes. HDI have also said that when Mr K initially logged his claim, he did so for illness and this was rejected by their system on the basis that he has accident only insurance cover. HDI have provided screenshots of that claim to support this. It was following this that Mr K submitted a claim by telephone. And it was only on the second call he had with HDI that he

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said that his pet had jumped off the bed and he and sought medical advice as a result. I can’t say why Mr K didn’t mention the accident he says took place when he initially made his claim and on his second call to HDI. I also can’t explain why his pet’s veterinary notes don’t support this. What I can say however is that the weight of the evidence in this case points to the condition arising from illness and not an accident, which is supported by Mr K’s vet’s view. In light of that, I am not satisfied that Mr K has established he has a claim that is capable of cover. Because of this I don’t think HDI did anything wrong in declining his claim. My final decision For the reasons set out above, I don’t uphold Mr K’s complaint against HDI Global Specialty SE. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr K to accept or reject my decision before 22 April 2026. Lale Hussein-Venn Ombudsman

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