Background
Faiz Siddiqui maintained a troubled relationship with his elderly father, who lived in the United Arab Emirates. Following a dispute in June 2024 over broken promises regarding a family visit, Siddiqui sent his father a series of harsh, abusive messages over several weeks, including statements such as “lying and acting with lack of integrity has now become 2nd nature to you” and “I will make sure you pay a heavy price for this misbehavior.” His father was 75 years old and suffered from poor health including diabetes, prostate cancer, and Parkinson’s disease.
On 29 July 2024, Siddiqui received a letter from his father’s UAE-based lawyers warning him to cease all contact with his father and family under penalty of criminal prosecution under the UAE Electronic Crimes Law, which carries potential imprisonment for up to two years and fines of AED 250,000 to AED 500,000. Siddiqui claims the receipt and contents of this letter caused him significant psychiatric injury, exacerbating his pre-existing Major Depression, Chronic Insomnia, and Generalised Anxiety Disorder. He held three legal expenses insurance policies (underwritten by ARAG through Zurich, Covea, and John Lewis) covering legal costs for disputes arising from “a specific or sudden accident” causing bodily injury.
Siddiqui sought coverage under these policies, arguing the letter and resulting psychiatric injury constituted an accident. ARAG refused coverage, and the Financial Ombudsman Service upheld the refusal, finding no accident occurred because the letter was the natural and foreseeable consequence of Siddiqui’s own abusive conduct toward his father.
The Court’s Holding
Mr Justice McKendrick dismissed Siddiqui’s judicial review challenge and upheld the Ombudsman’s decision. The court held that the Ombudsman correctly applied the law in concluding that Siddiqui’s psychiatric injury did not result from an “accident” within the meaning of the insurance contracts. The judge adopted the established insurance law principle from De Souza v Home & Overseas Insurance Co Ltd [1995] LRLR 453, which provides that an injury is not caused by an accident if it is “the natural and direct consequence of what he did, without the intervention of any fortuitous cause.”
The court found that Siddiqui’s course of conduct—sending a sustained series of abusive and threatening messages to his father—naturally and foreseeably resulted in a cease-and-desist warning from the father’s legal representatives. This was not a sudden, fortuitous event but rather the ordinary and expected consequence of the Claimant’s own wrongful conduct. The fact that Siddiqui did not anticipate or intend the specific psychiatric injury does not render the event accidental when the injury flows naturally from actions he deliberately undertook. The letter was not an independent or intervening misfortune; it was the predictable third-party response to his own campaign of abusive messages.
The court emphasized that while the Ombudsman must correctly direct themselves on the law of contract interpretation, they may depart from strict legal rules to achieve a fair and reasonable outcome, provided they do so transparently. Here, the Ombudsman applied the law correctly and did not purport to depart from it, making no error of law.
Key Takeaways
- An injury does not qualify as “accidental” merely because the insured did not intend or foresee it if the injury results from the natural and direct consequences of the insured’s own deliberate actions.
- Insurance policies covering accidents do not protect against injuries caused by third-party responses to the insured’s own wrongful conduct, even if those specific responses are surprising.
- Ombudsmen must correctly apply the law of contract construction, though they may depart from legal principles for fairness reasons if they clearly explain doing so; failure to identify and apply correct legal principles constitutes reviewable error.
- Foreseeability of a general type of consequence (e.g., legal action in response to abusive messages) defeats an accident claim, even if the specific form of that consequence is not predicted.
Why It Matters
This decision reinforces a fundamental limitation on accident-based insurance: such policies do not indemnify the insured against injuries flowing naturally from the insured’s own course of conduct. The ruling clarifies that “accident” in insurance law requires genuine fortuity—an external, unforeseen event—not merely an unexpected specific consequence of predictable conduct. Policyholders cannot trigger coverage by suffering unintended harm when that harm is the natural result of their own deliberate actions. The decision also reaffirms judicial oversight of ombudsman decisions: while ombudsmen enjoy significant discretion to reach fair and reasonable outcomes, they must correctly understand the law before purporting to apply it or departing from it.
For the insurance industry and consumers, the ruling emphasizes that legal expenses policies remain limited in scope—they protect against genuinely fortuitous misfortunes, not against foreseeable repercussions of the policyholder’s own misconduct. Siddiqui’s case illustrates that even severe psychological harm will not be covered if it stems predictably from the insured’s own course of wrongdoing.