Critical & Serious Illness Decision Reference 2022-0101

• Case Outcome: Rejected
• Subject Matter: Critical & Serious Illness
• Reference: 2022-0101
• Date: 23 March 2022
• Finantial Sector: Insurance
• Conducts Complained Of: Delayed or inadequate communication,Mis-selling, Mis-selling (insurance)

Decision Ref:

2022-0101

Sector:

Insurance

Product / Service:

Critical & Serious Illness

Conduct(s) complained of:

Delayed or inadequate communication

Mis-selling

Mis-selling (insurance)

Outcome:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant held a standalone serious illness policy from 1 November 2000 to 1

November 2020 that provided him with serious illness cover in the amount of €63,487.00

(sixty three thousand four hundred and eighty-seven Euro) for a fixed monthly premium of

€24.95 (twenty-four Euro and ninety-five Cent).

This complaint concerns the supply by the Provider to the Complainant of conversion option

quotations for life cover, instead of conversion options for serious illness cover, in 2016.

The Complainant’s Case

The Complainant sets out his complaint in the Complaint Form he completed in April 2020,

as follows:

“After receiving letters about the transfer of my plan to [the Provider] I rang for a

quote on my specified illness plan. The quote is from 28/10/2016 … The figures were

similar to what I was paying and plan didn’t expire until November 2020 so I didn’t

make any changes or exercise the conversion option.

I rang again (2019) and was referred to financial advisor, [Mr B.] who gave me quotes

and an explanation of all my options re life cover / illness cover / age limits. He

advised that he thought the quote I received [in October 2016] sounded like a life

only quote.