Employers Liability Decision Reference 2022-0131

• Case Outcome: Rejected
• Reference: 2022-0131
• Date: 11 April 2022
• Year: 2022
• Subject Matter: Employers Liability
• Finantial Sector: Insurance
• Conducts Complained Of: Maladministration

Decision Ref:

2022-0131

Sector:

Insurance

Product / Service:

Employers Liability

Conduct(s) complained of:

Maladministration

Outcome:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant, a public sector employee, incepted a Salary Protection Policy on 14

February 2011.

The Complainant is the Policyholder, and the Trade Union she is a member of is the

Grantee of the Salary Protection Scheme that her policy is incepted under. The Grantee

engages the services of an Insurance Brokerage to administer the Scheme on its behalf,

hereinafter ‘the Intermediary’.

The Provider was the Insurer of this Salary Protection Scheme, responsible for the

underwriting of applications for cover and assessing claims. The Provider ceased being the

Insurer from 1 December 2012, though it remains responsible for those claims that were in

payment at that time, for the duration of such claims.

This complaint concerns the Provider’s decision to cease payment of the Complainant’s

salary protection claim.

The Complainant’s Case

The Complainant completed a Claim Form to the Provider on 22 November 2011 advising

that she had been unfit for work since 17 May 2011 due to “sigmoid diverticular disease”.

2011

The Complainant’s GP completed and sent a Medical Certificate to the Provider on 2

December 2011 confirming that the Complainant was suffering from this condition.