Private Health Insurance Decision Reference 2022-0109

Case OutcomeRejected
Subject MatterPrivate Health Insurance
Reference2022-0109
Date29 March 2022
Finantial SectorInsurance
Conducts Complained OfDelayed or inadequate communication,Miscellaneous
Decision Ref:
2022-0109
Sector:
Insurance
Product / Service:
Private Health Insurance
Conduct(s) complained of:
Delayed or inadequate communication
Miscellaneous
Outcome:
Rejected
LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN
This complaint relates to the provision of information on the Provider’s website.
The Complainant’s Case
The Complainant submits that the Provider’s website does not provide clear or
unambiguous information. She states that the process of checking policy cover is overly
complicated “in order to deliberately confuse and mislead customers”.
The Complainant describes the process by which she can check her cover. A customer can
check their cover either with the code for their specific procedure, or through a search
function designed to check hospitals, GPs, and consultants. To access this latter option, she
says that the customer presses a button titled ‘Check hospital or consultant’.
The Complainant says that this wording is misleading, as she must, in fact, check that the
policy covers the hospital, the procedure, the date of the symptoms, and that the
consultant is participating.

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