Term Insurance Decision Reference 2022-0088

• Case Outcome: Partially upheld
• Reference: 2022-0088
• Date: 11 March 2022
• Year: 2022
• Subject Matter: Term Insurance
• Finantial Sector: Insurance
• Conducts Complained Of: Failure to process instructions

Decision Ref:

2022-0088

Sector:

Insurance

Product / Service:

Term Insurance

Conduct(s) complained of:

Failure to process instructions

Outcome:

Partially upheld

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant incepted a life assurance policy with the Provider on 1 December 2004

that provided her with life cover in the amount of €4,000,000.00 (four million Euro) and

specified illness cover of €750,000.00 (seven hundred and fifty thousand Euro) for a term

of 15 years, to 1 December 2019.

This complaint concerns the Provider’s refusal in November 2019 to allow the Complainant,

prior to the expiry date of her maturing policy, to convert €500,000.00 (five hundred

thousand Euro) of her specified illness cover to a new life assurance plan without the need

for medical underwriting.

The Complainant’s Case

The Complainant’s Financial Adviser contacted the Provider in September 2019 as the

Complainant was seeking to convert €1,000,000.00 (one million Euro) of her life cover

benefit and €500,000.00 (five hundred thousand Euro) of her specified illness cover to a

new life assurance plan without the need for medical underwriting. She sought to do this

before 1 December 2019, the expiry date of her maturing policy. The Provider advised,

however, that only the life cover benefit could be converted because the policy terms and

conditions did not allow for the specified illness cover to be converted.

The Financial Adviser says the Complainant ought to have been permitted to covert her

specified illness cover because, on at least three separate occasions, these being 1 October

2013, 21 November 2018 and 18 July 2019, the Provider confirmed by email that the

Complainant had an entitlement to convert €1,000,000.00 (one million Euro) life cover and

€500,000.00 (five hundred thousand Euro) specified illness cover without medical evidence.