Term Insurance Decision Reference 2022-0088

Case OutcomePartially upheld
Subject MatterTerm Insurance
Reference2022-0088
Date11 March 2022
Finantial SectorInsurance
Conducts Complained OfFailure 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.

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