Term Insurance Decision Reference 2022-0068

Case OutcomeUpheld
Subject MatterTerm Insurance
Date22 February 2022
Finantial SectorInsurance
Conducts Complained OfMis-selling (insurance),Complaint handling (Consumer Protection Code) , Delayed or inadequate communication, Dissatisfaction with customer service
Decision Ref:
Product / Service:
Term Insurance
Conduct(s) complained of:
Mis-selling (insurance)
Delayed or inadequate communication
Complaint handling (Consumer Protection Code)
Dissatisfaction with customer service
This complaint concerns a life assurance policy, with life cover of €50,000, which was sold
to the Complainant and his wife, who is now deceased in February 2015 (the “2015 Policy”).
The Provider is an independent intermediary who sold the 2015 Policy to the Complainant
and his late wife. The Policy was underwritten by a named insurer (the “Insurer”).
The Complainant’s Case
The Complainant submits that the Provider called to his home on 12 February 2015, and
that during this meeting he and his late wife disclosed to the Provider, that she had been
diagnosed with cancer [Date Redacted] “…. and was [treatment redacted]”. The
Complainant also contends that at this time his wife had lost her hair, that her illness was
clearly visible and that the Provider knew this and sympathised with them.
The Complainant asserts that at this time, in February 2015, he and his late wife already had
a life assurance policy in place with life cover of €40,000, purchased from the Provider in
2012 (the “2012 Policy”), and underwritten by a third party insurer (the “Former Insurer”).
The Complainant contends that the Provider recommended, due to his wife’s cancer
diagnosis, that they “would be better off changing” to another policy. The Complainant
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contends that the Provider advised them that the 2015 Policy which is the subject of this
complaint, was a “better option to go for” and said that if the Complainant and his wife
signed up “he would arrange all the paperwork when he went back to the office”. The
Complainant states that he and his wife agreed to this, and that they did not complete or
see the medical section of the Application Form.
The Complainant states that when his wife passed away [date redacted], he sent the insurer
all the documents required to process his claim under the 2015 Policy. He further states that
the Insurer reverted to advise that it would not pay the claim, because the deceased’s
medical history was not disclosed to it during the policy application. The Complainant
submits that the Insurer explained that, had it been aware of his late wife’s illness, it would
not have offered life cover to his late wife.
The Complainant further submits that he contacted the Provider on 24 August 2018, but
that the Provider would not assist him and “brushed [him] off”, and that the Provider did
not respond to numerous attempts to contact him after this point.
The Complainant says that the Provider had been his insurance broker for more than twenty
years and had arranged previous life assurance policies for them, including:
a policy in 2000 (the “2000 Policy”);
a policy in 2009 (the “2009 Policy”);
the 2012 Policy; and
the 2015 Policy.
The Complainant submits that he
found a document from a previous out of date [2012] policy that [the Provider]
arranged for us, and he states in it that I consume 5 units of alcohol a week, when in
fact [the Provider] was told on every occasion when we took out a policy, that I have
not drank any alcohol at all since 1991. He obviously just filled in what he saw
appropriate information to disclose himself on these policies”.
The Provider’s Case
The Provider issued a Final Response Letter to the Complainant on 8 April 2019, stating that
the reason the Complainant’s policy was taken out in 2015 was to replace a policy incepted
in 2000 “…which was due to mature in 2016”. The Provider further stated that the
Complainant “would have been left with no cover”, had the 2015 Policy which is the subject
of this complaint, not been incepted.
In subsequent submissions to this Office the Provider states that the purpose of the 2015
Policy was not to replace the 2000 Policy. The Provider submits that he visited the deceased
on 10 February 2015 “to do a review”, and that they agreed on the 2015 Policy “which
carried a longer term which is what she required”, and which had extra life cover. The

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