Whole-of-Life Decision Reference 2019-0255
| Case Outcome | Rejected |
| Subject Matter | Whole-of-Life |
| Reference | 2019-0255 |
| Date | 06 August 2019 |
| Conducts Complained Of | Failure to provide correct information,Delayed or inadequate communication |
| Finantial Sector | Insurance |
Decision Ref:
2019-0255
Sector:
Insurance
Product / Service:
Whole-of-Life
Conduct(s) complained of:
Failure to provide correct information
Delayed or inadequate communication
Outcome:
Rejected
LEGALLY BINDING DECISION
OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN
Background
The Complainant is 58 years old. He is a member of a Group Income Continuance Plan and
a Group Life Plan. The policyholder of both is a Trade Union, the individual members of
which can opt to join the Plans through the Provider. The Provider is the administrator of
these Plans since 2006, at which time the Complainant was already a member.
The Complainant’s Case
On 31 July 2014, the Complainant, who was in receipt of income continuance benefit under
his Group Income Continuance Plan at the time, retired on ill-health grounds. Thereafter
the benefit payments continued.
Subsequently, he received correspondence from the Provider dated 6 October, 10 October
and 20 October 2014 that provided him with incorrect, conflicting and confusing information
regarding his entitlements under the Group Income Continuance Plan and the Group Life
Plan. He placed a telephone call to the Provider on 21 October 2014 to try and confirm his
entitlements but this “further complicated” matters for him and he notes that the Provider
offered no apology at that time, for the errors contained in the correspondence.
In this regard, the Complainant sets out his complaint, as follows:
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