Whole-of-Life Decision Reference 2022-0090

Case OutcomeRejected
Subject MatterWhole-of-Life
Reference2022-0090
Date11 March 2022
Finantial SectorInsurance
Conducts Complained OfFailure to process instructions,Claim handling delays or issues
Decision Ref:
2022-0090
Sector:
Insurance
Product / Service:
Whole-of-Life
Conduct(s) complained of:
Failure to process instructions
Claim handling delays or issues
Outcome:
Rejected
LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN
The Complainants incepted a joint life assurance policy with the Provider on 1 October 1989.
The complaint relates to the Provider overcharging the Complainants for their policy, on the
basis that the Provider recorded the First Complainant as a smoker. He says this is incorrect
as he is not a smoker and that he declared in the Policy Application he completed on 5
September 1989 that he is not a smoker.
This Office, in accordance with Section 51(3) of the Financial Services and Pensions
Ombudsman Act 2017, can only consider conduct that occurred during or after 2002.
The Provider calculated the Complainants’ policy premium monthly, as per Para. 15, ‘Death
Benefit Charge and Policy Charges’, of the applicable Provisions, Privileges and Conditions
Policy Booklet. This complaint is that the Provider charged the Complainants the incorrect
premium since 2002, on the basis that it recorded the First Complainant as a smoker which
the Complainants say is factually incorrect.
The Complainants’ Case
The First Complainant, now age 80, says that he declared himself as a non-smoker when
completing the Policy Application to the Provider on 5 September 1989, with the Second
Complainant, now age 77, declaring herself as a smoker. In that regard, the First
Complainant answered the question “What is your average tobacco consumption per day?”
as “None” and the Second Complainant answered “10 per day”.

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