Not upheld: PPI mis-selling complaint against Avon Insurance Plc

Decision detail

Summary

Mr A complained that Avon Insurance Plc mis-sold him an insurance policy, believing it offered life assurance when it actually provided only accidental death benefit. The policy was marketed by RBS through postal mailing in 2002 and sold by Avon on a non-advised basis. Mr A discovered the discrepancy in early 2020 when diagnosed as terminally ill. The ombudsman found that the policy documentation was clearly titled 'Accidental Death Benefit Policy' and the terms explicitly set out the limited scope of cover. Avon's communications over 18 years consistently referred to accidental death insurance. The ombudsman rejected the complaint, finding that Avon provided clear, non-misleading information and that Mr A bore responsibility for reviewing the policy details before accepting the cover.

The Ombudsman's reasoning

The ombudsman found that although Mr A believed he had purchased life assurance, Avon sold the policy on a non-advised basis with clear documentation. The policy schedule was explicitly titled 'Accidental Death Benefit Policy' and the terms clearly set out that cover was only for death resulting from accidental bodily injury within 365 days. Multiple communications from Avon over 18 years consistently referred to the accidental death insurance. The ombudsman distinguished between accidental death policies (which do not require medical underwriting) and life assurance policies (which do require medical underwriting and assessment). The ombudsman concluded that the policy information was clear and not misleading, and that Mr A had a responsibility to review the information provided before deciding to proceed.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website