Not upheld: Other regulated complaint complaint against Liverpool Victoria Life Company Limited

Decision detail

Summary

Mrs D, on behalf of Mr D's estate, complained that LV improperly proportionately settled a life assurance claim following Mr D's death in May 2022. LV had identified that Mr D made a careless misrepresentation when applying for the policy in December 2021 by answering 'no' to questions about digestive system conditions and alcohol reduction advice, despite medical records showing he had such conditions and had been advised to reduce drinking. The ombudsman found the questions were clear and unambiguous, Mr D's medical history supported the misrepresentation, and under CIDRA the misrepresentation was qualifying and properly classified as careless. Therefore, LV was entitled to proportionately settle the claim, and the complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that the questions asked were clear and unambiguous, and Mr D's medical history showed he had conditions affecting his digestive system and had been advised to reduce alcohol intake, which should have been disclosed. Under CIDRA, since the misrepresentation was not deliberate or reckless, it must be deemed careless. As a careless misrepresentation, LV was entitled to proportionately settle the claim under CIDRA provisions, which the ombudsman confirmed was calculated fairly.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website