Partially upheld: Service failures generally complaint against TICORP Limited

Decision detail

Summary

Miss T purchased travel insurance from TICORP and made a claim for a pregnancy complication (leaking waters) that was not covered under the policy's specific definition of covered complications. She complained that TICORP mis-sold the policy, claiming she had emphasized the importance of pregnancy cover during the sales call. The ombudsman found the policy was not mis-sold as the adviser provided clear information about the 8-week threshold Miss T specifically asked about and the terms were provided. However, the ombudsman upheld the complaint in part, finding that the adviser should have directed Miss T to the specific definition of covered complications rather than simply confirming she would be covered, and awarded £100 compensation for this lack of clarity.

The Ombudsman's reasoning

The ombudsman found that whilst this was a non-advised sale where the firm only needed to provide clear and not misleading information (not ensure suitability), the adviser could have directed Miss T to the specific definition of covered complications. However, the ombudsman was not satisfied that even with this information, Miss T would have purchased a different policy, as she could not have known she would suffer an uncovered complication. The adviser did provide clear information about the 8-week threshold that Miss T specifically asked about, and the policy terms were sent to her. The ombudsman concluded the policy was not mis-sold but that £100 compensation was appropriate for the lack of clarity about the specific definition.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website