Not upheld: Unknown / needs review complaint against Insurance Factory Limited

Decision detail

Summary

Mr K complained that INSURANCE FACTORY LIMITED mis-sold a pet insurance policy by assuring him that claims for his dog's remaining eye would be covered. After the dog's other eye needed removal due to the same pre-existing condition, the claim was declined. Although the ombudsman accepted a call likely took place, it found unlikely that the adviser gave a blanket reassurance given the policy's clear exclusion of pre-existing and related conditions. The ombudsman was satisfied Mr K received sufficient information through the online sales process to make an informed decision, and therefore did not uphold the complaint.

The Ombudsman's reasoning

The ombudsman accepted that a call likely took place based on common industry practice, but found it unlikely the adviser gave a blanket reassurance that all claims would be covered given the policy's clear exclusion of pre-existing and related conditions. The ombudsman noted the adviser would not have known the condition was already present in the remaining eye. The ombudsman was satisfied that through the non-advised online sales process, Mr K was provided with sufficient clear information about the policy's features and limitations to make an informed decision.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website