Partially upheld: Home insurance claim disputes complaint against SiriusPoint International Insurance Corporation
Financial Ombudsman decision DRN-5972386 of 2026-02-19T00:00:00+00:00. Home insurance claim disputes complaint against SiriusPoint International Insurance Corporation. Outcome: Partially upheld.
Decision detail
| Reference | DRN-5972386 |
|---|---|
| Decision date | 2026-02-19T00:00:00+00:00 |
| Firm | SiriusPoint International Insurance Corporation |
| Product | Travel insurance |
| Claim type | Home insurance claim disputes |
| Outcome | Partially upheld |
| Remedy | 1. Pay £200 compensation for distress and inconvenience. 2. Promptly assess claim for rearranged flights and extended accommodation in line with policy terms. 3. Pay daily hospital benefit of £30 per day for each complete 24-hour period Mr C was in hospital (up to maximum of £1,500). 4. Pay simple interest at 8% per year on hospital benefit amounts from one month after claim was made to date of settlement. |
Summary
Mr and Mrs C complained about assistance received from Sirius under their travel insurance policy after Mr C was hospitalised abroad with an abscess and required emergency medical treatment at a private facility. Sirius advised that Mr C should be transferred to a public hospital in a country with reciprocal health agreement with the UK, but Mr C chose to remain at the private hospital and proceed with surgery. The ombudsman found Sirius fairly limited cover for private medical expenses as this is standard practice, but upheld the complaint regarding inadequate assistance because Sirius failed to contact Mr C directly as promised, instead allowing him to receive information from the treating hospital. The ombudsman directed Sirius to pay £200 compensation, assess claims for rearranged flights and accommodation, pay daily hospital benefit for all days Mr C was hospitalised, and pay interest on the hospital benefit.
The Ombudsman's reasoning
Sirius acted fairly in limiting cover for private medical expenses because the policy does not cover private treatment when a country has reciprocal health agreement with UK and adequate public facilities exist, and Sirius' medical team concluded transfer was medically safe. However, Sirius failed to provide adequate assistance by not contacting Mr C directly on the morning of 20 May 2025 as promised, instead allowing Mr C to receive information from the treating hospital, causing confusion and upset. Additionally, Sirius should pay the daily hospital benefit for the complete days Mr C remained in hospital because had he agreed to transfer, he would have remained in hospital for the same duration at the public facility, and Sirius is covering medical costs up to the point of his decision to remain at the private hospital.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| SiriusPoint International Insurance Corporation, all decisions | 10 | 15% |
| Home insurance claim disputes, all decisions | 25,340 | 38% |
| Travel insurance, all decisions | 7,644 | 37% |
Source
Read the original decision on the Financial Ombudsman Service website