Not upheld: premium increase fairness and fair value complaint against Casualty & General Insurance Company (Europe) Ltd

Decision detail

Summary

Miss B complained about a 49% premium increase on her lifetime pet insurance policy with C&G, from £1,337 to £1,992 annually, despite making no claims. She argued the increase was unfair and lacked transparency, and highlighted her vulnerable position as her dog's breed has restricted insurance availability, limiting her ability to switch insurers. She also raised concerns about fair value and whether C&G adequately considered her vulnerable circumstances and financial pressure. The ombudsman found that C&G treated Miss B consistently with other policyholders in similar circumstances, applied a reasonable risk model considering age, breed factors, inflation and vet fees, and provided fair value through comprehensive lifetime cover with a £16,000 annual vet fee limit. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman determined that while the FOS cannot dictate insurance pricing or risk assessment factors, it can examine whether a customer was treated fairly compared to other policyholders. C&G provided information about the main pricing factors and there was no evidence of differential or less favourable treatment. The ombudsman rejected the argument that vulnerability due to restricted market choice should result in more favourable pricing outside C&G's risk model. The policy was found to provide fair value given its lifetime cover for non-pre-existing conditions and high vet fee benefit limit. The ombudsman acknowledged Miss B's financial difficulty but noted that future premium increases are unknown and cannot be considered in the decision.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website