Partially upheld: non-disclosure of material medical information and policy cancellation complaint against Cirencester Friendly Society Limited
Financial Ombudsman decision DRN-6103173 of 2026-06-02T00:00:00+00:00. non-disclosure of material medical information and policy cancellation complaint against Cirencester Friendly Society Limited. Outcome: Partially upheld.
Decision detail
| Reference | DRN-6103173 |
|---|---|
| Decision date | 2026-06-02T00:00:00+00:00 |
| Firm | Cirencester Friendly Society Limited |
| Product | income protection insurance |
| Claim type | non-disclosure of material medical information and policy cancellation |
| Outcome | Partially upheld |
| Remedy | CFS must: (1) inform Mr C what medical evidence is needed to assess whether his condition remains stable; (2) allow Mr C to obtain this information with his GP's assistance; (3) refer the case to its underwriters once Mr C provides the evidence to decide whether a policy would have been offered and on what basis (potentially with a neurological exclusion); (4) if CFS decides it would have offered a policy, assess Mr C's diabetes claim against those terms and allow him to bring the policy up to date. |
Summary
Mr C held income protection insurance with CFS and made a claim in February 2025 after being diagnosed with type 1 diabetes. CFS discovered that Mr C had failed to disclose childhood diagnoses of an intracranial tumour and seizures, cancelled the policy, and declined his claim. The ombudsman found this was a careless misrepresentation under CIDRA, as Mr C failed to correct the application answers when sent a contract confirmation pack in July 2024. However, the ombudsman determined that CFS's underwriter had not made a clear decision about whether to decline cover entirely or offer it with neurological exclusions. The ombudsman partially upheld the complaint, requiring CFS to allow Mr C to provide additional medical evidence and reassess whether a policy would have been offered, and if so, to reconsider his diabetes claim.
The Ombudsman's reasoning
The ombudsman found that the questions asked were clear and unambiguous, requiring disclosure of any history of tumours or seizures. Although Mr C's conditions occurred in childhood and he had been symptom-free since treatment, the questions asked 'have you ever' rather than limiting to a specific timeframe. The misrepresentation was careless rather than deliberate because Mr C failed to review and correct the contract confirmation pack in July 2024. Under CIDRA, this constitutes a qualifying misrepresentation. However, the ombudsman found that CFS's underwriter stopped short of making a clear decision about whether to offer a policy with exclusions or decline entirely. Given the six-month gap between application and claim, the ombudsman concluded Mr C would likely have sought the necessary medical information if given the opportunity. Therefore, CFS should allow Mr C to provide additional medical evidence for reassessment rather than simply cancelling the policy.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Cirencester Friendly Society Limited, all decisions | 10 | 45% |
Source
Read the original decision on the Financial Ombudsman Service website