Partially upheld: claim settlement delay and poor customer service complaint against Chubb European Group SE

Decision detail

Summary

Mr D claimed for medical expenses under a travel insurance policy with Chubb. Chubb requested additional information about his travel itinerary and medical history, noting he had made a separate medical claim shortly before. Mr D disputed the fairness of these requests and complained about poor customer service. Chubb offered £200 compensation for service failures. The FOS investigator recommended increasing compensation to £300 total, which both Mr D and Chubb eventually accepted. The ombudsman partially upheld the complaint, finding Chubb's information requests were reasonable but its communication was inadequate, and confirmed the £300 compensation was appropriate.

The Ombudsman's reasoning

The ombudsman found that Chubb acted fairly in requesting additional information because: (1) the proximity of Mr D's two medical claims made it reasonable to review further medical evidence given the policy's pre-existing condition exclusions; (2) Chubb was entitled to validate the claim by requiring evidence that the trip started and ended in the UK; and (3) Mr D provided no further compelling evidence addressing Chubb's concerns. However, Chubb failed to provide clear, proactive communication about why the claim wasn't being settled and what further evidence was required, causing Mr D frustration and worry beyond what could reasonably be expected.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website