Not upheld: Service failures generally complaint against Medicash Health Benefits Limited

Decision detail

Summary

Mr and Mrs G complained that Medicash Health Benefits Limited refused to continue their 'Active Dual Bronze Plus' healthcare cash plan after Mr G left his employment. The policy was contractually linked to Mr G's employer and could not continue outside that arrangement. Although Mr and Mrs G requested to amend payment details and continue the policy, Medicash informed them it would end and offered an alternative essentials plan instead. The ombudsman found Medicash acted fairly as the policy terms were employment-linked, the firm properly communicated the cancellation, and offered alternative cover. The complaint was not upheld.

The Ombudsman's reasoning

The policy was contractually linked to Mr G's employment and could not continue once that employment ended. Medicash fairly communicated this to Mr and Mrs G and offered an alternative level of cover. While Medicash operates a community underwriting model without risk-rated premiums, it may review claims history when considering new applications or continuation outside company-linked arrangements to ensure scheme sustainability. The ombudsman found no evidence of unfair treatment compared to others in similar circumstances. Although 28 days' notice may not have been formally given, the policy would have been cancelled around the same time anyway given the employment termination date.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website