Not upheld: policy cancellation procedure and compensation adequacy complaint against Aviva Health UK Limited

Financial Ombudsman decision DRN-6325188 of 2026-05-12T00:00:00+00:00. policy cancellation procedure and compensation adequacy complaint against Aviva Health UK Limited. Outcome: Not upheld.

Decision detail

Reference	DRN-6325188
Decision date	2026-05-12T00:00:00+00:00
Firm	Aviva Health UK Limited
Product	private medical insurance
Claim type	policy cancellation procedure and compensation adequacy
Outcome	Not upheld
Remedy	Aviva's existing offer: reinstatement of policy on payment of backdated premiums and £300 compensation subject to verification check

Summary

Mr P complained that Aviva Health UK Limited unfairly declined his 2023 surgery claim, required him to pay missed premiums to reinstate his cancelled policy, and offered insufficient compensation of £300. The ombudsman declined to reconsider the surgery claim as it had already been decided by another ombudsman in April 2024 with no material new evidence. On the cancellation issue, the ombudsman found Aviva's offer to reinstate the policy with backdated cover on payment of missed premiums was fair because it provides continuous cover, and the £300 compensation was proportionate for the failure to conduct a needs review. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that while Aviva failed to follow its usual cancellation process, its offer to reinstate the policy with backdated cover on payment of missed premiums was fair because it provides continuous cover and Aviva is entitled to be paid for providing that cover. The £300 compensation was considered fair and proportionate for the modest mistake of not conducting a needs review, particularly when taken together with the reinstatement offer.

How this compares

Group	Decisions	Uphold rate
Aviva Health UK Limited, all decisions	181	22%

Source

Read the original decision on the Financial Ombudsman Service website