Not upheld: unfair premium pricing and alleged age discrimination complaint against Aviva Insurance Limited

Decision detail

Summary

Mr and Mrs L complained that Aviva Insurance Limited increased their private medical insurance premium by £399 at renewal in 2025, which they considered excessive given they had never made a claim and suspected age discrimination and loyalty exploitation. The ombudsman found that age is a legitimate consideration in health insurance risk calculation and that Aviva had applied the price increase fairly and consistently to other similar policyholders in accordance with its internal guidelines. The ombudsman noted that specific pricing parity rules under FCA's GIPP do not apply to private medical insurance and that the complainants' higher premium partly reflected their greater level of cover due to developed health conditions. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman determined that while age-related price increases may seem unfair to the complainant, age is a legitimate risk factor in health insurance pricing. The key issue was whether Aviva had singled out Mr and Mrs L for additional costs or applied increases consistently. Based on evidence that Aviva applied the pricing structure and increase equitably in accordance with its internal guidelines and to other similar policyholders, the ombudsman concluded Aviva had treated them fairly. The ombudsman also noted that GIPP rules do not specifically apply to private medical insurance, though broader fair value principles were considered.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website