Partially upheld: claims handling and service quality complaint against Admiral Insurance (Gibraltar) Limited

Decision detail

Summary

Mr K and Ms F complained to the FOS about Admiral Insurance's handling of a travel insurance claim when Mr K became unwell on holiday. The policy had incorrect travel dates, requiring underwriter referral. Mr K delayed seeking medical treatment due to concerns about costs, and complained about the service received. Admiral refunded the premium and upheld a separate complaint about incorrect advice. The ombudsman partially upheld the complaint, finding Admiral's actions reasonable and their premium refund offer fair, as they carried no risk under the incorrectly dated policy.

The Ombudsman's reasoning

The ombudsman found that Admiral acted reasonably in the circumstances. The incorrect trip dates provided clear grounds for underwriter referral, and Admiral was not unreasonable in asking for evidence and investigating options to assist Mr K. The decision timeframe (from 23:33 to before 15:00 the next day) was reasonable. Admiral offered Mr K the option to access treatment and recover costs afterwards, and discussed the PRC option. It is not Admiral's responsibility to advise on when medical treatment should be accessed. The premium refund is fair because Admiral carried no risk under the policy with incorrect trip dates.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website