Not upheld: policy cancellation due to non-payment and failure to reinstate complaint against AXA PPP Healthcare Limited

Decision detail

Summary

Ms S complained that AXA PPP Healthcare Limited unfairly cancelled her private medical insurance policy. The policy was taken out when Ms S was a minor, with her mother as the lead member and her father as the payer. After an initial renewal letter was sent to an old address in May 2024, AXA PPP attempted to contact the family through multiple channels in July 2024 (secure email, voicemail, and letter) and again in September 2024 to address address verification issues and payment arrangements. The policy was cancelled in July 2024 due to non-payment after payment details were removed pending address confirmation. Ms S discovered the cancellation in January 2025 and requested reinstatement, but AXA PPP refused as more than 120 days had passed. The ombudsman found AXA PPP acted fairly and reasonably in its communications and cancellation decision, and did not uphold the complaint.

The Ombudsman's reasoning

Although AXA PPP made an initial mistake by sending the renewal letter to an incorrect address, it subsequently took reasonable follow-up actions through multiple communication channels (phone, secure email message, and letters) to contact both Mr S and Mrs S. The ombudsman found that the secure message was clear and not confusing, the email did not expire after two weeks, and both Mr and Mrs S had opportunities to respond to the voicemail and letters. The policy was cancelled in accordance with its terms and conditions due to non-payment. The ombudsman also found it reasonable for AXA PPP to refuse reinstatement as more than 120 days had passed since cancellation, which is consistent with how AXA PPP treats all policyholders in similar situations.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website