Not upheld: pre-existing medical conditions coverage and premium quotation accuracy complaint against Aviva Insurance Limited
Financial Ombudsman decision DRN-6382247 of 2026-05-27T00:00:00+00:00. pre-existing medical conditions coverage and premium quotation accuracy complaint against Aviva Insurance Limited. Outcome: Not upheld.
Decision detail
| Reference | DRN-6382247 |
|---|---|
| Decision date | 2026-05-27T00:00:00+00:00 |
| Firm | Aviva Insurance Limited |
| Product | travel insurance |
| Claim type | pre-existing medical conditions coverage and premium quotation accuracy |
| Outcome | Not upheld |
| Remedy | Aviva Insurance Limited should pay £100 additional compensation (in addition to the £150 already paid, totalling £250 compensation). |
Summary
Mrs T complained that Aviva gave inconsistent information about covering her pre-existing medical conditions and then retracted an offer to reimburse alternative travel insurance. Aviva had made a recording error regarding a chest infection and paid £150 compensation, then initially offered to reimburse Mrs T's £385.78 alternative travel insurance premium. However, when Mrs T disclosed left ventricular dysfunction in August 2025 (a condition she had previously mentioned as under investigation in 2023), Aviva retracted the reimbursement offer on 1 September 2025, offering an additional £100 compensation instead. The ombudsman found the complaint not upheld, determining that Aviva's offer was based on incomplete information and that Aviva was not obliged to honour it, particularly as underwriting evidence showed Aviva would never have offered cover for Mrs T's conditions with complete information. The ombudsman concluded Mrs T had not suffered net financial loss and that the total compensation of £250 was fair.
The Ombudsman's reasoning
The ombudsman found that Mrs T had a responsibility to provide accurate and complete medical information to Aviva. While Aviva made a recording error regarding a chest infection (for which it paid £150 compensation), the subsequent offer to reimburse alternative travel insurance was based on incomplete information, as Mrs T had not disclosed her left ventricular dysfunction diagnosis. Aviva's underwriting evidence demonstrated it would never have offered cover for Mrs T's medical conditions if it had possessed complete information. Therefore, Aviva was not obliged to honour an offer made on the basis of incomplete information. The ombudsman calculated that even with Aviva's total compensation of £250, Mrs T had not suffered a net financial loss, as the alternative policy cost £385.78 and the difference (£135.78) would have been exceeded by higher premiums Aviva would have charged for cover.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Aviva Insurance Limited, all decisions | 5,098 | 27% |
Source
Read the original decision on the Financial Ombudsman Service website