Upheld: Service failures generally complaint against Vitality Health Insurance Limited
Financial Ombudsman decision DRN-8519783 of 2017-02-22T00:00:00+00:00. Service failures generally complaint against Vitality Health Insurance Limited. Outcome: Upheld.
Decision detail
| Reference | DRN-8519783 |
|---|---|
| Decision date | 2017-02-22T00:00:00+00:00 |
| Firm | Vitality Health Insurance Limited |
| Product | Other regulated product |
| Claim type | Service failures generally |
| Outcome | Upheld |
| Remedy | Vitality Health Insurance Limited to pay Mrs M £150 compensation for inconvenience and frustration caused by poor service administration. |
Summary
Mrs M complained about Vitality's administration of her private medical insurance policy, specifically regarding cashback payments and coffee shop vouchers. Vitality failed to identify that Mrs M was ineligible for cashback payments because her son had not undergone a required non-smoking test after turning 18, yet it paid the cashback anyway after Mrs M contacted them multiple times over 20 months. Coffee shop vouchers were not received due to an incorrectly recorded email address. The ombudsman found Vitality provided poor service but Mrs M suffered no financial loss, as she received all cashback payments due and Vitality offered voucher reimbursement. The complaint was upheld and £150 compensation ordered for inconvenience and frustration.
The Ombudsman's reasoning
Vitality provided very poor service by failing to identify Mrs M's ineligibility over a 20-month period. However, Mrs M did not suffer financial loss because Vitality paid the cashback anyway after she contacted them. The missed payments in October 2015 and January 2016 were justified as Mrs M had not undergone the required test. Regarding coffee shop vouchers, Vitality's error in recording the email address was slow to identify, but Vitality offered reimbursement and alternative compensation. While no financial loss occurred, Mrs M suffered frustration and inconvenience warranting compensation.
How this compares
| Group | Decisions | Uphold rate |
|---|---|---|
| Vitality Health Insurance Limited, all decisions | 15 | 30% |
| Service failures generally, all decisions | 32,767 | 33% |
| Other regulated product, all decisions | 51,105 | 30% |
Source
Read the original decision on the Financial Ombudsman Service website