Partially upheld: Service failures generally complaint against Vitality Health Insurance Limited
Financial Ombudsman decision DRN-8641644 of 2016-05-10T00:00:00+00:00. Service failures generally complaint against Vitality Health Insurance Limited. Outcome: Partially upheld.
Decision detail
| Reference | DRN-8641644 |
|---|---|
| Decision date | 2016-05-10T00:00:00+00:00 |
| Firm | Vitality Health Insurance Limited |
| Product | Other regulated product |
| Claim type | Service failures generally |
| Outcome | Partially upheld |
| Remedy | £50 compensation for trouble and upset caused by poor complaint handling |
Summary
Mr N complained that Vitality Health Insurance Limited refused to honour a 25% cash back benefit on a hotel booking after his employer cancelled the group medical insurance policy in October 2015, before his April 2016 stay. The employer cancelled due to Vitality's planned 50% premium increase. The ombudsman found the policy terms clearly required membership at time of stay, making Vitality's refusal fair. However, Vitality failed to respond promptly to the complaint and incorrectly advised that the complaint was outside FOS jurisdiction, causing Mr N trouble and upset. The complaint was upheld in part with £50 compensation ordered for the poor complaint handling.
The Ombudsman's reasoning
The ombudsman found the policy terms clearly stated eligibility for cash back required membership at time of stay, making Vitality's refusal fair despite the employer's cancellation being prompted by premium increases. However, Vitality's failure to respond promptly in writing and provision of incorrect information about FOS jurisdiction caused Mr N trouble and upset, 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