DRN-6215421

The complaint Ms W is unhappy with ReAssure Limited’s decision to cease paying her claim. (Ms W brings her complaint via a representative, but for simplicity, I’ll refer to submissions as being made by her personally). What happened Ms W was in receipt of income protection benefit for many years, however, ReAssure stopped paying her claim in October 2024 saying she’d reached the end of the policy’s term. Ms W said her policy was supposed to run until state retirement age and that as she’s not yet at that age, ReAssure has prematurely ended her cover. Ms W also said this is supported by her policy documents, specifically the statement of acceptance, and that should be the main consideration in this complaint. Ms W also said she’s a vulnerable consumer and that ReAssure’s actions have exacerbated her poor mental health. ReAssure said Ms W’s policy was incepted in 1991, when the state retirement age was at age 60 for women. It also said the policy terms also highlight cover ended when Ms W reached 60. ReAssure said it wrote to Ms W two-years before the policy was due to end. It also said it paid Ms W £350 for not responding to her initial complaint in April 2025. Our investigator initially upheld this complaint, however, upon reviewing additional evidence from ReAssure, namely the policy terms, she decided not to uphold it. Our investigator said the policy terms provided further clarity about the policy’s end date being upon the event of Ms W reaching 60 years of age. She acknowledged Ms W’s comments about her vulnerability, but said overall, ReAssure could fairly rely on the policy terms to stop paying benefit. Ms W, unhappy with that, asked for an ombudsman to review her complaint. In summary, she said the investigator placed too much weight on the policy terms and not enough on the statement of acceptance. She reiterated the state retirement age is now age 67 and so ReAssure should reinstate her policy and continue to pay her benefit. She highlighted ReAssure’s obligations under Consumer Duty and said the insurer hasn’t complied with it. Ms W also said her vulnerability makes a difference in this case and ReAssure didn’t provide her with any warning the benefit payments would stop, which has caused her significant financial stress. And so, it’s now for me to make a final decision. What I’ve decided – and why I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. Having done so, I’ve decided not to uphold it and for broadly similar reasons to those given by our investigator. Whilst Ms W’s statement of acceptance says the term of the policy is until retirement age, the policy terms specify that’s aged 60. And so, whilst I appreciate the

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national retirement age has been extended since 1991, that doesn’t mean ReAssure has to effectively extend the term of the policy to reflect that. I’ll explain why. The relevant rule that applies in this case comes from the Insurance Conduct of Business Sourcebook (ICOBS) and says ReAssure must assess claims promptly and fairly and must not reject a claim unreasonably. I’ve considered this and other relevant industry guidance whilst assessing Ms W’s complaint. Although I may not respond to every point Ms W has raised, I want to reassure her I’ve considered everything she’s said. The informal nature of this service enables me to do that so I can resolve complaints with minimal formality. Ms W’s policy was incepted by a different insurer back in 1990, which was later taken up by ReAssure. The insurer accepted Ms W’s claim and had been paying benefit for many years. ReAssure said it handled Ms W’s claim carefully throughout that time and fulfilled its obligation under the Financial Conduct Authority’s definition of a vulnerable consumer. ReAssure said it extended medical reviews in recognition of Ms W’s vulnerabilities and, at its last review in 2022, notified her the claim would come to an end in October 2024. Ms W disputed being told that but ReAssure has provided evidence to show it did reach out to her with this information. The insurer also wrote to Ms W two weeks before the cover was due to end to explain that which is what I’d expect it to do. Ms W said ReAssure has breached the Consumer Duty rules, specifically as its decision to end her cover has caused her significant financial harm. I understand why she makes that argument, especially as this was her main source of income, but that doesn’t mean ReAssure should continue to pay her claim beyond the term of the policy. The policy end date was agreed in 1991 and the Consumer Duty came into force in 2023. It doesn’t apply retrospectively. To be clear, the policy terms say: “Permanent Health Insurance Benefit This Benefit is payable in the event of a life assured being disabled for a continuous period equal to the Deferred Period relating to this life. It is payable at the end of each 4 weeks after the end of the Deferred Period. Payment will continue throughout disability until attainment of age 65 for a male or 60 for a female life or until death if earlier” Ms W questioned the validity of these terms and whether they are in fact related to the cover she had. I should note Ms W has been unable to provide any policy terms or a policy schedule but has provided the statement of acceptance. I’ve reviewed the terms provided by ReAssure and I’m satisfied they are the correct basis for which her claim should be considered. I say that because Ms W’s policy was a freedom policy offered by her previous insurer and having carefully considered the evidence provided by ReAssure, I’m persuaded they relate to her freedom cover. I also note the policy reference number matches the information contained in the sales paperwork from 1991. I’ve also seen evidence of other freedom policies sold by Ms W’s previous insurer between 1986 – 1992 and they all define national retirement age for women at 60 years. I should also say that’s consistent with the national retirement age at that time and that didn’t change until 2010. And so, even if I accepted Ms W’s argument that ReAssure assessed her claim against incorrect policy terms – and to be clear I don’t think that is the case – all other relevant policy terms from that time defined the retirement age in the same way, so it makes little difference to the outcome of this complaint for those reasons.

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My final decision For the reasons I’ve explained, I don’t uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Ms W to accept or reject my decision before 22 May 2026. Scott Slade Ombudsman

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