Life Insurance

A financial services firm arranging insurance must accurately communicate health information disclosed by the consumer to the insurer, and must calculate redress based on what the insurer would have paid had the information been properly di

A consumer applying for insurance under the Marine Insurance Act 1906 had a duty of utmost good faith to disclose all material information about their occupation, and an insurer may decline a claim or remove benefits if material occupationa

An insurer may apply proportionate settlement for underinsurance if the sum insured is significantly lower than the property's rebuild cost and this has been fairly communicated to the policyholder.

A firm must administer life insurance policies accurately and provide timely, clear communication when errors occur; compensation for distress and inconvenience must be fair and reasonable in the circumstances.

A bank must provide clear information to customers about how address changes will affect communications on joint accounts, particularly where safeguarding concerns exist.

A financial services provider is not liable for service limitations in unsupported countries if the terms and conditions clearly specify the geographic constraints and the consumer agreed to them.

A warranty provider must carry out repairs in accordance with its surveyor's recommendations, but failure to do so does not necessarily require remedial work if the underlying defect has been resolved and there is no evidence of structural

A mortgage lender is responsible for delays and poor service caused by its solicitors and must compensate consumers for financial loss and distress caused by preventable delays in the remortgage process.

A life insurance provider must give sufficient warning to policyholders when policy reviews show significant changes are needed, enabling them to make informed decisions about surrendering or maintaining the policy.

A financial adviser is not obligated to provide ongoing suitability reviews for protection policies unless an explicit agreement and fee arrangement for such service was in place.

A financial business is responsible for administrative errors in managing policy documents, but not for the personal consequences or third-party reactions that result from such errors.

A financial adviser who recommends a life insurance policy be placed in trust must take reasonable steps to ensure this is actually arranged, not merely advise the consumer to arrange it themselves through a solicitor.

A life insurance policy cannot be activated until the consumer has provided explicit consent, confirmed application details, and payment method information.

Reviewable whole of life policies must be reviewed and administered with clear communication to the policyholder about the likely future changes needed to maintain cover.

A broker must accurately disclose all material health information provided by a consumer to insurers, even when disclosed in a different context during the application process.

Insurers must provide clear, fair and not misleading information when collecting health information, but consumers bear responsibility for carefully reading questions and providing accurate answers.

A financial services provider must provide clear and adequate explanations to customers regarding material changes to their insurance policy, and must handle complaints fairly and promptly.

A business must put a customer back in the position they would have been in had nothing gone wrong, which in this case meant selling a joint decreasing term policy rather than individual level term policies for mortgage protection.

A provider is entitled to price the risk it takes in providing life cover, and it is not the ombudsman's role to second-guess legitimate commercial pricing practices if policy terms are clear and consumers are given adequate notice.

Life assurance sold to protect a mortgage must be suitable to the customer's circumstances at the point of sale, not based on hypothetical future scenarios.

A financial institution must verify consent from all joint policy owners before surrendering a jointly-owned policy and paying proceeds to one owner only.

A provider must give consumers fair, clear and not misleading information to enable them to make informed decisions about their insurance policy.

An insurer must provide customers with sufficient fair, clear and not misleading information about policy management to enable them to take appropriate action to maintain policy sustainability.

A reviewable whole of life policy must be administered fairly with clear communication at each review about the policy's ongoing viability and options, and reviews must not be missed.

A financial services firm must clearly inform consumers of their right to complain and refer complaints to the FOS, especially when advising them of adverse decisions.

A whole of life insurance policy pays the greater of the guaranteed death benefit or the fund value on death, not both amounts combined.

An insurer must put a consumer in the position they would have been in had the error not occurred, taking into account the actual facts and circumstances at the time of the error.

A life insurance provider must give clear, fair and not misleading information about policy reviews and foreseeable premium increases to enable consumers to make informed decisions about whether to continue or surrender their policy.

An insurance broker must accurately record and disclose material health information provided by customers during policy sales, regardless of whether the sale is characterized as non-advised.

Insurers have commercial discretion in deciding which risks to cover, but must treat customers fairly and consistently with others in similar circumstances.

An insurer may refuse to carry out repairs if there are reasonable health and safety concerns, including potential asbestos exposure, even if the consumer disagrees with the assessment.

An insurer should proactively notify customers of significant changes to their plan terms that become available, particularly where new features could materially benefit them.

A credit broker is only liable for mis-selling if there is sufficient evidence on the balance of probabilities that the consumer disclosed their intended use before entering the agreement.

Under the Consumer Insurance (Disclosure and Misrepresentation) Act 2012, an insurer may cancel a policy if the consumer failed to take reasonable care to disclose relevant information and the misrepresentation was qualifying.

A payment dispute only qualifies as an APP scam under the Faster Payments Scheme reimbursement rules if there is evidence of fraudulent or dishonest intent to deceive from the outset, not merely a civil dispute over service delivery.

An insurer may repair a mobile phone with non-matching parts of similar or equivalent specification where the policy terms clearly state this and colour matching cannot be guaranteed.

A term assurance policy recommendation is suitable if it matches the consumer's stated protection needs, is affordable, and the adviser adequately documents the rationale and alternatives considered.

Under CIDRA 2012, an insurer can decline a claim if the consumer failed to take reasonable care not to make a qualifying misrepresentation in their insurance application, and the insurer would have offered different terms or declined the po

Under the Consumer Insurance (Disclosure and Representations) Act 2012, a consumer must take reasonable care not to make a misrepresentation when applying for insurance, and if a qualifying misrepresentation is made, the insurer may decline

Under CIDRA, a consumer must take reasonable care not to make a misrepresentation when applying for insurance, and an insurer can decline a claim if the misrepresentation is qualifying and the consumer failed to disclose material informatio

Under CIDRA 2012, an insurer can decline a claim if the consumer failed to take reasonable care not to make a qualifying misrepresentation, provided the insurer would have offered different terms or declined the policy had the true informat

Reviewable whole of life policies can require significant premium increases or benefit reductions at review dates when fund values and cost of cover no longer support existing benefits, but insurers must provide clear information about poli

Life insurance policy review communications must clearly disclose charges and their monetary impact to enable consumers to make informed decisions about premium increases and cover adjustments.

An insurer is entitled to cancel a life insurance policy if premiums are not paid within 30 days of their due date, and the policyholder bears responsibility for maintaining premium payments.

A consumer must demonstrate they were offered an optional benefit and chose not to take it, rather than that it was wrongly omitted from their policy.

A firm must inform consumers of material changes to insurance cover following underwriting and provide clear documentation of the final terms, particularly when cover differs from initial recommendations.

An insurer's decision to decline a terminal illness claim must be based on medical evidence that confirms life expectancy of less than 12 months as required by the policy definition.

An adviser's recommendation is not unsuitable merely because the consumer's recollection differs from contemporaneous documentation, which should be given greater weight when assessing suitability.

A financial institution's computerised records showing a payment transaction, supported by policy terms allowing surrender, constitute reasonable evidence of policy payout even without retained physical documentation.

An insurer is not responsible for advice given by an independent adviser, and clear policy documentation demonstrating the terms of the agreement is sufficient to establish the consumer understood the policy type.

An insurer must provide policyholders with sufficient information to make informed decisions about their policy, but is not required to proactively advise on surrendering a policy when premiums no longer cover costs.

Financial advisers must provide clear disclosure of commission clawback terms and ensure clients understand the financial implications before they agree to a policy.

Under CIDRA 2012, a consumer must take reasonable care not to make misrepresentations when taking out insurance, and an insurer can decline a claim if the misrepresentation is qualifying (i.e., the insurer would have offered different terms

An insurer must make reasonable efforts to maintain contact with a policyholder before removing their address and allowing a paid-up policy to lapse without notification.

A term assurance policy is suitable if it addresses an identified protection need, is affordable, and its terms are clearly communicated to the consumer.