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FOS PMI cases and upheld complaints rise sharply

by Graham Simons
12 July 2024
Health insurance and IP complaints leap but uphold rates dip
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The Financial Ombudsman Service (FOS) took on 11.7% more private medical insurance (PMI) or dental cases in its 2023/24 financial year.

Data released this morning reveals the Ombudsman took on 1,621 new cases, making 313 Ombudsman decisions and upholding 27% of complaints.

This compares to the previous financial year when it took on 1,451 cases in this category, upholding 16% of complaints.

Across protection sectors, trends were broadly similar to the previous year, with the exception of whole of life assurance (reviewable) where the Ombudsman upheld 10% more complaints.

Looking into these product segments in greater detail, across income protection, there were 792 enquiries, with FOS dealing with 635 new cases, making 173 decisions and upholding 24% of complaints.

In the previous financial year, FOS dealt with 634 new income protection cases, upholding 20% of complaints.

Turning to critical illness cover, in its most recent financial year, the Ombudsman processed 689 enquiries, dealt with 588 new cases, made 104 Ombudsman decisions and upheld 16% of complaints. In the prior year, FOS dealt with 498 new cases, upholding 12%.

On term assurance FOS processed 1,230 enquiries, dealt with 935 new cases, took 176 decisions and upheld 20%, compared to 931 new cases and 14% upheld in the previous year.

And finally, in the whole of life assurance (reviewable) category FOS processed 549 enquiries, took on 480 new cases, made 62 decisions, upholding 37%, compared with 571 new cases and 27% upheld in the prior financial year.

For whole of life assurance (non reviewable) there were 531 enquiries, with FOS dealing with 401 new cases, making 74 Ombudsman decisions, upholding 21%, compared with 500 new cases, and 19% upheld in its 2022/23 financial year.

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