The Financial Ombudsman Service (FOS) took on more new private medical insurance (PMI) cases and upheld almost twice the percentage of complaints according to its latest data.
However, the regulator made fewer decisions on complaints in the sector during the second quarter of its 2023 financial year than in the corresponding quarter of last year.
The smaller number of cases making it to the full FOS review maybe due to the regulator introducing its trial of proactive settlement for complaints received.
Data for the second quarter of the ombudsman’s 2023/24 financial year covering July to September 2023 found it received 532 enquiries and 403 new cases, while 71 cases were referred for a decision, with 28% of cases upheld.
This compared with the corresponding quarter of last year when the Ombudsman received 427 enquiries, 354 new cases, with 123 referred for a decision of which just 15% were upheld.
Protection cases stable
Across protection products, the data showed the Ombudsman received 115 critical illness cover enquiries, 103 new cases, with 17 referred for a decision and 18% upheld.
This compared with Q1 2023/24 when there were 126 critical illness enquiries and 129 new cases, 22 cases referred and 17% of which were upheld.
When it comes to term assurance, 295 enquiries and 242 cases were received, with 38 referred and 28% upheld in the second quarter of the last financial year.
Compared with Q1 2023/24, there were 332 term assurance enquiries and 227 new cases, 55 cases referred and 16% of which were upheld.
And turning to whole of life reviewable and non reviewable there were 121 and 123 enquiries and 106 and 103 new cases respectively over this latest quarter, with 45 and 16 cases referred and 41% and 21% of cases upheld.
In contrast with the previous quarter, there were 142 and 105 whole of life assurance non reviewable and non reviewable enquiries, 119 and 109 new cases, 14 and 50 cases referred of which 22% and 31% were upheld.
