PMI complaints and upheld cases remain higher – FOS

Health insurance complaints received and upheld by the Financial Ombudsman Services (FOS) appear to have plateaued at higher levels following significant rises last year.

Latest data from the FOS showed complaints received and upheld rates were almost identical in the first half of 2024-25 to 12 months ago, both following a near 12% increase last year.

From April to the end of September 838 complaints were submitted to the FOS about private medical insurance (PMI) or dental cover, compared to 837 last year. (See tables below)

Uphold rates of 29% in the first April to June period and 27% from July to September were also consistent with the overall 2023-24 figures.

However, the Q1 figure of 29% was 10% higher than in Q1 2023-24.

The 2023-24 financial year had seen the number of complaints rise by 11.7% to 1,621 new cases and uphold rate surge to 27% from 16% in 2022-23.

 

Protection cases switch products

In contrast, overall protection complaints have continued at the previous low levels, while upheld rates have dipped in both quarters of the year so far.

However, there has been a swing in the products generating complaints with term assurance complaints down by almost 15%, but income protection (IP) grievances up by 17%.

Among the three main protection products there were 1,027 complaints submitted to the FOS in the first six months of 2024-25, on par with the 1,017 a year earlier.

Term assurance complaints fell to 401 from 467, critical illness complaints rose by 24 (10%) to 256 while IP complaints increased to 370 from 316.

 

 

 

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