Ombudsman's legally binding decisions

Filter our database

Last updated on 25 June 2025 with legally binding decisions up to the end of December 2024.

To narrow your search, you may also wish to select from the following:

 

Or search the database by decision reference number, if known:


 

PDFCritical & Serious Illness Decision Reference 2019-0344

Sector: Insurance

Product/Service: Health, Accident and Other

Primary Conduct Complained Of: Claim Handling

Outcome: Rejected

All Conducts Complained Of: Claim handling delays or issues, Delayed or inadequate communication, Disagreement regarding Medical evidence submitted , Poor wording/ambiguity of policy, Rejection of claim - did not meet policy definition of illness

Year: 2019

View Document