Insurance - Income Protection
Claim declined - definition of incapacity (own vs. any occupation)
Mandatory ADR
Max award: £445,000 (from 1 Apr 2025)
8 weeks firm; FOS 6 months
Uphold rate: 34% (FOS 2024/25)
Key Legislation
FCA ICOBS; Consumer Insurance Act 2012 — ICOBS 8.1; CIDRA 2012; Consumer Duty PRIN 2A
Complaint Route: Financial Ombudsman Service
Type: Ombudsman (binding on firm)
Max award: £445,000
Uphold rate: 34%
Average resolution: 180 days
Pre-conditions: Complain to firm first; firm has 8 weeks to resolve; then refer to FOS within 6 months of final response
Visit FOS websiteCompanies in This Sector
Royal LondonAvivaLV=Legal & GeneralVitality
Annual complaint volume: 305,726 (FOS 2024/25 total)
Note: Compensation range: Back-dated payments + ongoing monthly benefit + D&I