Insurance - Life / Critical Illness
Claim declined - non-disclosure or condition definition
Mandatory ADR
Max award: £445,000 (from 1 Apr 2025)
8 weeks firm; FOS 6 months
Uphold rate: 34% (FOS 2024/25)
Key Legislation
Consumer Insurance Act 2012; Insurance Act 2015 — CIDRA 2012; Insurance Act 2015 s.3-8; ICOBS 8
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 London (FCA 117672)Legal & General (FCA 117659)AvivaScottish WidowsVitality
Annual complaint volume: 305,726 (FOS 2024/25 total)
Note: Compensation range: Full sum assured (if upheld); proportionate settlement