Ombudsman's Bias in Favour of Insurance Companies Revealed

The Sunday Times revealed that, despite its reputation as a "consumer champion," the ombudsman required by its terms of appointment to be impartial generally decides more cases in favour of the insurance company than the complainant. Last year, only 33% of cases were decided in favour of the complainant. The ombudsman's decisions have led to several disputes, including a case where a policyholder was denied compensation for damage caused by two puppies, another where an insurer was allowed to claim a policy excess on a stolen wallet, and a third where a policyholder was not allowed to claim cancellation charges for a cancelled honeymoon.

Key Takeaways:

The ombudsman decided 67% of cases in favour of the insurance company, contradicting its reputation as a consumer champion.
A policyholder was denied compensation for damage caused by two puppies, as the ombudsman ruled that the insurer's use of the word "home" referred to the structure of the house, not the dogs themselves.
An insurer was allowed to claim a policy excess of £25 on a stolen wallet, even though the theft was undisputed.
A policyholder was not allowed to claim cancellation charges for a cancelled honeymoon, as the ombudsman ruled that there were separate insurance policies in respect of each individual.
A policyholder collected on multiple policies after chopping off his thumb and index finger, including two policies taken out with the same insurer in response to an advertisement guaranteeing acceptance.
The ombudsman's decisions have led to several disputes, highlighting the need for greater transparency and accountability in the claims process.

Statistics:

33% of cases decided in favour of the complainant in 1993.
£25 policy excess applied 10 times on the stolen wallet claim.
£25 policy excess claimed by the insured on the stolen wallet.
£500,000 total amount of policies taken out by the policyholder who chopped off his thumb and index finger.

Sources:

The Sunday Times, 1994.