Aviva Medios Healthcare - are we being treated fairly?
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A medical inflation rate equivalent to the average charged by the top 2 insurers for their respective best selling products has been advocated for determining future premium increases.
Whatever rate is chosen will impact upon compensation as the chosen rate needs to be applied against the extra annual costs policyholders have to bear to make up for the loss of their Guarantees.
If the rate measured against the top 2 insurers is chosen, its cumulative lifetime effect would cover some 20 years for most policyholders. That could produce the estimated average compensation of around £70,000 per policy.
If the choice is an Aviva medical rate that bears the cost of Medios' "gargantuan" unprovided claims, then the required calculation would produce greater compensation. However, ongoing Medios policyholders would join in picking up the bill through future premium increases. In effect, they would pay for the wrongdoings Aviva inflicted upon them.
It seems the Ombudsman's decision could have some unforeseen consequences and policyholders will need to take advice. Only the use of a medical rate of inflation referenced to independent parties seems to avoid the above identified pitfalls.0 -
Medios policyholders are well aware that Aviva cannot be trusted, as we are victims of its deceit, misrepresentations and lies. It has betrayed its promise to provide lifetime health protection for our families, after we bought into and paid for its lifetime cover and Guaranty protection.
At this crucial part of the complaints process, we must not forget the sheer evil of its individual acts, rather than be mesmerised by volume and the consequent need to categorise misbehaviour.
Documentation to mislead, deceive and misrepresent
- At an early stage in Aviva’s involvement, policyholders were misled into believing that policy wording was being harmlessly updated. Instead, Aviva applied stealth and cunning to extend its power to alter the policy. Its ploy was to identify and explain other key changes but to ensure that its improper grab for greater authority was left unmentioned and, therefore, unnoticed. The ruse’s purpose was to introduce an Unfair Term into the policy, albeit one that was unauthorised and therefore, ultimately, ineffective. Aviva’s conduct was the opposite to that demanded by its Regulator. Aviva also breached the fundamental obligation it had with policyholders for managing the policy.
- The Guaranty’s lifetime availability was surreptitiously removed, as was the right not to lose it. Aviva sought to obscure and hide its wrongdoing within thousands of words of print. Even perusal of relevant wording made little difference if one trusted Aviva. However, Aviva was bent on betraying that trust to rid itself of onerous liabilities. Again that was in direct contravention of disclosures demanded by its Regulator. Even so, Aviva probably didn’t then realise that its action was woefully inadequate. Aviva admitted that in 2013 when it was forced to reinvent that authority yet again (so it could cover Conditions) in order to present a seamless change to other sought after Condition changes.
- Ongoing New Entrants were misrepresented as the continuing base for the Guaranty in 2010’s documentation (issued late 2009) even though Aviva knew it was stopping those New Entrants in mid-January 2010. The need to plan the implementation of that contract breach, well beforehand, meant Aviva knew about it when demanding and collecting 2010’s premiums for a dramatically changing policy. A follow-on need was to keep policyholders generally unaware until 2011 that New Entrants had been stopped; the purpose was to position Aviva to benefit possibly from the Statute of Limitations in the event policyholders objected to 2005’s removal of lifetime cover, as 6 years would have elapsed by 2011. Consequently, Aviva continued to misrepresent the New Entrants’ situation at every following Premium Review Date. By 2013 policyholders’ had caught on to this trickery. However, so as not to appear to be admitting past misrepresentations, Aviva did not remove it but repeated it.
- Even under the public gaze generated by complaints, Aviva’s treachery continued in 2013’s documentation. Despite an explanatory letter that supposedly identified and explained key changes, Aviva reinvented an extended authority to enable it to change Conditions. That improper authority was neither mentioned nor explained. Its purpose was to remove crucial flexibility policyholders needed for changing circumstances. It was perpetrated seamlessly to conceal its impropriety. Also without mention or comment was the deletion of the Review Date Premium from the Schedule definition as its Schedule status conflicted with the Aviva pretence of a 1 year contract term (discussed below).
Motive (including Aviva’s golden era of profitability based upon misapplied premiums)
- Aviva desperately wanted to escape the burden of having sold a risk position on Age-Related Increases. Its cost merited premiums some 40% above standard rates, even before an increasing realisation of medical advancements extending age expectations. However, that risk position could only be called upon if policyholders retained their policies for between 10 to 20 years, meaning an average 15 year retention requirement. As most policy sales were in the 1996 to 2000 period, an increasing burden could only befall Aviva from beyond 2011. Thus an exit from the start of 2012 was crucial for Aviva to manipulate. If successful that also meant the majority of policies sold from 2001 onwards could never ever be eligible for any benefit at all; a perfect solution for Aviva.
- Aviva’s desperation for a 2012 exit was multiplied myriads of times over by its failure to make proper provision for future claims deriving from the risk position it had taken. When asked, Aviva refused to provide any information on provisioning until its Finance Director finally admitted, prior to or around the beginning of 2012 (to one of the policyholders on this site), that there had been none. That non-provisioning enabled a golden period of profitability for Aviva up to 2009, as it took the full benefit of premiums immediately to profit and made no provisioning. But that left the admittance of New Entrants as the only way left to ‘balance the books’, so their 40% loaded premiums could be misapplied in paying existing policyholders’ claims; a ballooning Ponzi scheme. However, that was ended in January 2010 as ‘Peter would no longer be able to pay Paul’, as age expectations were steadily rising and worsening Aviva’s position. The resultant Aviva breach in the stopping of New Entrants was concealed from policyholders through repeated misrepresentations in subsequent documentation. However, the cost of an ageing remaining population group could not be avoided. Worst still, no provisions were available to meet age-related cost increases as Aviva had failed to make proper provisioning. Hence, 2012’s 20% premium increase became the tipping point that led to the unravelling of Aviva’s misdeeds.
- Success for Aviva in its strategy to ‘steal’ policyholders Guarantees meant it would be secure in retaining the ill-gotten gains of its golden era of profitability to 2009, irrespective of policyholders having paid some 40% above standard rate over an average of 15 years for what had become a false promise of lifetime risk protection.
- The potential impact upon policyholders was to deprive them of a lifetime of Guaranty benefit that many had just started to become entitled to, at around the time of or recently before Aviva’s improper 20% premium hike. However, all questions about their Guaranty were rebuffed. The resultant uncertainty was equalled by the havoc Aviva caused with its attack on Key Features and its ignoring of its Age-Related premium protection. Consequently, policyholders were unable to make informed decisions about their policies.
Final acts of treachery
- Aviva had set everything up for a 2012 exit. Possible Statute of Limitations protection for challenges against the removal of lifetime cover was potentially available. Repeated misrepresentations had kept policyholders from becoming aware that New Entrants had been stopped in January 2010. Accordingly, Aviva’s next move was to approach certain chosen brokers to gain support for its stopping of the Medios policy, with the intent of compelling ongoing policyholders to transfer to its cheaper Healthier Solutions policy. Unexpectedly, that plan hit a hitch when brokers rebelled against it. That necessitated Aviva hatching a new tactic to encourage policyholders to relinquish their Guarantees. Thus 2012’s 20% premium increase was born. Its purpose was to make the Medios policy over-expensive and thus facilitate Aviva’s promotion of its cheaper Healthier Solutions policy.
- Policyholders were alerted for the first time, causing some to query the 20% premium increase. Aviva responded with a didactic explanation of how an ageing population creates larger claim risk and therefore demands an increased premium. That’s how the news of January 2010’s stopping of New Entrants seeped out. The next rush of questions caused Aviva to change the story to one of Rate Review. But that was then replaced by yet another story that “customers have received cover for which they have not been paying”; the given support was that “customers have not received age-related increases (other than the single increase set out in the policy terms)”. As usual, anything to do with the Guaranty was not mentioned. Aviva just cut out the reality of the policy’s purpose and replaced it with what it sought to create; the removal of all Key Features, no Guaranty, and no provisions to cover claims from past risk commitments. Whilst that was Aviva’s dream outcome, it would become policyholders’ daily nightmare. Consequently, certain policyholders reviewed and scrutinised past documentation, which enabled the unravelling of Aviva’s misdeeds.
Without remorse and willing to do anything to escape sanction
- Instead of remorse, Aviva launched a false defence of half-truths, omissions and misdirection due to the humongous amounts of money at stake – represented by its golden era of profitability, created from its non-provisioning.
A 15 year plus term contract for most policyholders became transformed into a 1 year contract term and, as stated above, contradictory evidence from policy documentation was stealthily made to vanish so as to sheer-up that pretence.
An average 15 year wait for Guaranty benefit, together with its 40% extra cost, became transformed into a policy one chooses to renew annually, take-up with another, or walk away from without loss.
Paid for commitments had to be disregarded in favour of Aviva’s right to charge what it liked.
False and misleading claims were made that the Guaranty still existed in an effective form and was therefore not an issue and any change had no effect.
Aviva even audaciously claimed it could alter any part of the policy without mention that such power was ineffective as it had been improperly taken and did not even cover the vital Conditons it had 'changed' (that latter shortcoming was acknowledged by Aviva in its 2013 Terms).
Differences in cover start dates with annual policies were glossed over and lost from sight.
Terminology excluded all mention of Review Date, and was replaced with Renewal Date, along with the associated connotation of a new contract/new policy.
Continuing cover became a non sequitur. Lifetime cover was rubbed from existence.
Obligations for New Entrants were as if they had never existed.
Indeed, no history or other Key Features had any place or mention.
Aviva’s presentation was an intricate embroidery of lies, distortions and cover-up concoctions.
It’s hardly surprising Aviva fooled inexperienced reviewers or even its Regulator, as Aviva had been fooling policyholders for years through foul means of one sort or another.
- When the truth came out, Aviva lied to pervert the course of the FSA’s investigations as it needed to prevent an MP, who happened to be a Government Minister, from further stirring matters. The MP’s contact point was Aviva’s holding company. Yet that holding company caused its subsidiary, through its top UK Health Complaint Manager, to misdirect with the lie that “they (FOS) could not uphold Mr #’s complaint in his favour” – no mention of the Guaranty of course but then that wasn’t something Aviva wanted to say anything about anyway. Obviously both intervention and lie were carefully thought through corporate actions that were presented by a top expert who knew exactly what he/she was doing! And that very same top expert was the actual Aviva Health official that had then presented Aviva’s case to FOS!!AVIVA HAS ACTED APPALLINGLY AND CANNOT BE TRUSTED.ANY POLICYHOLDER WOULD EXPECT TO BE IN JAIL IF ENGAGING IN THIS SORT OF BEHAVIOUR.0 -
This is the latest we have from them. Anybody have any further updates?
"I am writing further to keep you updated with our investigations into your complaint.
Senior colleagues at our service are continuing to review the issues you have raised regarding your Aviva Medios policy. Although I remain unable to give any definite timescale for a resolution, I am hopeful we will be able to provide you with a substantive update over the next few months.
Once again, my sincere apologies for the length of time our investigations are taking, and I thank you for your continued patience."0 -
I had a telephone conversation being told almost the same thing word for word. They should be able to say more than that by now. This could be strung out for years & I'm sure that's what Aviva would like. Has anyone suggestions as to how we can be more pro-active rather than just waiting for the FOS. I fear they are being led a merry dance by Aviva's lawyers & would probably like to move this on to someone else. We will see.0
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Any pronouncement by the Ombudsman will be posted on this site.
Besides helping complainants, this will benefit hundreds of policyholder who use this site and are waiting to see what happens prior to submitting claims.
Thousands of other policyholders remain unaware that their Guaranties have been ‘stolen’.
Aviva has sought to foster that ignorance through concealment and misrepresentation rather than compliance with its basic regulatory duty to inform.
Its responses to all appear to be based upon lies, distortions and cover-up concoctions, which ensure many policyholders continue to be ignorant of their Guaranties and policies.
Consequently, the Ombudsman needs to instruct Aviva to communicate its pronouncement to all policyholders if Aviva’s misdirection is to be put right.
The Financial Conduct Authority (“FCA”) appears to be relying upon FOS for initial action and policyholders must therefore remain patient.
That does not remove questions over regulatory failure – the last infamous one being the Equitable Life debacle (again concerning a Guaranty) where pay-outs still rumble on.
Certainly the regulator was fooled by Aviva.
Questioning that failure is especially pertinent as the FCA knew the product to be toxic prior to Aviva’s latest shenanigans within its 2013 Review Date documentation, issued nearly 10 calendar months ago.
Scope does exist for subsequent political fall-out and for heads to role.
That’s especially the case due to the involvement of a Government Minister; which is newsworthy in itself but more so because Aviva lied to the Minister to pervert regulatory investigations.
There is also a new legal requirement for a full investigation and written regulatory report to HM Treasury for significant regulatory failures and this case passes the relevant size criteria.
Response to mwng’s following question
The absence of a public register for submissions, by parties to action, inhibits responsible reporting of contentious cases. Inability to rely upon third-party documentation from any one party also precludes comment upon possible outcomes. Consequently, newspapers and policyholders must await the Ombudsman’s decision and policyholders must trust that all things come to those that wait – but, hopefully, not too late for some of them!0 -
It must be time for the media to be made aware of this. I'm astonished that they haven't picked up on it already as it is a pretty scandalous situation.
Anyone know a journalist with a decent IQ who can get his head around it? Or are they all busy chasing celebs (easier copy)?0 -
Happy to give all my paperwork to any serious journalist who wants to see it. So far Aviva have not had to face any proper public scrutiny on this. High time that they did.davidstone wrote: »Any pronouncement by the Ombudsman will be posted on this site.
Besides helping complainants, this will benefit hundreds of policyholder who use this site and are waiting to see what happens prior to submitting claims.
Thousands of other policyholders remain unaware that their Guaranties have been ‘stolen’.
Aviva has sought to foster that ignorance through concealment and misrepresentation rather than compliance with its basic regulatory duty to inform.
Its responses to all appear to be based upon lies, distortions and cover-up concoctions, which ensure many policyholders continue to be ignorant of their Guaranties and policies.
Consequently, the Ombudsman needs to instruct Aviva to communicate its pronouncement to all policyholders if Aviva’s misdirection is to be put right.
The Financial Conduct Authority (“FCA”) appears to be relying upon FOS for initial action and policyholders must therefore remain patient.
That does not remove questions over regulatory failure – the last infamous one being the Equitable Life debacle (again concerning a Guaranty) where pay-outs still rumble on.
Certainly the regulator was fooled by Aviva.
Questioning that failure is especially pertinent as the FCA knew the product to be toxic prior to Aviva’s latest shenanigans within its 2013 Review Date documentation, issued nearly 10 calendar months ago.
Scope does exist for subsequent political fall-out and for heads to role.
That’s especially the case due to the involvement of a Government Minister; which is newsworthy in itself but more so because Aviva lied to the Minister to pervert regulatory investigations.
There is also a new legal requirement for a full investigation and written regulatory report to HM Treasury for significant regulatory failures and this case passes the relevant size criteria.
Response to mwng’s following question
The absence of a public register for submissions, by parties to action, inhibits responsible reporting of contentious cases. Inability to rely upon third-party documentation from any one party also precludes comment upon possible outcomes. Consequently, newspapers and policyholders must await the Ombudsman’s decision and policyholders must trust that all things come to those that wait – but, hopefully, not too late for some of them!0 -
I have just discovered this forum, but it reflects my own concerns about the Medios policy I have held since 1999. I was sold on the 'no age related price increases' and recently found that although I am 14 years older than at commencement, I could get a cheaper quote for a completely new policy now, with a much lower excess.
I would like to add my backing to the campaign. What is the simplest way to register my complaint with Aviva and FOS without having to repeat all the lengthy arguments presented on this forum?0 -
Aviva seems to be rightfully preparing for a lambasting by the Ombudsman.
That’s noticeable from a definite change in Aviva’s response to medical claims. Claimants now have to disclose their full underwriting profile through complete disclosure of medical status and treatments, irrespective of claim matter or its significance.
This new direction could well be a response to Lawton’s 23rd June submission to the FOS, on behalf of us all, where Lawton says:
“In the event of there being no continuing viable policy that offers equivalent Guaranty benefits to the original policy, then policyholders also seek cover from Aviva at no cost for illnesses uninsurable with other insurers at their respective standard rates, where those illnesses have occurred during their policy term and after Aviva’s first substantive contract breach.”
Certainly, it is crucially required information if Aviva is to determine its Medios run-off liabilities. Even more crucial to that is the quantification of liabilities for Age-Related lifetime protection, as well as for premium and excess overcharges and other hurt. Analysts will soon be putting Aviva ‘to the sword’ for all that information in a rush to quell institutional shareholder cries to quantify ensuing liabilities (and to maintain their own reputations).
Doubtless, the FCA will need to focus upon the impact of Medios run-off liabilities on Aviva’s capital requirement, especially as Guaranties often have very big numbers attaching to them; the FCA should be highly motivated in that task due to having been fooled too many times already by Aviva.
There will also be related follow-up questions on this same subject from institutional shareholders, sensitive to any related future capital raising need or possible dividend reduction.
Except for the quantification of liabilities deriving from existing illnesses, all other figures should be readily available. That’s because Aviva’s wrongful actions, to rid itself of its unwanted liabilities, have stretched over many years, plus policyholders’ claims have been increasingly notified for most of the last 2 years.
Answer to Spruce’s preceding question
I followed Guardog’s excellent post 97 and also referred to the first paragraph of his post 117.0 -
I have also been in touch with the Ombudsman's offices and understand that the papers are now sitting with the senior ombudsman who is collating all of the information necessary.
I believe that the response will be looking at "the whole issue" in view of the number, nature and complexity of the complaints and indeed my own complaint (some 25 pages in length) has been submitted using information that has been provided by AVIVA themselves who have admitted, amongst other things that "we did not have the original pricing basis or reports for the business.....", together with the provision of statistical information that indicated incorrect claims reserving had taken place for many years.
It was indicated to me that there should be a decision in the next 6/8 weeks however in my mind the longer they take the greater the likelihood that the Ombudsman will make a damning report and recommendations against AVIVA with so much evidence to take into account. From my own dealings with them it certainly appears to me that they still haven't got the slightest idea of what "treating customer fairly and providing a fair and reasonable outcome for the customer" as is required now by the FCA, means.
As has also been stated the FCA have been kept informed of developments here by a number of irate policyholders, their MP's etc and I would expect that they are regularly monitoring this site.
Once the Ombudsman has made his decision I am sure that the FCA will be taking great interest in the outcome for policyholders although, given the gravity of the situation I am disappointed, although perhaps not surprised that this has not been addressed by AVIVA already.
I would also expect at that point in time, and particularly if aggrieved policyholders do not feel that they have achieved a satisfactory outcome that appropriate action will follow in the national and insurance press making full use of the papers and journalists who wrote about this product back in the 1990's.
I for one will certainly be following this up through a number of press contacts I have and I am happy to have any input in this respect from other aggrieved policyholders.0
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