Aviva Medios Healthcare - are we being treated fairly?

davidstone

Full text has been sent to you Barry Man

Barry_Man

Thanks - very brief indeed.

Michaels_2

I am a policyholder who has yet to complain.
My tardiness is because my wife and I are claiming under our policy.
We worry a complaint could jeopardise acceptance of our claims as Aviva seems intent on ending Medios Policies.
Already, we have learnt that Aviva ignores law and contract when the stakes are high.
Lying to a Government Minister showed there is no limit to Aviva’s determination to impose its will, whether right or wrong.

We are not alone as can be seen from AvivaVictim4001’s Post.

We know from this site how Aviva has ‘robbed’ us of our Guaranty.
We also understand how Aviva ‘stole’ further through wrongly increasing premiums by an extra 12% for 2012 and then repeated that wrong charge for 2013 with an extra add-on for medical inflation.
“By hook or by crook” was how one Poster portrayed Aviva’s intent.

What we don’t understand is the part Excesses play within policyholders’ claims.
We would be ever so grateful for this to be explained to us.
By way of information, my wife and I each have a compulsory excess of over £1,000, as do other Medios policyholders.
That means we have jointly paid out over £2,000 for EACH of 2012 and 2013 – a total of £4,000+.

We know someone will help us as that always happens on this site.
Please do accept our thanks in advance for such incredible support.

burtwood

Your problem, Michaels, is understood.
You might feel more able to complain once FOS has issued a Final or Agreed Decision.
If you do complain, it would be helpful to explain your reticence in taking action.

As for the Excess, Medios Healthcare policyholders will recall they elected for an Excess of 50%, 40% or 30% when they committed to their policies.
It’s a unique policy feature as such Excesses are huge when compared to short term health policies.
In return policyholders receive Premium Discounts that range from 37.5% to 17.5%.
Presently, a married couple that took a 50% Excess option (as many did) need to pay out the first part of their annual claims that is equivalent to just over 80% of their Annual Premium.
In effect, such claimants pay-out nearly double their Annual Premium, as Michaels seems to have done.
When their Annual Premium increases by 20% so does their Excess by a slightly lower percentage.
Therefore any Premium Overcharge by Aviva has almost a double effect on policyholders (with a 50% Excess) when their annual claims exceed their Excess.

Obviously, it is in Aviva’s interest to hide this relationship as otherwise policyholders will be encouraged to include paid-out Excesses in their claims.
Surprise, surprise, that’s exactly what Aviva has done.
This new Aviva twist just adds to its past cover-ups of:
- misleading (when usurping its authority),
- omitting crucial information (when removing lifetime available cover),
- misrepresenting (when concealing the wrongful termination of New Entrants), and
- misbehaviour (when excluding Premium from Policy Schedule to avoid conflict with its claim of 1 year term contract).
Yes, we also know that Aviva is given to lying.

How has Aviva perpetrated this further nastiness must be the next question.
Well, Aviva’s Review Date Premium Notices have always detailed how Premiums and Excesses were calculated, and the relationship and connection between both was clear.
If Premium was increased then, for many, that caused an almost similar increase in Excess.
However, that detail and relationship information was removed from 2013’s Review Date Premium Notice – it was as if no relationship existed between Premium and Excess.
Making the information disappear could only disarm policyholders in advancing their claims; a Perfect Day solution for Aviva’s efforts to diminish policyholders’ claims.

Always the same with Aviva, it misleads, omits or misrepresents vital information!!!!!
Yet another Aviva ‘twist’ in this saga of vanished Guaranties.

ianb24

I have just discovered this discussion, and would like to join the fray, so to speak.
I took out a Medios policy in November 1996, I have the original policy documents. On several occassions over more recent years I have queried the premium increases imposed by Norwich union now Aviva, but only had a response via my broker that I was not being overcharged. Reading all this it is clear to me that I was and am.
I am very gateful to read all the posts, and I assume that I should send a letter to Aviva as per post 97. Please correct me if I am wrong.
Or am I too late ?
I will let a friend of mine who also took out a similar policy know about these threads. I am sure that he will be concerned and get involved.

Guardog

The template letters in Post 97 are latest available, ianb24, and will hopefully suit your needs. In the FOS letter, you might also need to claim for any Excess payment made in 2012 or 2013 that resulted from premium overcharge - see burtwood's comment in Post 115.

Policyholders’ main concern is that Aviva has ‘robbed’ them of their Guaranties. That was discovered after premium overcharges for 2012 and 2013 caused detailed examination and analysis of policy documentation. Claims for each ‘robbed’ Guaranty could average around £70,000 for each policyholder; whilst claims for premium overcharges are likely to be no more that £1,500 for each policyholder (unless Excesses or full premium refunds for 2010 onwards are relevant).

For your information, the 2012 premium overcharge was 12% and that was repeated for 2013, with an addition for medical inflation. The 2012 premium overcharge directly resulted from an Aviva contract breach aimed at destroying the remainder of policyholders' Guaranties. Prior year increases form no part of the current dispute and should have been explained to you in a letter that accompanied each premium request.

On claim timing, there appears to be no present problem for policyholders. A past Aviva strategy to statute bar all claims from 2012 seems to have failed following the uncovering of related Aviva wrongdoings; namely Aviva usurping its authority, misleading on and not declaring changes, repeated misrepresentations, and other misbehaviour. General guide for the time within which claims must be made appears to be 3 years from when knowledge of the complaint first became available to plaintiff.

Hopefully, any FOS claim determination will provide for all policyholders to be informed of claim issues. Otherwise, policyholders will need to depend upon Press or other public comment in order to discover their losses and the potential for claims (NB see davidstone’s Post 110 regarding present claim situation).

From reading Posts on this site, you will realise no matter with Aviva is ever straightforward as it has been committed to off-load its Guaranty liabilities by ‘hook or by crook’. Persistent and seemingly planned misbehaviour from prior years is even partially repeated and covered-up in its latest documentation. You will also be aware from this site that Aviva has even been caught-out lying and misleading in recent dialogue involving the FSA (now FCA) and FOS. There appears no end to Aviva's deception and the resultant impact upon policyholders goes far beyond present premium overcharges.

how_2

As some complainants are not yet on FOS’s circulation list and many others have yet to file complaints, general communications from FOS will be Posted on this site.

One such FOS communication received today by another policyholder reports:

“At present we are continuing to correspond with Aviva regarding a potential resolution to the issues you have raised."

Hesketh

Thank you Guardog for your helpful 26th April insight into claims.

Is any more information available on the £70,000 loss caused to each policyholder by Aviva’s heinous wrongdoings?
Plus do we know the likely form in which compensation might be provided?

I ask and Post these questions as the answers, crucially, interest all of us.
Most of us need to act fast to establish whether we have been left ‘high and dry’ by Aviva’s heinous actions without any means of alternative protection for our families.

I have already worked out the 12% premium overcharge Aviva inflicted upon me for the last 2 years.
Also I know the premiums I wouldn’t have paid after 2009 but for Aviva misleading through repeated misrepresentation.
Plus direct enquiry with another policyholder informs me that Aviva is delaying or not providing information on 2013’s premium detail (which would help Excess claim calculation); apparently, Aviva continues to employ any and all trickery to obfuscate, mislead upon and avoid its liabilities.

PMW2012

Adamson wrote: »

Just checking whether others have been directly approached by the Press.

Seems hunt is on for personal stories relative to Aviva’s wrongdoings and current events.

Also asked questions about identity of MP/Government Minister that’s involved.

If so, please let me know through direct email.

I would be very interested in talking to the press if they care to contact me. I have had a lot of expereience in dealing with the Financial press and indeed appeared in various papers over the years as a case study so if you have any contacts in this respect please let me or them know.
As you can see from my own entries, and one I am about to write I have considerable knowledge of this product and not just as a customer (see PMW2012 entries.)
Happy to liase with you and have a chat if it will be of any help.

fsLegal

Readers are familiar with the criminal law concept that punishment should befit the crime.
Civil law remedy, instead, seeks to provide redress through establishing available remedies and measuring loss.
FOS’s purpose is to determine whether Customers are Treated Fairly and, for that purpose, its decision-making references are the FCA’s (formerly FSA) Rulebook, commercial practice and law.
Consequently, it is necessary to consider the nature of Aviva’s wrongdoings and then related remedies.
Comments below are opinion and not advice and any presented facts are subject to verification.

Fundamental Contract Breaches, Repeated Misrepresentations, and FCA Rulebook Non-Compliance
The authority to change only standard terms was altered unilaterally by Aviva.
It wrongfully granted itself the right to change all terms.
Clearly that act was ultra vires (invalid)and a fundamental breach of agreement.
Incredibly, Aviva used that deception as its defence!!
Accordingly, Aviva claimed it could do anything and, therefore, no value could attach to policies.
Rather like a thief caught with ‘a hand in the till’ but feigning unfettered right of access and removal!!!

Aviva’s unilateral cancellation of lifetime available cover is yet another agreement breach.
That breach was fundamental as lifetime availability was a key feature of the parties’ agreement.
Dire consequences also result for alternative cover for illnesses arising during the policy’s term.

The non-losable, lifetime available Guaranty depended upon New Entrants.
Aviva admits it removed that “base-line”, which resulted in fundamental contract breach.
Three years plus of Aviva misrepresentations then followed to hide that “base line” contract breach.
However, Aviva’s misdoings to evade Guaranty obligations, before they kicked-in some 11 to 20 years after the policy start, is more about misbehaviour and punishment and that does not fall within FOS’s remit.

Aviva’s charge of extra premium for its own contract breach was as audacious and misconceived as any of its other wrongdoings, as well as a breach of its Guaranty to protect against Age-Related Increases.

Aviva’s lies to a Government Minister, about the status of FOS’s process, does not constitute the common law crime of perverting the course of justice as no Court is involved, irrespective of any Aviva intent (including that of its holding company) to prevent the provision of evidence to the FCA for the purpose of its investigations. However, FOS is now on notice not to trust Aviva and the FCA’s concern will extend to Aviva’s non-compliance with its Rulebook Principle 1 obligation on integrity.

Aviva’s defence professes its policy to be a 1 year contract but that belies a 15 year + term and continuing policy for many if not most policyholders; again this is a misbehaviour issue that does not fall within FOS’s remit.
Aviva’s misbehaviour in ‘concealing’ a related change to 2013’s Policy Schedule is equally not within that remit.
The lie itself is akin to an employer using a contractual annual salary review to feign that an employee becomes newly employed at each review date!!!

Unsurprisingly, the above wrongful acts do not comply with one of the FCA’s fundamental obligation requirements:
FCA Principle 6 – “A firm must pay due regard to the interests of its customers and treat them fairly”, the non-compliance being that Aviva failed to meet the following expected outcomes, which the FCA considers to be core to its regulatory decisions and actions:
“Consumers are provided with clear information and are kept appropriately informed before, during and after the point of sale.”
“Consumers are provided with products that perform as firms have led them to expect, and the associated service is of an acceptable standard and as they have been led to expect.”
“Consumers do not face unreasonable post-sale barriers imposed by firms to change product, switch provider, submit a claim or make a complaint.”
Other FCA Principles and Rules were also not complied with by Aviva such as those covering: conflicts of interest; conducting business with integrity, and adequate provision of information to make informed decisions.


Note
Aviva’s disclosure of the wrongful alteration of its authority and its wrongful removal of available lifetime cover has no bearing on the fact that such actions were fundamental contract breaches.
Also, Aviva ‘misled’ on the former and failed to identify or explain either matter.
Equally, that misbehaviour constituted non-compliance with the FCA’s Conduct of Business Rule ICOBS 6.4.11, which stipulates that “Throughout the term of a policy, a firm must provide a customer with information about any change to any term of the policy, together with an explanation of any implications of the change where necessary”.