Capital One PPI - stalling?

KKmatters

dunstonh wrote: »

Yes you should. This should be an acknowledgement of receipt of your complaint and after 8 weeks a holding letter letting you know they havent been able to resolve it yet but will do in extra time. It does appear that you are receiving those from your comments.

So, I told FOS about acknowledgement but they said a resolution should still have been offered - guessing the operator misled me a little - I may just phone CapitalOne myself to see as it's been over 4 weeks since their last letter. I thought the claim would actually still progress as normal i.e. in a queue even though FOS take on the case - if they intervene i'm not sure I want to delay the progress - I may wait a while longer to see what happens.

dunstonh

So, I told FOS about acknowledgement but they said a resolution should still have been offered - guessing the operator misled me a little

A company should aim to resolve within 8 weeks but there is no requirement for them to do so. After 8 weeks, you have the right to refer to the FOS but that is the only thing.

KKmatters

I have contacted CapitalOne again today as I've heard nothing from them since 14th January - the lady on the phone advised that a final decision had been posted out to me on 17th January and after confirming non-receipt of this she is sending me a copy of the letter.

From the conversation with her she advised that the reason for not upholding my claim was because - on the original internet application I didn't indicate I wanted PPI so when I telephoned to activate my card they offered me CRP and I accepted she doesn't have full details of the call but will send me the copy letter.... so I wait again!

dunstonh

KKmatters wrote: »

I have contacted CapitalOne again today as I've heard nothing from them since 14th January - the lady on the phone advised that a final decision had been posted out to me on 17th January and after confirming non-receipt of this she is sending me a copy of the letter.

From the conversation with her she advised that the reason for not upholding my claim was because - on the original internet application I didn't indicate I wanted PPI so when I telephoned to activate my card they offered me CRP and I accepted she doesn't have full details of the call but will send me the copy letter.... so I wait again!

That is not good news for you. It does match the typical Cap One's method which sees most complaints rejected and not overturned by the FOS.

KKmatters

dunstonh wrote: »

That is not good news for you. It does match the typical Cap One's method which sees most complaints rejected and not overturned by the FOS.

Not good news at all... I'm wracking my brains thinking about the conversation and do remember the phone call to activate my card but can't remember disclosing information regarding pre-existing medical conditions or that i receive 12 months sick pay from my employers.... and I can't recall ever receiving an 'agreement' for the insurance.... dear me I didn't hold my breath on this one after reading other cases - so shouldn't be disappointed just annoyed at myself - next time I will question and question the need for insurance and be a bug bear lol

dunstonh

Not good news at all... I'm wracking my brains thinking about the conversation and do remember the phone call to activate my card but can't remember disclosing information regarding pre-existing medical conditions or that i receive 12 months sick pay from my employers.

The upside is that they didnt record the call. So, in cases where people make unprovable allegations, Cap one nearly always win. However, in cases where there are provable issues (such as pre-existing medical conditions which impact on cover) they are more likely to lose.

KKmatters

dunstonh wrote: »

The upside is that they didnt record the call. So, in cases where people make unprovable allegations, Cap one nearly always win. However, in cases where there are provable issues (such as pre-existing medical conditions which impact on cover) they are more likely to lose.

Thank you for your response dunstonh, I appreciate the help..... so to re-iterate basically I still have a case even if they recorded the telephone call where I supposedly accepted, if they didn't ask about medical issues at the time I can appeal - I'm positive I've never disclosed this information and obviously GP records will provide sufficient evidence to support this.

Just out of interest IF medical information was disclosed should they have still proceeded with the 'sale' knowing that it would be ineffective or would/should they have set exclusions on the policy?

dunstonh

Just out of interest IF medical information was disclosed should they have still proceeded with the 'sale' knowing that it would be ineffective or would/should they have set exclusions on the policy?

Pre-existing medical condition is a bit over used by consumers when making complaints. It doesnt mean a complaint will be upheld where as most seem to think it will be.

A pre-existing condition that is significant enough to make claiming on the policy unlikely would be an upheld complaint. However, a pre-existing condition that only prevents claims on the policy on that condition but not other unrelated conditions would not normally be upheld. e.g. a back complaint as a pre-existing condition would only prevent claims on that condition or anything arising from that. Nothing else. So, that would unlikely be upheld in complaint.

Unlike most forms of insurance, PPI is underwritten effectively at point of claim. So, they dont stick personal exclusions on it. At claim, they would check and say ok or no because of xyz.

KKmatters

Thank you for replying, in my case I think I still may have a little hope based on what you advise and my pre-existing condition could impact or trigger other health issues so it would rule out quite a lot of the cover. I know from recently applying for travel insurance I can get cover at a high premium rate but even things I hadn't considered like cholesterol levels were indicated as 'risk'!!!!

If when I get the letter I do decide to appeal against their decision in your experience and knowledge of CapitalOne would I be best to appeal direct or at this point get FOS involved?

dunstonh

I know from recently applying for travel insurance I can get cover at a high premium rate but even things I hadn't considered like cholesterol levels were indicated as 'risk'!!!!

High cholesterol would be something I would not consider enough of a condition to invalidate the policy as it would only stop you claiming on anything related to that. Although it is something that should be considered and I suspect that is where the judgement call will be required to be made. I wouldnt want to call it. A decent file would cover it would be able to use that to reject the complaint. Poor admin may leave them in a position where the FOS side with you.

Once Cap One have made their decision, there is rarely any point going back to them to persuade them unless you have information that you didnt supply before. Next stop would be FOS.