Failed PPI claim declined by ombudsman 17 March 2018 at 11:47AM in Reclaim bank & credit card charges 14 replies 5.9K views

Tim1976

Hi all
I hope someone may have some advice. I attempted to claim Back PPI on a Lloydstsb platinum credit card a few years ago.They said over the phone that I did have PPI and asked me what reason I had to claim. I said that I wasn’t aware I had PPI on the card. They said ok we will come back to you. They wrote to me to say that my claim had been declined and if I wanted to appeal I should contact the ombudsman. They didn’t explain why. I then forwarded this onto the ombudsman and my claim was rejected. The reason was that I had ticked the box myself. It was taken out it 1998 so I really couldn’t remember. My question is, does the ombudsman look at other reasons or just the one I put forward (I was made redundant twice in the period and a hernia op whilst having the card and didn’t claim as I didn’t realise this was covered). Or is it dead because I didn’t ask the right questions. I hope someone can help

Many thanks
Tim

BooJewels

Perhaps if you understood the process better it might make more sense to you and that starts with using the right terminology.

The process isn't a claim for a refund, it's a 'complaint' that the policy was mis-sold to you. If you voluntarily ticked a box to take out this extra service, you can't then claim that they forced you to take it against your will or knowledge. If it's a pen mark on a paper form, it's even more compelling than a pre filled tick box on a digital form.

Other grounds for mis-selling include things like you being self employed (therefore employment cover wouldn't pay out) or not even employed - or other factors that would deem cover to be unnecessary or that you could never claim on it.

So it sounds like that bank and FOS are correct in their conclusion, if that was the grounds you used as the basis of your complaint for mis-selling. The fact that you forgot that you had it and failed to claim doesn't indicate that they mis-sold it to you. As it was a credit card, these premiums appear on credit card statements every month, as the amount relates to your current balance, so you would have seen it on there every month, so your argument that you didn't know about is somewhat weakened by that. Sorry Tim, it doesn't sound like you have much hope of settlement.

dunstonh

They wrote to me to say that my claim had been declined and if I wanted to appeal I should contact the ombudsman. They didn!!!8217;t explain why.

That is an unusual process. The process is basically uniform across providers to comply with the FCA guidelines.

1 - You get an acknowledgement of your complaint
2 - In that acknowledgement, they will repeat what they believe are the reasons for your complaint in a bullet point style or summary style. They also tell you about the FOS and what happens next
3 - Once the complaint is declined, they write to give you the reasons for the decline. Not necessarily in detail but say your reason was eligibility, they would say that the reason you gave for thinking you were not eligible does not apply and you would have been covered. Not big detail but summary style. Some points may be ignored if they are not applicable for the product. That letter tells you that you can refer to the FOS if you wish.

So, in that process they should have done more than what you have said.

The reason was that I had ticked the box myself.

That certainly eliminates a number of the possible complaint reasons. It doesnt prevent a complaint from succeeding but does limit the odds.

My question is, does the ombudsman look at other reasons or just the one I put forward (I was made redundant twice in the period and a hernia op whilst having the card and didn!!!8217;t claim as I didn!!!8217;t realise this was covered).

Both the bank and the FOS consider your reasons for complaint. They do also consider credibility. For example, if you used a template letter (rather than a personalised letter of a PPI form) and your template contained a load of BS reasons (as many templates do) then you lose credibility. For example, if you said you were told this that and the other that was all wrong and it turned out you bought it via a mailshot and no staff member was involved, then your credibility is much reduced.

Forgetting to claim on the policy does not make it missold.

Or is it dead because I didn!!!8217;t ask the right questions.

The FOS and the provider dont just look at your reasons. They look at the scenario of the sale as the provider has it documented and how you have said it happened. Your reasons are important as they are seen as the trigger of your complaint. If you have given duff questions then it can harm you but only if the reasons given were lies and caught out as such.

What were your complaint reasons? Were they strong complaint reasons where evidence is likely to exist? Or were they the weak unprovable reasons where there is likely to be nothing to support your allegations?

societys_child

I said that I wasn't aware I had PPI on the card.

Problem with that is, any PPI you paid, would be clearly itemised on the monthly statement(s). It's only charged on an outstanding balance, so if you paid the balance off each month, you'd pay nothing.

Or, you never checked your statements?

BooJewels

societys_child wrote: »

It's only charged on an outstanding balance, so if you paid the balance off each month, you'd pay nothing.

Indeed, as I touched on earlier, any amounts paid would be clearly shown on the monthly statement.

But I hadn't considered the idea that he possibly always cleared his balance and therefore actually never paid it, in which case, there's nothing to potentially repay anyway.

Tim1976

Thank you all, the amount of info on the web and all the advise to not go through a PPI company and to just use a template letter makes you feel like its a really simple process that anyone can do - i also had an egg card which I put through a PPI company which was taken out around the same time and they got it paid out so I wondered why they were successful and I wasn!!!8217;t. It does lead me to believe that it!!!8217;s all about the wording of the complaint I guess

societys_child

Statistically, you have more chance with DIY than using a CMC.
Template letters are not always a good idea, as they may use complaint reasons that don't apply, which may reduce the credibility of your complaint.

Much depends on the sales process at the time and what documentation still exists.
A successful complaint reason with one lender, may not apply to others.

dunstonh

the amount of info on the web and all the advise to not go through a PPI company and to just use a template letter makes you feel like its a really simple process that anyone can do -

Template letters have the lowest success rate. If you personalised it and removed all the reasons that did not apply, then its absolutely fine. However, some people leave every reason on there and that is the problem with templates. Many complaints end up on a decision based on the balance of probability. The decision goes to the most credible side. If your template used every reason going then you are going to appear, putting it bluntly, as a liar. So, you lose credibility.

CMCs also get a lower success rate. Partly for the same reason. They often include every reason under the sun.

A template is fine as long as you personalise it to your scenario and only include your reasons. Personalised complaints have the highest success rate. Indeed, the FOS actually encourage people to put the complaint in using your own words.

If you letter contained lies and you were caught as such and the firm could find no other reason that you were missold, then it is an easy rejection. However, succeeding with one firm and failing with another is not unusual and probably not down to wording.

Firm A and Firm B will have different products. They have different eligibility criteria, sales processes, internal file keeping will be of different standards. Timing may be different. One may be post regulation, the other earlier. They may have changed their process and/or product a dozen times over 20 years. Then you have auto-payouts. Some operate auto-payouts on small amounts. Others do not. Some have had periods where they were auto paying out anything under £3k.

So, wording is unlikely unless you left in dodgy reasons which reduced your credibility and it was a balance of probability decision going with the most credible side.

Nasqueron

BooJewels wrote: »

Other grounds for mis-selling include things like you being self employed (therefore employment cover wouldn't pay out) .

This is a well known PPI firm myth (and one they have stopped using at least in terms of adverts I have seen), PPI DID cover the self employed in many circumstances, especially MPPI. Only if the claim terms are considered onerous by the FOS (e.g. having to dissolve your firm) would that be a valid complaint

FOS decision 104/3 was upheld because the terms of the PPI were such that the person would have had to permanently cease trading to claim on it, for that person, a dental technician, that's clearly ludicrous as nothing short of some life changing disability like losing his hands would stop him being able to go back to work

http://www.financial-ombudsman.org.uk/publications/ombudsman-news/104/104-ppi.html#cs3

However, in case study 118/1 the complaint was rejected as the terms were considered to be fine

http://www.financial-ombudsman.org.uk/publications/ombudsman-news/118/118-payment-protection.html#cs1


In their general notes, case studies 17, they quote a couple of rejected complaints:

A policy said the consumer had to show they had "stopped work because [they] could not find enough work to meet all [their] reasonable business and living expenses" before a claim could be made for unemployment. This did not require finality in the consumer's changed employment situation, so we decided it was not an onerous or unusual term.

A policy said the consumer had to "have involuntarily ceased trading, declared this to HMRC, be registered as unemployed, and be available and actively looking for employment". We decided it was not an onerous or unusual term, because it was comparable to what an employed consumer would have to do.

BooJewels

Thanks for the information Nasqueron. I suppose I was only going by my own narrow field of experience where I wasn't granted cover because I was self employed (and more recently due to health reasons) and friends who have had complaints upheld because they were self-employed and couldn't have claimed - maybe in their case because they were never actually asked about employment during the sale.

Tim1976

Thank you all for your comments it!!!8217;s been really useful. Very much appreciated as it has been going round my head !!!8216;if only I had done this or done that!!!8217;. Glad to forget all about it and move on!