Financial ombudsman - insurance claim declined

jade2612

I have submitted a complained to the financial ombudsman against gatesafe insurance, underwritten by Wakam. I have a few questions, any opinions or helpful information is appreciated.

My complaint has been accepted and a case started, just waiting for a case handler to be available to investigate. How long usually does this take. 

Is it common or not for insurance company’s to make an offer to settle the claim once a case as been created by the financial ombudsman? 

DullGreyGuy

It varies, depends on how busy they are and which section is dealing with it as not all sections have the same level of backlog etc.

According to their own website they are saying on average at the moment it is 90 days; my personal experience has always been longer than this but one was in the middle of the PPI stupidness and the others during Covid. 

It's not common for insurers to change their decision after a complaint has been registered. Uphold rates vary significantly across the products but on average about 28% of insurance complaints go the way of the customer and in some classes it can be less than 10%. 

You can search the db of decisions made my the ombudsmen at the FOS on their website (it doesn't include decision made by the lower level adjudicators). Appears, by eyeball, that the upheld rate for Wakam seems above the industry average. 

dunstonh

Is it common or not for insurance company’s to make an offer to settle the claim once a case as been created by the financial ombudsman? 

There is often a small window where the FOS will give a firm the chance to settle the complaint without suffering the FOS fee.   However, that tends to only apply to firms that pay an individual FOS fee and not those that pay a block fee.  Most insurers would be on the block fee arrangement.

Where a firm has offered a payment (often as a goodwill gesture), and you have declined it, some firms will withdraw the goodwill gesture and let the FOS decide the outcome.