Travel Insurance Complaint Upheld But Ignored

Kezzers86

Hi,

I made a travel insurance claim with Allianz Assistance and they denied for a range of random and not relevant reasons, it felt like they were looking for any reason. 

Anyways, I complained and my complaint was upheld by their complaints team and the claim team were supposed to open the claim to sort it out. They ended up denying the claim again, for another reason. 

Neither the complaints team reply to my emails, nor do the the claims team. 

I have called them 6 times but after two hours you are disconnected. 

It has been 3 months now. Did try the financial ombudsman but didn’t hear back. 

Since my complaint was upheld by their own team, is this grounds for me to try a small claims court to get the money that way? 

Thanks 

born_again

Have you tried contacting FOS on your complaint, to see it's status.?
They are not quick & complaints can take months to just get looked at.

DullGreyGuy

Kezzers86 said:

Since my complaint was upheld by their own team, is this grounds for me to try a small claims court to get the money that way? 

What was the action from the complaints team in the Final Response letter? Sometimes complaints teams will say the claim should be paid and in other cases they will say the claim should be re-evaluated. The later doesn't automatically mean you will be paid. Depending on that will really determine if you should be escalating your existing complaint or starting a new complaint about the reason for decline, assuming you don't agree with that either. 


The FOS won't ignore complaints submitted to them but they have fairly long wait times. When you submit the complaint via their webform you should get an automatic acknowledgement. In 2 months ish you get an email saying it's been appointed to someone and 2 months later again you'll get contact from that person to discuss the case. You can phone the FOS general telephone number and they'll advise where the escalated complaint is. 


A complaint being upheld is not "grounds" for court (the court decides if its Small Track, Fast Track etc not you), court action and the complaints/FOS process are independent. You would need to send them a letter before action and would be sensible to focus on the latest rebuttal rather than the original decline. You can then proceed to issue after the sensible time limit (eg 21 days) in your LBA has passed. When you do issue you should inform the FOS as they cannot review complaints that are subject to legal action. 

Kezzers86

DullGreyGuy said:

Kezzers86 said:

Since my complaint was upheld by their own team, is this grounds for me to try a small claims court to get the money that way? 

What was the action from the complaints team in the Final Response letter? Sometimes complaints teams will say the claim should be paid and in other cases they will say the claim should be re-evaluated. The later doesn't automatically mean you will be paid. Depending on that will really determine if you should be escalating your existing complaint or starting a new complaint about the reason for decline, assuming you don't agree with that either. 


The FOS won't ignore complaints submitted to them but they have fairly long wait times. When you submit the complaint via their webform you should get an automatic acknowledgement. In 2 months ish you get an email saying it's been appointed to someone and 2 months later again you'll get contact from that person to discuss the case. You can phone the FOS general telephone number and they'll advise where the escalated complaint is. 


A complaint being upheld is not "grounds" for court (the court decides if its Small Track, Fast Track etc not you), court action and the complaints/FOS process are independent. You would need to send them a letter before action and would be sensible to focus on the latest rebuttal rather than the original decline. You can then proceed to issue after the sensible time limit (eg 21 days) in your LBA has passed. When you do issue you should inform the FOS as they cannot review complaints that are subject to legal action. 

The complaint handler when he called me said “ regardless of what’s in your policy, if we have told you what to do , we have to honour it, I directed him to the initial call I made where I asked for advice and followed it exactly, this made the basis for upholding my complaint. I was also given £100 compensation for the messing around and refusal first time round,  the cost of accommodation and travel was in excess of £500.

DullGreyGuy

Without having the whole story no one here will be able to give a reasonable view on prospects of success. Clearly if you're hoping that they have to abide by erroneous information given then hopefully you already have gotten a transcript of that call for taking to court. 

This is a grey area of law that requires judgement... to play devils advocate, if the advisor had said do X and we'll pay to £10,000,000 then you'd have no chance of enforcing that as clearly that isn't the case and isn't within his authority to do so (were that not the case you'd get their mates calling all the time for such a promise and then go 50/50 on the monies). So it comes down to the details and what your losses are explicitly for having followed that advice. 


The FOS are not bound to come to the same conclusions as a court would but are required to find "fair" outcomes and so are more likely to consider it reasonable that someone follows the instruction of their bank/insurer etc but even then there is a limit (not £1m for you). 

I'd stick with the FOS complaint than go to court