In 1992 Jeremy bought a suite of insurance products from a door to door insurance salesperson. In 2017 Jeremy was diagnosed with cancer and made an insurance claim. The insurance company paid him about $3,000. This didn’t seem enough to Jeremy, but he was very sick at the time and felt unable to challenge the insurer’s decision.
In 2020 Jeremy felt better and asked the insurer why his sickness policies had not provided cover. The insurer replied that Jeremy had cancelled the sickness policies in 2010. Jeremy had no recollection of cancelling the policies so complained to the insurer.
The insurer sent Jeremy a copy of a fax sent from Jeremy’s work number, apparently signed by Jeremy, asking the insurer to cancel four sickness policies. The insurer also sent Jeremy a letter they had sent him confirming the cancellation, with a cheque attached refunding the premium Jeremy had paid in advance.
Jeremy did not accept that he had written the fax and said the insurer had cancelled the policy without his permission. Jeremy wanted the policy reinstated and for the insurer to accept an additional claim for his illness under the reinstated policy.
The insurer responded that they were satisfied they had followed Jeremy’s instructions and declined to reinstate the policy.
Jeremy did not accept the insurer’s response and complained to FSCL.
We agreed that the handwriting on the fax did not look like Jeremy’s, but the signature did. Jeremy agreed that the signature was similar to his but said that he did not remember signing the instruction to cancel.
We asked Jeremy about the letter and the cheque the insurer had posted him. Jeremy agreed that the letter had been posted to his work’s physical address but said that all other insurance mail went to his work PO Box. We asked Jeremy whether the money had been deposited into his bank account, and when Jeremy checked his bank statements, he could see that he had received the refund.
We explained to Jeremy that when looking impartially at all the information available to us it seemed reasonable for the insurer to accept the instruction to cancel the policy. While the handwriting on the fax was not Jeremy’s, it appeared to be signed by him, had come from his work fax number, and the person who had written the fax knew his insurance policy numbers.
We reminded Jeremy that the refunded insurance premium had been deposited into his bank account. We could not see that a fraudster had anything to gain by cancelling the policies.
Jeremy continued to maintain that he had not cancelled the policies but agreed that from an impartial perspective he could understand why the insurer and we might think he had. On this basis, Jeremy was prepared to discontinue his complaint.
Insights for participants
When Jeremy came to us, he was adamant that the insurer had ‘ripped him off’. We were able to spend the time going through the complaint and, from an independent standpoint, help Jeremy understand the insurer’s perspective. Sometimes you will not be able to resolve a complaint, and that is where we can help.