Ombudsman and Income Protection

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Jopeoc

Registered User
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Hello is it worth appealing an Income Protection denial to the ombudsman and what is waiting time approx?Thank you.
 
Impossible to say without more details.
Why do you think that they weren't justified under the policy terms and conditions to reject the claim?
Have you already made a formal complaint to the income protection provider and obtained a final response letter?
That is a prerequisite for taking a case with the FSPO.
What grounds did they give for the refusal to pay out?
Anecdotal evidence posted here recently suggests that at least some FSPO cases are taking years these days.
 
Have a look at their website as they do publish some case outcomes. Would give you an idea of the approach they take.
 
They stated I did not meet the definition of disablement under the policy and I was medically fit to resume my normal occupation
 
Did you challenge/appeal the decision?
Did they explain in more detail exactly why they rejected the claim?
Did you make a formal complaint and get a final response letter?
FSPO is irrelevant until you get the latter.
 
Jopeoc said:
it is being appealed
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In that case it's premature to be thinking about the FSPO as you'll have to let the appeal take its course first and even then you'll still have to make a formal complaint (if merited) and get a final response letter before you can think about going to the FSPO.

Bear in mind that income protection policies usually have restrictions in terms of the circumstances in which they will pay out (and often also for how long). The refusal to pay out here may well be legitimately in compliance with the policy terms and conditions. We don't have any details on that to judge.
 
To answer OPs initial and specific question:

Yes, it is absolutely worth it; a lot of cases referred to mediation result in a settlement.
The current waiting times are approximately 6–9 months for mediation i believe.
 
"I did not meet the definition of disablement under the policy and I was medically fit to resume my normal occupation"

It is not up to them to make that decision
What do you doctors or consultants say if they say you cant work, you cant work

and yes always appeal
 
Hello.Is a return to work possible while still referring to Ombudsman to cover period off or is this not possible?
Is mediation a possibility before a final decision?
Thank you
 
Jopeoc said:
Hello.Is a return to work possible while still referring to Ombudsman to cover period off
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Yes, and if you're fit for work again and can return to work then you should. Your complaint - to the insurance provider in the first place and then to the FSPO if necessary - in respect of failure to pay out for a previous period off work isn't affected by your return to work.

Did you do this yet?
ClubMan said:
In that case it's premature to be thinking about the FSPO as you'll have to let the appeal take its course first and even then you'll still have to make a formal complaint (if merited) and get a final response letter before you can think about going to the FSPO.
Click to expand...
 
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Hi all.I now need to go to FSPO.Any advice please.Do I just submit my own evidence and disregard insurance reports?
 
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