Customer threatens to complain to FOS for not being entitled to a refund after receiving a payout for his claim

This happened a few years ago so I don’t remember the exact conversation. I also don’t expect everyone to be experts on insurance but you would think that certain things are obvious, especially when you have documents that clearly state it.

For those that never had to deal with uk insurance or know much about it, here’s the important bit. FOS is the financial ombudsman service. If a customer is not satisfied with a complaint they can escalate this to FOS who will investigate further and basically decide who’s in the right, there’s a bit more to it but as an insurer we would have to comply with their decision.

Also the way our policies work is they are 12 month contracts. Like most insurance the agreement is basically you pay £x amount and for (12 months) if you need to make a claim you are covered. So although you can call to cancel mid term, if you’ve claimed and we pay out you’re not entitled to any refund as the contract fairly states.

This customer had taken out pet insurance with us and had been renewing for a few years until his pet sadly passed away. So after speaking to our claims team and being told he would receive a payout they transferred him to me to cancel.

I confirmed that the policy had now been cancelled and sympathised with his pet passing away. He then asked when he would be receiving his refund. I tried to explain that as he had made a claim and would be receiving a payout he isn’t entitled to a pro rata refund for cancelling. He then got annoyed with this answer saying that’s illegal and we have to refund him as he’s cancelling. I try and explain as clearly as I can the contract and even said his logic wouldn’t make any sense but he just wouldn’t understand and continued to get more annoyed.

After trying my best to explain he said he will be taking this further to FOS as we’re breaking the law and trying to scam him. At this point I just gave up and said ok if that’s how you feel would you like me to make an official complaint as FOS will not just accept any complaint with a customer unless they have exhausted all of the insurers complaint procedure first. He declined saying he has already done this and will be going straight to them. I just thought fair enough I’ve done everything I can and the call ended.

I did check his file after to see the complaint and saw that it was for something completely unrelated. I can’t remember what it was but remember thinking it was stupid so explains why this person was so difficult to deal with. Anyway knew he would have to come back to us because of this as FOS will just turn him down when they discover the complaint isn’t related so I kept my eye on the policy for a while to see if anything came of it. As far as I can tell the customer never followed up and that was the end of it.

submitted by /u/Fluffyat
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