DRN-6242932

The complaint Mrs L complains she was given incorrect information about her claim settlement value by Royal London Mutual Insurance Society Limited (THE) on her critical illness policy. Throughout the claim and complaint process, Mrs L has had a representative helping her. In this decision, any reference to Mrs L includes the actions and comments of her representative. What happened The events are well known to both parties, so I’ll only summarise them here. Mrs L raised a claim after being diagnosed with a listed critical illness. The claim was accepted by Royal London. Mrs L called to confirm the claim value and was informed it was £25,000. The next day, Mrs L was sent an email by Royal London and was informed the claim value was only £6,250. Unhappy, Mrs L raised a complaint. Royal London upheld Mrs L’s complaint and offered her £250 compensation for the trouble and upset caused. Mrs L wasn’t happy with this and brought the complaint to this service. Our investigator didn’t uphold Mrs L’s complaint. She thought Royal London’s offer was fair and reasonable. Mrs L appealed. She still didn’t think it was a fair outcome. As no agreement could be reached, the complaint has been passed to me to make a final decision. What I’ve decided – and why I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. At the outset I acknowledge that I’ve summarised her complaint in far less detail than Mrs L has, and in my own words. I’m not going to respond to every single point made. No discourtesy is intended by this. Instead, I’ve focussed on what I think are the key issues here. The rules that govern the Financial Ombudsman Service allow me to do this as it’s an informal dispute resolution service. If there’s something I’ve not mentioned, it isn’t because I’ve overlooked it. I’m satisfied I don’t need to comment on every individual point to be able to reach an outcome in line with my statutory remit. I don’t think it’s in dispute about what Mrs L is entitled to under her policy. The issue is around the incorrect information that was given to her. This would have raised her expectations, however, it was a mistake. So, Mrs L isn’t entitled to the higher amount under the policy and it would be a case of a compensation award for the distress and inconvenience caused. I appreciate that it must have been distressing for Mrs L to find out she’d been provided with incorrect information. This would have given her false expectations as to the value of the claim. However, this was only over a short period. She received an email with the correct amount less than 24 hours later. This caused Mrs L inconvenience in having to then query which was correct. Although this is a distilled version of events, I’ve considered everything in the round and I think Mrs L has been caused an unreasonable amount of distress and

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inconvenience which has required a reasonable amount of effort to sort out and has impacted Mrs L over several days. In line with our website guidelines, I think the £250 compensation offered by Royal London is fair and reasonable in the circumstances. So, I won’t be asking Royal London to pay anything in addition to this. I’m very sorry that my decision doesn’t bring Mrs L more welcome news at what I can see is a very difficult time for her. I’m sorry to hear about her diagnosis and wish her all the best for her recovery. My final decision For the reasons I’ve given above, my final decision is that I don’t uphold this complaint. I don’t require Royal London Mutual Insurance Society Limited (THE) to do anything further. Under the rules of the Financial Ombudsman Service, I’m required to ask Mrs L to accept or reject my decision before 13 May 2026. Anthony Mullins Ombudsman

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