The High Court has dismissed Irene Smartt’s appeal against a Financial Services Ombudsman (FSO) decision concerning the cancellation of her serious illness cover (SIC). Mr Justice Hedigan held that the Ombudsman’s conclusion was reasonably based on the documents before him.
Smartt complained that EBS, which provided her insurance, cancelled her SIC without her consent or notice. She said she discovered the cover had ended when she tried to claim after being diagnosed with breast cancer in November 2010. She maintained that she had not instructed EBS to end the cover and believed it continued under her earlier policy. She also alleged that documents were later amended to suggest she did not require SIC.
EBS said it had followed her instructions in February 2008 to replace her mortgage protection policy, which included SIC, with a lower level of cover that did not. The Ombudsman decided the complaint on written evidence. Smartt had not requested an oral hearing, and the High Court ruled she could not raise its absence for the first time on appeal.
The judgment records that Smartt had held life assurance and SIC since 2000. After she reduced her mortgage balance in December 2007, EBS advised her that she might reduce her life cover. In January 2008, she said she wanted to reduce the cost of life assurance. She was offered a policy including SIC at a monthly premium of €120.30 and life cover without SIC at €17.17. The judgment records that cost was given as the reason for choosing the latter.
In February 2008, Smartt signed documents indicating the replacement policy did not include SIC and acknowledging that the implications of replacing the existing policy had been explained. A welcome pack warned her to check that the new cover met her expectations. The previous policy was replaced later that month. In March 2009, she sought additional mortgage protection without SIC, described in the application as “the cheapest cover required at this time”. She did not dispute that she had not sought SIC in the 2008 reorganisation; she said she thought it was already covered.
The judge noted that the Ombudsman considered two versions of a page in the Mortgage Protection Planner, one with a box ticked and one without, and that EBS had not explained the difference. The Ombudsman did not rely on that discrepancy, finding the other documents sufficient. The judge said the dispute over the boxes and apparently changed dates did not address Smartt’s central complaint: that she was not told SIC would not continue.
Applying the deferential standard for appeals from the Ombudsman, the court found he was entitled to rely on the signed documents and the evidence that Smartt had been alerted to the consequences of replacing her cover. The appeal was dismissed. The judgment did not make a separate finding on the alleged document changes.