The High Court dismissed Jacinta De Paor’s appeal against the €850 compensation awarded by the Financial Services Ombudsman for distress and inconvenience caused by incorrect information from Quinn Healthcare about cover for her cancer treatment.
Mr Justice Brian J. McGovern delivered judgment on 20 December 2011. The appeal concerned only the amount awarded for distress and inconvenience. The court was not deciding the underlying complaint afresh or substituting its own assessment of compensation. It had to determine whether the Ombudsman’s decision, considered as a whole, was vitiated by a serious and significant error or series of errors.
De Paor joined Quinn Healthcare’s medical expenses scheme in October 2007, taking a Personal Care Plan for herself and her son. After she was diagnosed with breast cancer in August 2008 and underwent surgery, she asked about cover for further treatment, including radiotherapy at the Mater Private Hospital. She was incorrectly told that changing to a Family Care Plan would cover the treatment. Quinn later said a two-year waiting period applied to increased benefits under the upgraded plan.
The judgment records that Quinn acknowledged the misinformation. It initially agreed to pay for eight chemotherapy sessions but refused radiotherapy cover. After De Paor referred the complaint to the Ombudsman, Quinn agreed to pay outstanding eligible radiotherapy and chemotherapy claims, waive the waiting period for eligible treatment up to the Family Care Plan level, and pay five outstanding hospital claims totalling €8,740.05. It also agreed to pay €989 for shortfalls and in-patient excesses on those claims, and to cover the cost of changing her son’s plan for specified periods.
The Ombudsman’s 24 February 2011 report awarded De Paor €850 for distress and inconvenience. She argued that the amount was insufficient given the repeated incorrect statements and the distress she experienced while undergoing treatment. The court noted that the Ombudsman had considered both Quinn’s errors and the steps it took to address their financial consequences.
The judge said the issue was not whether he would have awarded more, but whether the decision met the legal threshold for intervention. He found nothing in the decision that did so and dismissed the appeal. The judgment’s opening describes the motion as seeking to affirm the Ombudsman’s finding while modifying the compensation amount; the court’s operative conclusion was to dismiss the appeal.