Topquote, Openwork, L&G and the FOS

MartG

New Member
Mar 21, 2018
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#1
Hi, I'd like to share my bad experiences with L&G, Topquote (TQ), Openwork (OW) and the FOS.

In 2012 I had brain surgery (MVD) for a condition called Trigeminal Neuralgia (TN). After a few weeks recuperation I went back to work. This was, at the age of 40, my first illness (save the occasional cold) and got me to thinking about my wife and young daughter. I decided to arrange life insurance and critical illness cover and called TQ.

I told the salesman all about my TN and operation. The salesman told me that the policy was guaranteed for 20 years.

Three days later a 'confirmation call' with the purpose of 'confirming I was happy with the policy and wanted to continue' was made. The call lasted just a few minutes. The TQ employee tells me that the reason he's recording the call is 'for my protection'. He also says 'all I have down is one member of your family having cancer?' I reply, 'yes, that was my Father'.

The next day an Agent came to our house in the evening. My wife answered the door and thought it was a cold-call until he called her by name. She said 'you do know my husband's just had brain surgery?' he replied 'yes'.

My wife was in the habit of photographing the 4” scar on the left side of my head which still had dried blood on it. She wanted to keep a record of my recovery. The hair on the scar side of my head was shaved for the op and although growing back it was noticeably shorter than the rest of my head. This photo was taken less than 72 hours before the Agents visit.

We checked the applications and mine clearly mentioned my TN. The Agent told us the premiums were guaranteed and produced 'Statements of Price' confirming this which he duly signed and dated. A week later we received 'Summaries of Requirements' prepared by the Managing Director of TQ. In it he states that the premiums were guaranteed. They weren't. They were reviewable.

Everything ticked by as normal for a while and we just paid our premiums and generally forgot all about it. In 2015 I fell ill. I spent a lot of time in hospital and was eventually told I'd had 3 silent heart attacks, Cardiomyopathy, and multiple Pulmonary Embolisms. I was diagnosed as NYHA 3.
After a while we approached L&G and claimed on my critical illness cover.

Within a day or two of our claim being submitted L&G were on the phone. A softly spoken man who seemed so sympathetic towards my problems set about explaining that his advice to me would be to cancel my cover. I said that I wouldn't cancel so the calls continued.

After a while I was told (with a detectable hint of pleasure in his voice) that as I hadn't informed them of my TN my insurance was void.

L&G had treated me appallingly but I realised that they probably didn't know about the TN. So I turned my attention to the broker, TQ.

During the course of their investigation their Complaints Specialist asked me to lend him all the paperwork that I had from L&G (600+ pages) I agreed, naively, yes but with his assurance that he would return every page to me. He didn't. He shredded them.
He did tell me that he had scanned and kept about 350 pages he felt of relevance to OW and he would print and return these. In the end about 150 turned up with an apology for his miscalculation and a cheque (not banked) for £100.
One of the missing pages clearly stated that L&G believed blame lay with TQ and another said that L&G believed the problem occurred when TQ sent them my application. Presumably due to their non-return these pages were not judged as relevant.

L&G continued taking new business from them.

As for my claim I moved on to the FOS where an Adjudicator took on my complaint. She received copies of the application forms from OW. Mine did not mention TN or an operation. The Agent's statement was taken as evidence by the FOS. Reading it you'd think it a description of an incredibly diligent, professional and experienced man of the utmost integrity. In his role he reports back to the office anything he sees that he feels does not match up with the application.
Anything that is except bloody 4” scars and shaven heads.

I offered the photo of my head to the Adjudicator but she wasn't interested, I offered to pay for and undertake a lie detector test for me and my Wife and pay for the agent to have one to but that was also rejected.

I asked TQ for a copy of the original sales call. Unluckily for me but luckily for them it was 'lost'. Another convenient 'loss'. Even OW described losing the call as 'not good practice'.

I received an emailed copy of my application from the Adjudicator who had got it from TQ. The top centimetre or so was missing from the scans of each page. I thought this a bit odd and requested a copy directly from TQ. The copy they sent me also left off the very top of the pages. So I asked again, this time specifying that I wanted the complete page. A copy arrived but scanned upside down! Their accompanying email offered an explanation for this. Apparently their scanner didn't work unless the paper was placed on it upside down. I called Canon's UK service department to see if this was a problem they'd ever come across before. The engineer couldn't talk for laughing for several minutes before telling me that this scenario was simply impossible and scanners do not differentiate between the right way up or upside down. The complete albeit upside down scans revealed a fax header.
The very next day my Wife requested a copy of hers. It arrived later that day. Complete with fax header and the right way up.

Over a long time hundreds of emails were exchanged between the Adjudicator and I. But to no avail. Using the confirmation call as her primary source she denied my claim. This call, despite being short enough to send as an attachment with no problems was edited by OW prior to being sent.
The Adjudicator did get L&G to apologise for their treatment of me and pay £300 in compensation. She also stated in writing that, other than a direct debit mandate, it was 'unlikely' that we had received any paperwork from L&G. Which we hadn't.

(the confirmation call is currently being looked into by the EU commissioner for justice as it does not appear to comply with the EU Data Protection Directive)

My complaint was passed to an Ombudsman who, despite the mountain of evidence and literally hundreds and hundreds of emails, made his decision in less than 5 days. Unsurprisingly he sided with TQ/OW.

My struggle continues though and I am far from giving up. In the meantime I have made a complaint with regard to my Wife's policy and the fact that it was not guaranteed as we had been told and was therefore mis-sold. Despite telling us a grand total of 7 times that our policies were guaranteed OW denied mis-selling. As did the FOS Investigator.

We told TQ's agent on the night of his visit that any increase in premiums would be unaffordable to us. The irony being that little did I know the reason it would be unaffordable was the man who sat next to me and the company he represented.

I requested OW send me details of 'any and all' the commission from my Wife's policy. As is their way they denied having received my SAR. I sent it again this time recorded delivery and they had no choice but to reply. They offered a figure as the 'total' amount they had received. I called L&G who confirmed the figure from OW then went on to tell me about the monthly commission OW have been receiving and will receive for the next 15 years. I can only assume OW forgot all about it. I have complained to the ICO and expect another breach.

I requested that the Adjudicator ask OW about their commission. OW replied to her that they didn't have this information and instead provided her with figures as if my Wife had taken out an identical policy today. The Adjudicator was happy to accept these figures. I asked L&G directly how much a policy in today's terms would cost using the exact same details as back in 2012. It turned out that OW could provide L&G cover for less than L&G could. The figures provided by OW also showed guaranteed policies to be cheaper than reviewable ones.

They also told the Adjudicator that a guaranteed policy back in 2012 would have cost my Wife 41p more per month. So they were able to provide some figures for 2012 when it suited.

OW sent my wife a 'final outcome' letter in April of last year. A while later they sent another one, a sort of 'final, final outcome letter' if you will. Neither admitted mis-selling instead referring to it as an 'error' (or, more accurately, 7 errors).

In her first final outcome letter the Complaints Specialist from OW told us that we 'should've checked'. I can't help feeling this advice should be followed by the MD of TQ when he prepares his Summaries of Requirements.

It's now in the hands of an Ombudsman who has (after 9 months) reached his provisional decision. He has found that they have in fact mis-sold my Wife's policy in part. The 'in part' bit means he does not find that they did it intentionally as is my belief.

Both the Adjudicator and Ombudsman state as part of their reasoning that my Wife has had 5 years of cover and L&G would have paid out in the event. How they know this is beyond me. Our experience of L&G would suggest a very different outcome.
I'm confident our sycophantic friend from L&G would be on the phone straight away.

The Ombudsman's solution is that OW pay my Wife £200 in compensation and that she continues her insurance at the guaranteed monthly premium of £41.13
OW's 'final, final offer' (made last year) is £200 in compensation and guaranteed premiums of £40.72 per month. (?)

Since being found to have mis-sold the policy the penalty to OW has gone down and the cost to my Wife has gone up!

At this rate we will soon be paying them.


Thanks for looking!
Any advice gratefully received