I am absolutely delighted to have received £71,584.76 via a Financial Ombudsman Service insurance determination in favour of my care home client.
The allegedly ‘specialist care homes insurance’ policy which my client held for 14 years refused to assist when the worst happened in 2019 and the client needed to appeal a CQC Notice of Decision. My client paid their legal costs out of pocket, because they were fortunately just about able to do so, but it has then taken three years and a complaint to the FOS, (which the insurer fought tooth and nail), to get the costs reimbursed – plus 8% interest on top ✨
The insurer in question isn’t one my team usually works with and I’m relieved that I have never seen one of our genuinely specialist healthcare insurance clients treat an insured in this manner. If you operate a care home, please make sure (a) that you hold appropriate insurance and (b) that it is with a reputable insurer that will start from a position of seeking to assist rather than seeking to decline.