Man loses challenge over insurance company refusal

A man has lost his legal challenge over an insurance company’s refusal to pay out on his claim for serious illness cover.

Derek O’Regan made a claim to Zurich Insurance after being diagnosed in early 2011 with rheumatoid arthritis in his ankle and knee joints, leaving him unable to continue his work as a plasterer.

One of his young children has been diagnosed with a related illness and it was impossible not to feel sympathy for the family, the Court of Appeal said.

The three-judge court yesterday said it had no option but to dismiss Mr O’Regan’s appeal against the High Court’s rejection of his challenge to the Financial Service Ombudsman’s rejection of his complaint alleging Zurich wrongfully removed serious illness cover from insurance taken out by himself and his wife Sonia without their consent.

The couple took out policies with Zurich from 2004 which included serious illness cover and they alleged that cover was wrongfully removed from policies taken out in 2008 and 2009.

They agreed they had not read the relevant policy application forms before signing them and said they trusted the Zurich financial consultant with whom they were dealing. That consultant maintained serious illness cover was not included in 2008 and 2009 for reasons of affordability as the couple were both out of work at the time and the couple were fully informed of their choices. He also said he was not made aware of the relevant medical history.

Giving the appeal court’s judgment, Mr Justice Gerard Hogan said there was credible testimony on foot of which the ombudsman made findings rejecting the complaint. Provided there was credible testimony to support the ombudsman’s findings of primary fact and such findings are clearly stated, the High Court has limited scope to review those findings, he said.