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Aviva ignored signs of financial abuse by sibling and supported by FOS


Titchytitch
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@BankFodder heres to wishing aviva do whats right but i highly doubt it, ive sent the letter to the FOS colleague who has agreed the extension i'll keep you updated on what they say the officer also agreed last night to send me Avivas response once she gets it 

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@BankFodder response from FOS 

Thank you for your email, I am happy to wait until you've received the subject access request and an additional two weeks, please get in touch with me to let me know once you've received the information you're awaiting. 

 

In terms of the call recording, the final decision has now been issued, we won't be in the position to revisit this complaint even if you feel that crucial evidence has not been considered. It is likely to case that if the evidence in question was crucial to the outcome of the complaint, the Ombudsman would have requested this from Aviva prior to issuing the final decision. 

 

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In other words it's a fob-off

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Even if the FOS considers that it has been misled, it seems that they are prepared to do anything about it.

This speaks volumes about the limp wristed nature of the FOS and its investigators and ombudsman.

Anyway, we'll see if the SAR eventually makes any reference to them confirming the procedure. I can imagine that they won't want to allow any procedure to be disclosed to you on the basis that it is not your personal data.

When you eventually decline the decision then also you will begin a complaint to the Independent Assessor.

I suggest another letter – just as a precaution.

 

Quote

Thank you again for confirming the extension for my decision to accept or decline the final response of the ombudsman.

In case I decide to decline and then complaint to the Independent Assessor, will you please confirm that my time for making that complaint will run from the date that the decision is formally declined – or do you want to tell me that time is already running?

 

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Yes and copies to any other addresses that you have for the FOS

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@BankFodder the FOS response 

 

Thank you for your email.

 

Before you refer a complaint to the independent assessor (IA) you would first need to raise a service complaint with us directly. Your service complaint will be reviewed by a manager, and if you remain unhappy with our response you can refer it to the IA. I think it would be helpful to outline that service complaints do not consider the merits of the case e.g. the final decision or address the reasons why you're unhappy with the decision, the approach taken etc. It will only consider whether we have provided you with a good level of customer service throughout the complaint i.e kept you up to date throughout our investigation, progressed your complaint within a reasonable timeframe etc. 

 

I hope this explanation was helpful, If you wish to raise a service complaint, please let me know, it would also be helpful to explain your reasons for the service complaint so this can be adequately addressed. 

 

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Please can you quote the post you are referring to

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9 hours ago, Titchytitch said:

@BankFodder the FOS response 

 

Thank you for your email.

 

Before you refer a complaint to the independent assessor (IA) you would first need to raise a service complaint with us directly. Your service complaint will be reviewed by a manager, and if you remain unhappy with our response you can refer it to the IA. I think it would be helpful to outline that service complaints do not consider the merits of the case e.g. the final decision or address the reasons why you're unhappy with the decision, the approach taken etc. It will only consider whether we have provided you with a good level of customer service throughout the complaint i.e kept you up to date throughout our investigation, progressed your complaint within a reasonable timeframe etc. 

 

I hope this explanation was helpful, If you wish to raise a service complaint, please let me know, it would also be helpful to explain your reasons for the service complaint so this can be adequately addressed. 

 

 

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I am making a complaint about the service standards applied to the investigation of my complaint against Aviva insurance – reference number XXX.

I understand that the ombudsman service will want to investigate this service standards complaint first of all but afterwards I will require then it is escalated to the independent assessor.

I understand that the independent assessor will not interfere in the decision made by the ombudsman but once again, I emphasise that this complaint is about the standard of that investigation.
 

My service standards complaint
The ombudsman, who declined to uphold my complaint, based that decision mainly on the fact that Aviva had apparently followed their “process” and because they had followed that process, their action in entering into a contract of motor insurance was fair.

  1. There is no indication in the ombudsman’s report that the ombudsman had ever had sight of the Aviva process or had even considered whether that process was fair.
  2. By Aviva’s own admission, the Aviva call handler who took the original fraudulent telephone call was suspicious or uncomfortable about setting up the policy and decided to ask a manager.
  3. It is clear that had the call handler simply relied on her own instinct, that the fraudulent policy would never have been taken out and none of the resulting events would have happened.
  4. On 2 June 2021 I received a phone call from Aviva complaints department and during the conversation the complaints call handler pointed out that the call handler in XXX year had made a mistake because she had the authority to decide whether or not to provide the insurance cover and she had no need to go to the manager.
  5. In other words, if the call handler in XXX year had adhered to the Aviva “process” the fraudulent policy would never have been provided.
  6. My complaint is that either the ombudsman has never seen any document laying out the Aviva “process” and that they have simply accepted Aviva’s word for it.
  7. It may be that Aviva has deliberately or inadvertently misled the ombudsman.
  8. My complaint is that the ombudsman did not ask to see a copy of the Aviva “process”.
  9. If that is the case then the ombudsman’s investigation was not complete and this must surely fall below the FOS service standards.

 

Suggested course of action

I understand very well that the ombudsman service will not reverse its decision under any circumstances.
However, so far I have not indicated to the ombudsman service whether I will accept or decline that decision.

I suggest that a suitable course of action is that if it is correct that the ombudsman has never seen the “process”, that the case be remitted back to Aviva with a recommendation that they withdraw themselves from the issue.
I'm not seeking any other "award"
 

Police fraud investigation
I should point out that the person responsible for the fraud – who is my brother – is facing arrest for a number of similar frauds on loan companies and is currently being investigated for the fraud against Aviva.

The police have already indicated that they will want to speak to Aviva and in fact the police have already been provided with a copy of the ombudsman’s decision because it contains a very comprehensive account of the events which led to the setting up of the fraudulent policy.


Independent assessors timescale

I understand that the timescale for a decision by the independent assessor is 14 days. However I do understand that it will be necessary to ask Aviva to provide certain information and therefore I am indicating right now that I’m happy that the 14 day deadline be extended to a full 28 days.


Yours faithfully

 

 

You will need to enter the relevant year in place of the XXX

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@BankFodder thank you is it worth mentioning that the fos had no dealings with myself and was going by the information filtered via the first investigator? I never spoke to her and neither did she try to understand the case? If not I think this letter is good to go 

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I'm not sure that the ombudsman's role is to talk to you or to bring in new evidence. I have a feeling that their role is simply to review the evidence assembled by the investigator.

From that point of view, did you speak to the investigator and did you supply information there?

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Well I suppose that the first one was the investigator/adjudicator. The second one was actually the ombudsman.

I have a feeling that the role of the ombudsman is simply to review the evidence and the findings of the adjudicator – but maybe you could have a search of the FOS website and find out.

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@BankFodder @BankFodder please see below 

3 minutes ago, BankFodder said:

Taking your complaint further

If you or the business don’t want to accept what we’ve said, you can ask for your case to be referred to an ombudsman.

The ombudsman will then look at all the details of your complaint afresh, and make a final decision. As part of this process the ombudsman may decide to issue a provisional decision which will set out the decision he/she is minded to make on your case. The ombudsman will then ask both parties to make any final representations which he/she will consider before issuing a final decision on your case. 

Once a final decision is issued, you will be asked to confirm by a specified date whether you accept or reject it. If you accept the ombudsman's decision, the business has to do what the ombudsman has told them to do. This might, for example, include making the business pay you compensation. And, if you accept it, it is unlikely you will be able to pursue the business in court for the same complaint. 

If you don't want to accept the ombudsman's decision, you don't have to. But it does mean our involvement has come to an end and the business doesn't need to do anything. You may still be able to take legal action against the business, but we won't be involved in this. 

Our rules are flexible and there might be some cases where after a provisional decision has been issued, the parties may agree to settle the complaint at that stage, sometimes on the basis proposed in the provisional decision or otherwise. If you agree to compensation offered by a business at any stage, this may mean you won't be able to pursue the business in court for the same complaint. You may want to consider taking independent legal advice if you are unsure about agreeing to a settlement. 

 

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@BankFodder it was referred  but it wasn't seen as afresh she was still filtering the investigation through Katie who was the investigator so the complaint wasn't impartially investigated it was pointless referring if Katie was still involved 

And she didn't speak to me to make a final representation she just went straight to final decision I think they based their decision on the fact 

A) aviva followed a process 

B) the policy investigation where my documents were given which were stolen 

C) the letters I had supposedly received 

 

So the way it was handled was completely wrong 

 

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That's excellent.

I've amended the letter to reflect that. See what you think – and also check for typos because I dictate everything and often I miss errors

 

 

2 hours ago, BankFodder said:

 

I am making a complaint about the service standards applied to the investigation of my complaint against Aviva insurance – reference number XXX.

I understand that the ombudsman service will want to investigate this service standards complaint first of all but afterwards I will require then it is escalated to the independent assessor.

I understand that the independent assessor will not interfere in the decision made by the ombudsman but once again, I emphasise that this complaint is about the standard of that investigation.
 

My service standards complaint

 

Reliance on Aviva's "process"
The ombudsman, who declined to uphold my complaint, based that decision mainly on the fact that Aviva had apparently followed their “process” and because they had followed that process, their action in entering into a contract of motor insurance was fair.

  1. There is no indication in the ombudsman’s report that the ombudsman had ever had sight of the Aviva process or had even considered whether that process was fair.
  2. By Aviva’s own admission, the Aviva call handler who took the original fraudulent telephone call was suspicious or uncomfortable about setting up the policy and decided to ask a manager.
  3. It is clear that had the call handler simply relied on her own instinct, that the fraudulent policy would never have been taken out and none of the resulting events would have happened.
  4. On 2 June 2021 I received a phone call from Aviva complaints department and during the conversation the complaints call handler pointed out that the call handler in XXX year had made a mistake because she had the authority to decide whether or not to provide the insurance cover and she had no need to go to the manager.
  5. In other words, if the call handler in XXX year had adhered to the Aviva “process” the fraudulent policy would never have been provided.
  6. My complaint is that either the ombudsman has never seen any document laying out the Aviva “process” and that they have simply accepted Aviva’s word for it.
  7. It may be that Aviva has deliberately or inadvertently misled the ombudsman.
  8. My complaint is that the ombudsman did not ask to see a copy of the Aviva “process”.
  9. If that is the case then the ombudsman’s investigation was not complete and this must surely fall below the FOS service standards.

Ombudsman's failure to follow the published rubric

According to the FOS website, the ombudsman will "… then look at the details of your complaint afresh….". The FOS website also says that "the ombudsman will then ask both parties to make any final representations which he/she will consider…".
So far as I can gather, the ombudsman formed their decision solely on the information which had been gathered by the initial investigator and had not started "afresh" – from zero – as required by the FOS rubric.
In particular, at no point was I approached by the ombudsman for any information. Nothing was discussed with me. I was not involved in any way in the ombudsman's consideration of the events.
Furthermore, I was not asked to make any "final representations" before the ombudsman issued their final decision in my case.
Although I understand that apparently the decision is now fixed in stone, by any reasonable standards the only possible finding would be that the ombudsman investigation was flawed and therefore the final decision has been invalidated.
 

Suggested course of action

I understand very well that the ombudsman service will not reverse its decision under any circumstances.
However, so far I have not indicated to the ombudsman service whether I will accept or decline that decision.

 

  1. In view of the fact that the ombudsman's own published "process" has not been applied to the handling of my complaint, the decision by the on this man should be considered as vitiated. In that case, the decision would be considered to have no validity at all and so there will be no question of the ombudsman being asked to reverse it as they would effectively be no decision to alter.
  2. A second or alternative suitable course of action is that if it is correct that the ombudsman has never seen the “process”, that the case be remitted back to Aviva with a recommendation that they withdraw themselves from the issue.


 

Police fraud investigation
I should point out that the person responsible for the fraud – who is my brother – is facing arrest for a number of similarattempted frauds on loan companies but which excercised greater diligence than Aviva.  He is also currently being investigated for the fraud against Aviva.

The police have already indicated that they will want to speak to Aviva and in fact the police have already been provided with a copy of the ombudsman’s decision because it contains a very comprehensive account of the events which led to the setting up of the fraudulent policy.


Independent assessors timescale

I understand that the timescale for a decision by the independent assessor is 14 days. However I do understand that it will be necessary to ask Aviva to provide certain information and therefore I am indicating right now that I’m happy that the 14 day deadline be extended to a full 28 days.


Yours faithfully

 

 

 

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Don't understand

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@BankFodder does this bit read correctly as the rest is fine 

 

  1. In view of the fact that the ombudsman's own published "process" has not been applied to the handling of my complaint, the decision by the on this man should be considered as vitiated. In that case, the decision would be considered to have no validity at all and so there will be no question of the ombudsman being asked to reverse it as they would effectively be no decision to alter.
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Yes. That's fine. "Vitiated" means legally destroyed/invalidated so that it loses all effect

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 .........  my complaint, the decision by the on this man should be considered as vitiated .........

 

 should read

 

 .........  my complaint, the decision by the ombudsman should be considered as vitiated .........

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