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


Titchytitch
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If you click on what BF posted a bit earlier on this thread, wherre it says 22nd September, you go to post #474 on your other thread. Is this the letter you're referring to?

 

HB

Illegitimi non carborundum

 

 

 

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@BankFodder this is the letter but I think we said we needed to incorporate some hits @unclebulgaria67 mentioned 

 

Dear Independent Assessor

Reference number XXX
 

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 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 although of course I have referred to some of the elements within the ombudsman's decision.
 

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.

It is important that I emphasise that the decision to reject my complaint turned on the ombudsman's acceptance that there was a "process" and that by following this "process", Aviva had acted fairly.


My service complaint is based on my entirely reasonable belief that the ombudsman has never seen the Aviva "process".
Because the ombudsman had never seen the Aviva "process", the ombudsman was unable to know whether the "process" had been followed.
The ombudsman found that by following the "process" Aviva acted fairly. It was impossible for the ombudsman to reach this decision when they had never had sight of the "process", had no direct knowledge as to whether the "process" had been followed and were unable to judge its fairness in any event.


Aviva themselves admitted that the call handler who took the original fraudulent telephone call was suspicious and uncomfortable about setting up the policy and so they decided to refer the matter to a manager.


It is clear that 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.
One might say that the failure by the Aviva call handler to rely on her own instinct and the overriding of her concerns by her manager were the root cause of everything that happened as a result.

 

On 2 June 2021 I received a phone call from Aviva complaints department and during that 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.

Clearly there was a "process" in place but it seems it was not followed. 
In other words, if the call handler in XXX year had adhered to the Aviva “process” the fraudulent policy would never have been provided.


 

My complaint is:

The ombudsman did not require to see any document laying out the Aviva “process” and that they have simply accepted Aviva’s word for it.

It may be that Aviva has deliberately or inadvertently misled the ombudsman.
The ombudsman did not enquire as to whether any "process" was followed by Aviva.
The ombudsman did not assess and Aviva "process" for fairness.

 

If that is the case then the ombudsman’s investigation was not complete and this must surely fall below the FOS service standards.

 

Although this is not directly relevant to the ombudsman investigation or to my complaint, you may be interested to know that on XXX date my brother was arrested by the police and charged with an offence in relation to this fraud and others.

It should go without saying that if my brother has profited from the proceeds of crime in the form of fraudulently obtained loans and insurance policies then the victims of these thefts are the insurance companies or lenders which have been dishonestly persuaded to provide him with their money or the services.

It is a wholly unacceptable situation that I, as a victim of domestic abuse, should be required to repay to Aviva the proceeds of my brothers fraudulent activities and also be saddled with the catastrophic effect upon my own financial reputation amongst credit reference agencies and financial institutions.

The ombudsman service by its failure to conduct a proper investigation has been complicit in this unfair treatment of me and complicit in the domestic abuse of which I am a victim.

For the avoidance of doubt, domestic abuse is not necessarily limited to the immediate family but also can occur within the extended family.

An encouraging article written recently by Theresa May pointed this out and of course it is true. (I can provide you with a reference for this if you want.)

I would point out that I have attempted to obtain the ombudsman service policies on domestic abuse and also the domestic abuse policy of Aviva, and neither have been forthcoming.

 

Finally I would ask the Independent Assessor to consider whether the FOS has complied with the FCA guidance in DISP 3 - https://www.handbook.fca.org.uk/handbook/DISP.pdf - in particular the requirements in DISP 3.6

 "the Ombudsman will take into account:
(1) relevant:
(a) law and regulations;
(b) regulators' rules, guidance and standards;
(c) codes of practice; and
(2) (Where appropriate) what he considers to have been good industry practice at thee relevant time"

 

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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I've moved the post to this original thread. We are keeping the other one for the data protection issue.

I'm not quite sure where we are. Is the draft above okay? If there are things to be added then what are they?

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Fit within letter a question, Did the FOS really follow the FCA rules and apply them diligently ?

 

https://www.handbook.fca.org.uk/handbook/DISP.pdf

 

DISP 3 : Complaint handling Section 3.6 : Determination by the
procedures of the Financial Ombudsman
Ombudsman Service

3.6 Determination by the Ombudsman
Fair and reasonable.....................................................................................................
The Ombudsman will determine a complaint by reference to what is, in his
opinion, fair and reasonable in all the circumstances of the case.

Section 228 of the Act sets the 'fair and reasonable' test for the Compulsory
Jurisdiction (other than in relation to a relevant complaint within the
meaning of section 404B(3) of the Act) and n DISP 3.6.1 R extends it to the
Voluntary Jurisdiction.
Where a complainant makes complaints against more than one respondent
in respect of connected circumstances, the Ombudsman may determine that
the respondents must contribute towards the overall award in the
proportion that the Ombudsman considers appropriate.
In considering what is fair and reasonable in all the circumstances of the
case, the Ombudsman will take into account:
(1) relevant:
(a) law and regulations;
(b) regulators' rules, guidance and standards;
(c) codes of practice; and
(2) (where appropriate) what he considers to have been good industry
practice at the relevant time
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Based on the suggestion by my site team colleague @unclebulgaria67I have introduced an amendment – coloured in red. Obviously change the colour back to black but I think that you can consider that the letter is now complete and that you should send it off by email and also by recorded delivery.

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It's probably too late - and if it is I don't think it matters a great deal as I'm sure it's been covered adequately already - but there is one particular aspect of this that nags away at me and might be worth including if not already covered.  And that's to do with the conduct or method behind the ombudsman's decision.

 

The decision seems to be predicated on the finding that Aviva  correctly followed their internal procedures and policies, and that therefore they did nothing wrong.  This seems to me to be blatantly flawed logic in the conduct of the investigation and leads to a manifestly unfair outcome for the OP.

 

It would appear from the ombudsman's investigation and decision that Aviva has a policy which allows person A, purporting to be acting on behalf of person B, to contact Aviva and to open an insurance policy in the name of person B, and that person B can be held contractually liable under that policy without ever being aware of its existence, and without Aviva even checking that person B has given person A authority to act on their behalf.  The ombudsman appears to have decided that because Aviva followed their internal procedures/policies (no matter how stupid, unreasonable or unfair they might be) then they cannot have treated person B unfairly or unreasonably.  That is outright bonkers and cannot procedurally be correct.

 

What that means is I could contact Aviva and, purporting to be acting on behalf of HM Elizabeth II, open a policy in her name insuring a fleet of bulletproof Rollers.  And when HM failed to pay up on the premiums, Aviva could put a default on her (good luck with that by the way) and if HM complained to the ombudsman they would simply say:  "Very sorry Ma'am, but I'm afraid you haven't been treated unfairly or unreasonably in this instance".  I don't think so!

 

I cannot believe that the ombudsman can be right to reject a complaint simply on the grounds that the insurance company followed its policies if those policies are inherently and manifestly unfair, unreasonable and downright stupid.  And in this case I'd go further - the policies enable and are complicit in the potential commission of fraud against innocent third parties.

 

So, the point I'm making is that if the ombudsman follows what appears to be their own procedural rule or methodology that so long as the subject of the complaint follows their own policies then the complainant cannot have been treated unfairly etc, then that is manifestly wrong if the policies in question are unreasonable or unfair ab initio.  This point applies to ALL ombudsman investigations and not just the current one.

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@Manxman in exile its very frustrating and mind boggling all of this thank you for your input I've emailed the letter above to the independent assessor and posted a hard copy to hopefully they will see that this can't be right and Aviva have somewhere down the line cooked this whole thing up and need to take ownership of their actions instead of coming after me for money when I've had no use of the insurance 

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The points referred to above by MIM have been dealt with in the letter

Quote

My complaint is:

The ombudsman did not require to see any document laying out the Aviva “process” and that they have simply accepted Aviva’s word for it.

It may be that Aviva has deliberately or inadvertently misled the ombudsman.
The ombudsman did not enquire as to whether any "process" was followed by Aviva.
The ombudsman did not assess and Aviva "process" for fairness.

 

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1 hour ago, Titchytitch said:

@Manxman in exile its very frustrating and mind boggling all of this thank you for your input I've emailed the letter above to the independent assessor and posted a hard copy to hopefully they will see that this can't be right and Aviva have somewhere down the line cooked this whole thing up and need to take ownership of their actions instead of coming after me for money when I've had no use of the insurance 

 

Just one question - and apologies for asking it.  (I think it's got nothing to do with today's deadline, so it's not urgent or anything, and further apologies if it has already been raised.).

 

Another plank in the ombudsmans' "reasoning" was that you must have known about the insurance policy in your name because Aviva had sent you umpteen letters regarding it.  You say you never received those letters.

 

Either in this thread or the other one I seem to recall you mentioning a "family meeting" or suchlike attended by, amongst others, your brother and your husband, at which this insurance matter was discussed.  Is it at all possible that your husband (or another family member?) had intercepted the letters sent by Aviva to you at your home address before you received them?

 

Ethel Street asked pretty much the same question at point (3) of their post #12 in this thread, but I'm not sure you ever answered it?  They were pointing out that the ombudsman's decision fairly clearly indicated that they did not believe that you had never received the letters from Aviva.  

 

Could the letters have been intercepted and did you ever tell the investigator this?

 

Again - apologies for asking but I've formed the impression that you are not on the best of terms with the rest of your family... 

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There are two issues here.

Firstly, the way in which the policy was set up.

Secondly, the conduct of the policy over a period of time and the apparent communications by Aviva with the OP.

Although there have been references in the ombudsman's decision to the communications which Aviva say that the OP must have known about, the main thrust of the investigation was the way in which the policy was set up in the first place.

The ombudsman's decision identifies no direct evidence that the OP didn't receive any communications. Aviva have either failed or have declined to produce any evidence that their communications were received by the OP.
The ombudsman's conclusion on that aspect of the matter is simply speculative – that the OP must have seen the communication.

On the other hand, all the evidence of a fraudulent third-party unauthorised initiative by the brother is clearly evidenced and is admitted by Aviva and is accepted and is commented upon by the ombudsman.

The root cause of this issue is the fact that Aviva were prepared to set up a policy in the name of a stranger simply on the say-so of an unknown person on the telephone who claim to be the husband of the policyholder even though he used a different name and a different address and according to Aviva was clearly not prepared to let them speak with "his wife".

The rest of the story is predicated on the claim by Aviva that this was a valid policy which was badly set up and that they acted properly in agreeing to set it up in the way that they did.

If it were true that the OP did come to know of the policy and then became complicit in the continuation of the fraud, nobody has actually come out and said that or proved it.

So what I hear is being suggested is that the OP, being eventually in receipt of the communications, went along with it and therefore legitimised a previously non-legitimate insurance policy.

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@Manxman in exile the brotehr had told the police it was a verbal agreement that as set up whereby I was present my husban my late father my eldest brother and him.

 

I was at my own home with my toddler at the time ,if there was a verbal agreement why did he claim to be my husband to aviva?

 

Aviva have sent me a boxful of generic letters which I haven't received at all he also had me as registered keepers for his car again no v5 documents came to  me and he sold and transferred cars so either hes forged my signature or he's done it all online so where these letters have gone is a complete mystery all I can think of is the fact he had access to the insurance portal so they sent him all the documentation 

 

I have asked aviva to send me anything with my signatures on as it didn't come through int he subject access so I think he has been intercepting with the mail as I didn't receive anything even with the fraudulent loans I only found about them through my credit report x

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52 minutes ago, BankFodder said:

...
If it were true that the OP did come to know of the policy and then became complicit in the continuation of the fraud, nobody has actually come out and said that or proved it.

So what I hear is being suggested is that the OP, being eventually in receipt of the communications, went along with it and therefore legitimised a previously non-legitimate insurance policy.

 

It's not entirely clear to me what you are saying, but isn't that exactly what the ombudsman has found in their decision?

 

"However, despite this, I am unable to accept that Mrs B knew nothing at all about the policy. Aviva have provided us with evidence that they sent 12 letters to Mrs B at her address during the time the policy was active, including renewal letters, all to her home address. Mr Z did not live at that address and so I can’t see how at least some of the letters would not have reached Mrs B.

 

In 2017 Aviva also issued a letter to Mrs B at her home address following concerns being raised by the police after pulling Mr Z over. The letter asked Mrs B to provide a copy of her driving licence, the V5, and a recent bank statement. These documents were subsequently returned to Aviva in line with the request."

 

Decision Reference DRN-2022549 (financial-ombudsman.org.uk)  page 3

 

Ethel Street picked up on that at the outset and said something like "to put it bluntly, the ombudsman thinks you are lying" and then went on to ask the OP if anybody could have intercepted her mail.  I don't know if the OP answered that question or not, but if she didn't I'm not attributing any complicity to her and I'm not accusing her of lying, I'm assuming she missed the question or otherwise overlooked it.

 

The reason I asked the question again is that if somebody sent me 12 correctly addressed letters it would be inconceivable that I would receive none of them - that is unless they were intercepted by my wife, who is the only other person who could have access to my mail ahead of me.

 

I don't know what the domestic arrangements of the OP are, but the ombudsman clearly states that the brother does not live at the same address.  So that suggests to me that, assuming the letters were intercepted before reaching the OP,  they must have been intercepted either by the OP's husband or by a member of the OP's family living at the OP's address.  And given the behaviour of her brother, I don't think I'd put intercepting her mail beyond other members of her family or even her husband.  Someone at the OP's address must have done it.

 

It seems to me that if the ombudsman puts such store on the 12 letters sent to the OP (and the ombudsman appears to be satisfied that they were sent) I'm wondering if the OP was ever given the opportunity to rebut the omdudsman's conclusion that she must have received them.

 

In any event, if I were the OP I would want to know exactly how 12 correctly addressed letters have gone missing and I'd be asking myself who would have intercepted them.  Of course, it may come out in the criminal investigation and I would have thought questions about the interception of the letters might be asked in the course of that investigation.

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"However, despite this, I am unable to accept that Mrs B knew nothing at all about the policy. Aviva have provided us with evidence that they sent 12 letters to Mrs B at her address during the time the policy was active, including renewal letters, all to her home address. Mr Z did not live at that address and so I can’t see how at least some of the letters would not have reached Mrs B.

 

It's very clear from the wording that this is mere speculation. He finds unbelievable – but he has got no evidence to show that the OP had received the communications.
The OP has told us that she hadn't received them and she explained why. I'm not aware that she was given an opportunity to explain this to the ombudsman.

Anyway, it's over now. I expect that the independent assessor's report will be a whitewash job as well and so it's now down to attacking Aviva directly on data protection issues

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Having had responsibilities for records management for a large Insurers, it is totally believable that no letters were received.  Data records in regards to letters being sent are not very reliable.  

 

But the crux of the matter is Aviva allowing the policies to be issued in the first place. 

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@unclebulgaria67 I believe they sent the letters into the portal for customer to access and prob communicated more via email and online but I had no access to that portal.

In the same way he asked the loan company for outstanding monies on a loan they said they could only give that information to the account holder which was me, if I wasn't present they would email the statement so of course he can access the statement as it was his email linked so I was none the wiser and neither the companies.

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@BankFodder response from independent assessor 

 

Your complaint about the Financial Ombudsman Service: PNX-3555972-Y8B1

 

Thank you for your correspondence received 8th October 2021. I am a caseworker and I assist the Independent Assessor.

 

I have reviewed your concerns and I believe there may be some misunderstanding about the role of the Independent Assessor.

 

The role of the Independent Assessor

 

The Independent Assessor’s role is to review the practical handling of cases investigated by the Ombudsman Service. Practical handling covers customer- service related concerns such as, delays, staff attitude, lack of correspondence, not advising of the right to an Ombudsman review, etc.

 

It is not the Independent Assessor’s role to review a case against the financial business or to assess how the Service chose to investigate the matter.

 

The investigation of a case, including the information requested, the weight attached to the information and the outcome of the case all fall within the judgement of the staff of the Ombudsman Service, as does who is assigned to a case. The Independent Assessor cannot challenge the Service’s judgment on any of the above as set out in her Terms of Reference.

 

Nor can the Independent Assessor’s comment on or change the Service’s processes including the way it trains its staff, who it employs, its investigatory methods or any procedures or policies it adopts.

 

What this means for your complaint

 

As your complaint concerns the judgement of the Ombudsman in deciding upon the case, the Independent Assessor is unable to take your complaint further.

 

Why you were referred to our office

 

The Ombudsman Service has to refer customers to our office, and tell them the timescale in which they must do so. However, only our office can confirm whether or not a complaint falls within the Independent Assessor’s remit or if a case is ready for her to review.

 

No further action will be taken at this stage

 

I understand you are unhappy with the outcome reached by the Service.

As a decision has been issued on the case, you would need to consider seeking further advice if you wished to take the matter further.

 

Unfortunately, there is nothing more this office can do to assist you.

 

As a result, we only respond to further correspondence if you come back to us with concerns we consider the Independent Assessor can address, or we have something useful to add.

Edited by Titchytitch
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Thank you for this letter.

I'm afraid I disagree with you that I am challenging the ombudsman's decision.

It clear from my letter that I and criticising the way that the decision has been arrived at. I understand very well that you will not change the ombudsman's decision and I'm not asking you to do that.

However I am complaining that the ombudsman's approach to the problem has not been fair – and in particular the ombudsman has not informed themselves as to the process used by the insurance company, whether that process was actually applied, what the process is. It also appears that the ombudsman has assumed that if there is a process in place then it must be fair.


I'm also complaining that the ombudsman has not complied with FDA requirements in DISP 3.

Of course I understand very well that if eventually you agreed with me that my criticisms of the way the ombudsman has carried out the investigation are justified, although you would not overturn the ombudsman's decision, this would certainly put the decision into a kind of limbo – but it seems to me that that is the inevitable result of any complaint against the way that an ombudsman has formed a decision.

So once again, I am not ask you to overturn the ombudsman's decision. I'm asking you to look at the process by which the ombudsman arrived at that decision.
No more than that.

Yours sincerely

 

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@BankFodder response from aviva 

 

Good Morning,

 

I am emailing today to confirm to update that we are not in a position to provide a response to your query just yet, we are currently reviewing all data held again to locate if there is anything further to provide in line with your query.

 

I will provide a further update by the end of the week.

 

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Dear XXX

Thank you for this message.

I don't fully understand why you are not able to provide me with the information I am seeking or to confirm that you don't have it.
You recently complied with a subject access request but only after you relied on a statutory extension for some reason which I didn't fully understand.

That means that you have had three months to understand the content of your files in respect of my personal data and in respect of which you apparently made a full disclosure.

I'd be grateful if you clarify what might be the problem.

Yours sincerely

 

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@BankFodder I've spoken to the police officers supervisor and he has basically said I can put a complaint in on the police website can you please help me draft a complaint based on what I've told you ? 

 

For everyone else's reference the police are not taking this further as the police are saying there's not enough evidential evidence to take this to cps

 

My eldest brother had given a false statement to say a verbal agreement was made in his presence along with my hubby but they never saw eye to eye with my husband as we eloped to marry, so they have never shared rhe same space as each other 

Aviva believe a verbal agreement was present "yet he claimed to be my husband" when setting the policy up and they are saying they have sent me letters which I've received 

 

So in short no further action will be taken but I can put a complaint in and the police are saying its a civil matter not criminal so any questions I've put to the police they have said I need to take it up with Aviva and they have refused to take a statement from my husband or the extended family member to whom they admitted to reversing the insurance premiums 

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No point in making any further complaint to the police.

I think you are already starting to understand that the ombudsman won't help you, the independent assessor won't help you, the police won't help you.

None of this is surprising.

You will have to go it alone.

Write out your own statement explaining why this story of a verbal agreement must be untrue.
Get your husband to do the same thing – independently.
I understand that you may have a cousin to whom your elder brother has already said that he had no idea what was going on with the insurance. Try and get a statement or recording of him saying that or an exchange of SMS messages.

 

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