The Ombudsman's final decision
Summary: We will not investigate Ms X’s complaint about the Council allowing her mother’s life insurance payments to lapse. Further investigation would not lad to a different outcome and any financial responsibility owed by the Council is best decided by the Courts.
The complaint
Ms X complained the Council failed to make her mother’s life insurance payments after it took responsibility for her finances. She said because of this the life insurance policy lapsed. Ms X said the Council’s failure to continue the payments, means the estate has missed out on a life insurance payment following her mother’s (Mrs Y’s) death. Ms X said the Council has not confirmed whether it will reimburse the amount that the insurance company would have paid if it had maintained the policy.
The Ombudsman’s role and powers
We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or continue an investigation if we decide: further investigation would not lead to a different outcome.
(Local Government Act 1974, section 24A(6), as amended, section 34(B)) The law says we cannot normally investigate a complaint when someone could take the matter to court. However, we may decide to investigate if we consider it would be unreasonable to expect the person to go to court. (Local Government Act 1974, section 26(6)(c), as amended)
How I considered this complaint
I considered information provided by the complainant and the Council.
I considered the Ombudsman’s Assessment Code.
My assessment
The Council has accepted that it did not maintain the direct debit for Mrs Y’s life insurance policy after it became the Appointee for her finances. It said since Ms X’s complaint, it had sought legal advice around the status of a contested life insurance plan. It said it needed that advice to decide whether to reimburse Mrs Y’s estate for any insurance payment that would have been owed. The Council said getting this legal advice had taken longer than anticipated. It apologised to Mrs X for that delay.
The Council has set out its reasons for the delay and apologised. Although frustrating for Ms X, further investigation by the Ombudsman would not lead to a different outcome. We cannot expedite the requested legal advice. In addition, the Council’s decision whether to reimburse Mrs Y’s estate is a decision around it accepting financial liability for allowing the policy to lapse. It would not be unreasonable for Ms X to pursue any claim around this at court because it is the only body which would be able to decide the liability issue.
Final decision
We will not investigate Ms X’s complaint because further investigation would not lead to a different outcome, and it is reasonable for Ms X to consider court action around the life insurance policy.
Investigator's decision on behalf of the Ombudsman