Utmost Paneurope DAC v The Financial Services & Pensions Ombudsman (Unapproved) [2022] IECA 77 (30 March 2022)

Utmost Paneurope DAC v The Financial Services & Pensions Ombudsman (Unapproved) [2022] IECA 77 (30 March 2022)

The Court of Appeal held that the FSPO must have due regard to the Consumer Protection Code when assessing the reasonableness of a financial service provider's conduct, but the failure to expressly analyse the Code in this case did not affect the outcome because the obligation to verify claims was acknowledged and did not alter the assessment of Utmost's conduct. The FSPO cannot direct payment under a policy absent a finding of contractual entitlement.

Citation
[2022] IECA 77
Parties
Appellant/respondent: Utmost Paneurope DAC; Respondent/appellant: Financial Services and Pensions Ombudsman; Notice Party: W
Jurisdiction
Ireland
Judgment Date
30 March 2022
Procedural Posture
Statutory Appeal Under S.64(6) of the Financial Services and Pensions Ombudsman Act 2017 / Court of Appeal Judgment on Questions of Law Following High Court Decision
Outcome
Appeal dismissed; High Court decision affirmed in substance
Legal Topics
Ombudsman Jurisdiction, Consumer Protection Code, Insurance Contract Exclusions, Standard of Review on Statutory Appeal, Remedies in Statutory Complaints
Administrative Law Insurance Law Financial Services Regulation Ombudsman Jurisdiction Consumer Protection Code Insurance Contract Exclusions Standard of Review on Statutory Appeal Remedies in Statutory Complaints

Case Brief

Summary, issues, holding and outcome

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Parties

Utmost Paneurope DAC

Appellant/respondent

Financial Services and Pensions Ombudsman

Respondent/appellant

W

Notice Party

Procedural Posture

Statutory Appeal Under S.64(6) of the Financial Services and Pensions Ombudsman Act 2017 / Court of Appeal Judgment on Questions of Law Following High Court Decision

Legal Issues

  1. 1 Is the Ombudsman required to have regard to applicable Central Bank codes when determining reasonableness of a financial provider's conduct?
  2. 2 Does the Ombudsman have jurisdiction to direct payment under a policy absent a breach of contract finding?
  3. 3 Can the High Court draw different inferences from documentation than the Ombudsman on statutory appeal?

Ratio Decidendi

The Court of Appeal held that the FSPO must have due regard to the Consumer Protection Code when assessing the reasonableness of a financial service provider's conduct, but the failure to expressly analyse the Code in this case did not affect the outcome because the obligation to verify claims was acknowledged and did not alter the assessment of Utmost's conduct. The FSPO cannot direct payment under a policy absent a finding of contractual entitlement.

Court Disposition

Appeal dismissed; High Court decision affirmed in substance

Orders

  • Decision of the FSPO set aside
  • Matter remitted to the FSPO for review by a different decision maker, having regard to the Code