Case Studies

2015

Case Study 1 Phishing

Phishing

What is phishing?

Phishing is a form of fraud. A fraudster will try to obtain information from consumers such as login details or account information by pretending to be your bank. They may do this in an email, text, by phone or using other communication channels.

Usually a consumer receives a message that appears to have been sent by their bank. The message will contain an attachment or links in the message which may install malware on the user's device or direct them to a malicious website set up to trick them into telling personal and financial information, such as passwords, account numbers or credit card details. Fraudsters, once in possession of these details, may then access your accounts and defraud you of your money.

Banks may on occasion send you marketing information on new or existing products. It is important to note that these emails will not ask you for Internet Banking login details or personal information.

If you have any suspicions you should contact your bank immediately using the contact number on your credit/debit card or from their authentic website.

Banking complaint - current account - phishing - fraudulent transactions - customer care - partly upheld - award of €500

Background

Maura's computer was hacked into and she contacted her bank to alert them of the situation. The bank placed a caution on her account and said that she could cancel her card if she wished. Maura declined to do so. A few days later Maura got an email, which given that her computer had been hacked into, she believed to be from her bank. Maura disclosed her account details via the email. It is not known if the computer hack and subsequent email were linked. Over the course of the next three days Maura's account was defrauded of €2,310.00 in separate transactions. On the third day Maura was contacted by the bank about the fraud. Maura does not think it fair that she must pay for an innocent mistake. Maura feels the bank had some responsibility to her for the advice on cancelling her card, and not informing her until the third day that her account had been defrauded.
The bank states that it does not have to monitor people's accounts under its terms and condition. It states that Maura acted in such a way that compromised her account and breached the conditions of her card and it is not therefore in a positon to refund her the stolen amount.

Key issues arising
  • Whether more advice should have been given to Maura regarding her decision not to cancel the card.
  • Whether the bank is responsible to monitor Maura's account.
  • Whether Maura breached the terms and condition of her card.

Outcome of the Ombudsman's investigation

The Ombudsman found that Maura, being the consumer in the position of having less information should have been given more information about the pros and cons of cancelling her card for safety reasons after her computer had been hacked.
The Ombudsman found that the bank was not responsible under the strict interpretation of the terms and conditions to monitor Maura's account. However, given that she had alerted it to the fact that her account had been hacked perhaps more scrutiny should have been given to the account by the bank. Maura's account was defrauded over three days and it was not until the third day that the bank contacted her. The Ombudsman was not confident that this corresponds to a high level of vigilance on the bank's part, given that it was put on notice of possible suspicious activity three days before hand. He directed the bank to pay €500 for lack of due care on both counts.
On the main issue the Ombudsman could only find that Maura had breached the terms and conditions of her contract and had disclosed her banking details to a fraudster which enabled it to steal from her account. He took the view, therefore, that the bank was entitled, on this basis, to refuse to refund the unauthorised transaction.

Case Study 2 Pre-existing medical conditions

Pre-existing medical conditions Pre-existing medical conditions

Pre-existing medical conditions complaints regarding the turning down of claims due to pre-existing conditions exclusions are seen across a range of insurance products including but not limited to travel insurance, medical expenses insurance, payment and mortgage protection insurance.

Insurance policies, generally, will not cover a person for any condition they had prior to the taking out of an insurance policy. In some cases whether the insured person was aware they had the condition is not a relevant factor. Certain pre-existing exclusions state that if an insured ought to have known they had a pre-existing condition or whether they had symptoms of the pre-existing condition it will not provide cover.

The Pre-existing exclusion, in general, is not reliant on telling this information to the insurer. It is a blanket clause which excludes cover for all pre-existing conditions. In some instances the clause excludes cover for a certain period of time and once that time period has lapsed the insured will be covered for the pre-existing conditions

If an insurance company relies on a pre-existing exclusion to turn down a claim, the onus is on it, to prove that the exclusion applied to the loss.

Insurance company - travel claim - pre-existing condition - customer care - complaint handling - upheld - award of €5,000

Aoife suffered from a medical condition in 2009-2010. She was symptom free when she booked a holiday and took out insurance cover in 2014. While on holiday Aoife had breathing problems and on a doctor's advice was admitted to hospital. Aoife was admitted to a private hospital and contacted her travel insurance company for assistance. Aoife was six days in the private hospital. On making a claim while still in the private hospital, Aoife was informed by the Insurance Company that there was no cover under her policy as the insurance company deemed her condition to pre-exist her insurance contract. Aoife, due to mounting bills was transferred to a public hospital. Aoife argued that her new condition had nothing to do with her previous condition. She also pointed out that she was extremely stressed waiting 6 days for a response from her insurance company. There was also a 5 month period in which she waited for a response to her complaint.

Key issues
  • Whether Aoife had a pre-existing condition.
  • Whether six days is considered too long a time to make a claim decision.
  • Whether there were customer service issues in the handling of the complaint.

Outcome of the Ombudsman's investigation

The Ombudsman questioned whether the insurance company had sufficient evidence to declare that the condition Aoife suffered from was pre-existing. The insurance company reviewed its medical file and agreed it did not pre-exist the contract and agreed to meet the claim.
The Ombudsman then turned his attention to the delays incurred and in doing so he considered that:

  1. Aoife did not receive full treatment in a private hospital.
  2. There were delays in her treatment that had a knock on effect on health and repatriation.
  3. The stress and trauma to herself and the family in trying to deal with the situation without the assistance of the Company.
  4. The time and effort involved in the appeals process.

The Ombudsman directed the insurance company to pay Aoife €5,000 for the reasons listed above.

Case Study 3 Chargeback

Chargeback

What is chargeback?

When you have a transaction on your credit card you may wish to reverse it for the following reasons:

  • You did not authorize the transaction or the merchant may have put the transaction through twice.
  • You did not received the goods or service you paid for.
  • The goods you received were faulty or otherwise not as described.
You should try and a get your money back first from the merchant. If you are not successful you should then approach your bank. It may be in a position to reverse the transaction. This is called a charge back.

Reason why a chargeback may not be reversed:
Time frames -Your credit card agreement will contain a timeframe in which the disputed transaction must be notified to the bank. If you exceed this timeframe your bank may not attempt to reverse the charge.

Banking complaint - credit card - chargeback - time limits - customer service - upheld - award of €350.

Cora brought some camera equipment online to the amount of €350 in August 2014. The equipment arrived without some parts. Cora, tried to resolve the matter with the online retailer but to no avail. In December 2014 she contacted her bank to make a charge back on her account as the goods she received were not as described. The request for chargeback had to be in writing and Cora states at no time in her conversations with the bank in December 2014 was this brought to her attention. The bank refused to proceed with the chargeback as Cora was outside the 120 day time frame to submit it. It states that its customer service representative would not have been in a position to tell Cora of the need for the request to be in writing as they were not trained in the area.

Key issues arising
  • Whether Cora was informed over the phone for the need to put her request in writing.
  • Whether the bank's representative who advised her ought to have known that she had to put her request in writing.

Outcome of the Ombudsman's investigation

The Ombudsman was mindful Cora stated that she contacted the customer service number listed on the Provider's website for information on chargebacks. It is a mystery, therefore, why the staff available did not have the requisite information on the chargeback process.

The Ombudsman was satisfied that the Cora was not informed, at any time during the telephone calls with the bank that there was an urgency on the matter and/or that the Chargeback Department would be unable to process the claim for her if the chargeback form was not received in writing. The Ombudsman was satisfied that the bank gave no indication to Cora that there might be a problem if the documentation was not received within the 120 days. This was most unsatisfactory.
Accordingly, the Ombudsman directed that the bank compensate Cora for its shortcomings by crediting her account with an amount of €350.