Pinnacle Insurance Limited · DRN-5956474

The complaint Mr H has complained that his premium for his pet insurance by Pinnacle Insurance Limited had increased substantially on renewal making it both unreasonable and unfair. What happened Mr H took out two policies for his two cats in 2019. At that time the underwriter was not Pinnacle who took over underwriting this policy in around 2020. I shall call one cat Su and the other cat Sa in order to fully protect anonymity. Mr H’s complaint primarily centres around the premium increase he was asked to pay for Sa. Mr H needed to claim for his cat Sa over the years. He said that at renewal in July 2025 his premium to insure Sa increased from £1,265.40 per year to £2,105.52. He felt this was grossly unfair and unreasonable and complained to Pinnacle. Pinnacle didn’t think it had done anything wrong, as it felt it had calculated the premium in line with its underwriting guide. Mr H remained dissatisfied and brought his complaint to us. The investigator didn’t think Pinnacle had done anything wrong. Mr H disagreed and so his complaint has been passed to me to decide What I’ve decided – and why I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. First I do want to offer Mr H my condolences on the loss of his cat Sa, who sadly passed away suddenly, shortly after he brought his complaint to us. I am very sorry for his loss. Obviously that does mean that Mr H hasn’t had to continue to pay the increased premium for Sa but that doesn’t take anything away from the validity of his complaint. In pricing complaints such as this, our main role is to assess the factors which caused the premium increase and to ensure Mr H wasn’t singled out and treated differently to anyone else in similar circumstances. This is because all insurers are entitled to decide what risks they want to insure and what risks they don’t. This is part of their commercial discretion and is permitted by the regulations of the Financial Conduct Authority which regulates them. In order to be fair to all consumers, each insurer will have its own underwriting guide which details those risks which are being insured and how more importantly they are rated. This is obviously commercially sensitive information so although Pinnacle has shared its underwriting guide with us, I am not permitted to disclose this to Mr H as a member of the public and also given we publish our decisions. But I have seen it and analysed it. It’s clear to me that Pinnacle has followed its own underwriting guide. This means it applied the same rating to Mr H and his cat Sa as it would have to anyone else with the same claims history, age, breed, sex and other things, so it’s clear to me that Mr H hasn’t been singled

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out and treated differently. Pinnacle told me that in 2025, claims for Sa it had paid to date was £11,100.35. That will always have an impact on the renewal premium, as such claims then actuarially increase the risk considerably. Not always on the basis of what is diagnosed either, as Mr H believes, simply it’s the case that the amount of the claims paid will always affect the risk profile. However as this service isn’t the regulator, I can’t tell any insurer what premium price it should charge for the insurance it provides to any consumer. That simply isn’t within my remit. Further there is no legal requirement for pet owners to have pet insurance, although it can be very sensible, so it remains it was Mr H’s choice to insure his cats for the cost of vet fees and the other benefits provided. The next thing to look at is what warning and notices was Mr H given that lifetime premium rates might rise. Mr H took out his policies through another policy administrator and underwriter on what is called an ‘unadvised’ basis. Which means it was for Mr H to read the policy terms and conditions and other policy documentation to ensure this policy met his own needs. So as this complaint is only against Pinnacle, I can’t consider what Mr H might have been told at the time he bought the policy, as the investigator explained. If Mr H wants to complain about that, then he would need to raise a complaint separately against both the policy administrator and the underwriter at that time. Pinnacle has detailed what it said in its renewal documents which the investigator also more fully detailed in her view. I will paraphrase it as follows: Premiums (a) The premium for this policy is fixed for 12 months and reviewed annually on the anniversary of the policy start date. … (b) Each year, at least three weeks before the current policy year is due to end, we will send a renewal notice by your chosen method of contact setting out the new policy terms and conditions and premium for the next policy year. … When reviewing your premiums, we will consider any future impact to one or more of the following: 1.Changes due to new information arising from our own experience suggesting that our future claims experience is likely to be better or worse than previously assumed. This information includes changes to the number and types of claims we expect to pay or changes to the average expected amount paid per claim. 2. Changes due to new information arising from external sources such as general industry, population or reinsurer experience suggesting that our future claims experience is likely to be better or worse than previously assumed. This includes information on the cost of veterinary treatments (which may vary depending upon your location) and general information about the breed of your pet. 3. Changes to your circumstances such as the age of your pet, your claims history or any change to your address. … Any changes to your premium we make will not: 1. be made as a result of any reason other than changes in the assumptions mentioned in Section 5 D 4 (b) above; or 2. be made to recover any previous losses. (my emphasis). … As a result of the premium review, your premium may go up, stay the same or go down, and there is no limit to the amount of any change.’

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In the renewal of July 2025 Pinnacle also explained the following: Why is [name of cat] premium different to last year? There are different things affecting the price of your pet insurance including where you live and the breed of your pet. Vets charge different fees across the UK for the same treatment and some breeds are more prone to certain types of medical conditions in their lifetime. We’re very sorry if your premium has gone up, we try our hardest to limit any increases. The premiums of all customers pay for the claims of the few so unfortunately everyone is affected, even if you haven’t claimed. The table below explains the reasons why your price may be different to last year. Age of Pet: Sadly, as pets get older the risk increases as it is more likely they’ll have health problems and require treatment by a vet. This may increase Premiums, even if you haven’t claimed. Cost of vet fees and treatment: Whilst every vet practice differs, we’ve seen the overall cost of vet fees increase significantly due to high inflation. Fees charged by vet practices have to cover a range of costs including their staff salaries, equipment, medicines, premises and other overheads. All these costs have increased a lot for vet practices in recent years which pushes up vet fees. In turn this increases the amount insurers have to pay in claims. Developments in treatments, technology and medicine also mean vets can provide better care and treatment for our pets. But this means treatments are more expensive, we pay more in claims and premiums increase, even if you haven’t claimed. Claims: Your premium reflects any previous claims you’ve made with us. We expect those who have claimed for a previous condition or illness are more likely to claim again in the future. Your premiums are only fixed until renewal and you should expect them to go up every year. There is no limit to premium increases so these could be significant to you each year and over the lifetime of the policy. If a claim is paid on your policy your premium would more than double at renewal.’ So clearly Pinnacle did explain to Mr H that his premium might increase and indeed that claims would influence the amount of the increase substantially and there was no limit to premium increases. I’m afraid this is not unusual in the lifetime pet insurance market, given the well reported increases in vet fees and vet procedures over the past few years. So on the basis that Pinnacle followed its underwriting guide in setting the premium for Sa’s cover and that it further told him how the premium might change and why in its renewal invitation, simply means that I consider there is very little evidence to show that Pinnacle has treated Mr H unfairly here.

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Mr H raised the point that Pinnacle wouldn’t let him negotiate the premium amount by reducing his cover for Sa at renewal. I understand this element is being dealt with by a separate complaint as this wasn’t discussed in Pinnacle’s final response letter for this complaint. Lastly, I note that given Pinnacle’s delay in dealing with Mr H’s complaint, it paid Mr H £30 compensation as detailed in its final response letter. Mr H hasn’t raised any issue on this but for completeness sake, I consider this is reasonable for its delay and indeed is in line with our approach to compensation more fully detailed on our website. My final decision So, although I appreciate and understand Mr H will be disappointed with my decision, for these reasons, it’s my final decision that I don’t uphold this complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Mr H to accept or reject my decision before 3 April 2026. Rona Doyle Ombudsman

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