Red Sands Insurance Company (Europe) Limited · DRN-5877740

The complaint Miss C’s complaint is about a claim she made on her Red Sands Insurance Company (Europe) Limited (‘Red Sands’) pet insurance policy. Miss C says Red Sands treated her unfairly. What happened Miss C’s pet received a diagnosis of gastrointestinal disease from its vet for which it received treatment. Miss C made a claim in respect of this and paid an excess for that diagnosis. In March 2025 Miss C’s pet was treated for breathing difficulties and then anaemia. Red Sands applied a separate policy excess for these claims to the earlier gastrointestinal disease. Miss C was unhappy with this and said the problems were linked to it so no excess should have been applied. Red Sands considered things and asked for evidence from Miss C’s vet. The evidence was overall inconclusive but suggested that the anaemia could be linked to the gastrointestinal disease. As a result, Red Sands agreed to treat the claims for both anaemia and breathing difficulties as part of the gastrointestinal disease. Miss C’s complaint is that the second policy excess she paid was not returned to her by Red Sands. Our investigator considered her complaint and concluded it should not be upheld. Miss C does not agree so the matter has been passed to me to determine. 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. Having done so, I don’t uphold Miss C’s complaint. This is why. The policy provides cover of £1,000 of veterinary fees per condition per policy year, with one excess deductible per condition. From what I’ve seen Miss C’s claim for gastrointestinal disease, when combined with the claim for the anaemia and breathing difficulties came to £1,235.35, so £235.35 over the policy limit. Red Sands paid her vet this sum. This seems to have occurred because Red Sands initially treated the March 2025 claim as distinct from the gastrointestinal disease. But after complaining that they should not have done that, Red Sands eventually accepted Miss C’s position that only one limit should be applied. Red Sands say that they’ve overpaid on Miss C’s claim but are not seeking reimbursement from her in respect of this. Miss C says that Red Sands should refund the second excess she paid them because it was their mistake that they overpaid her veterinary practice. I don’t think that’s reasonable.

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The reason Red Sands overpaid Miss C’s claim was because it was treated as distinct from the earlier gastrointestinal disease. I can see why. There was nothing in the clinical notes that identified the anaemia or breathing difficulties as connected and even after Miss C argued that they were, the veterinary evidence was not conclusive. But given her position and an indication that they could be linked by her vet, Red Sands agreed to accept what Miss C was saying. The impact of this was that they’d overpaid beyond what they should have and Miss C should have made up the £235.35 herself. The fact that Red Sands are not asking her to do so is more than reasonable in my view. I don’t however think that Red Sands now need to pay her an additional £99 in respect of the second policy excess she paid. The second excess she paid brings their overpayment down to £136.35. Again, that’s more than Miss C was entitled to have funded under the policy. And given Miss C’s position was always that the March 2025 claim should be treated as part of the gastrointestinal disease claim, her entitlement would always have been less than the amount she has already paid out. If things had gone as they should, Miss C would have paid a total of £235.35 herself. The fact that Red Sands aren’t seeking this from her is reasonable. As such I won’t be directing them to pay her anything further. Miss C has asked what rule the investigator relied on when he reached his conclusions. The relevant term is the £1,000 policy limit here. And I don’t agree that Red Sands did something wrong by paying more than they should here for the reasons I’ve set out above. Rather Red Sands agreed to do what Miss C wanted them to do. The net result was that a £1,000 policy limit applied. The fact that she has ended up paying £99 instead of a total of £235.25 is more than she is entitled to in the circumstances. My final decision For the reasons set out above, I don’t uphold Miss C’s complaint against Red Sands Insurance Company (Europe) Limited. Under the rules of the Financial Ombudsman Service, I’m required to ask Miss C to accept or reject my decision before 14 April 2026. Lale Hussein-Venn Ombudsman

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