A private medical insurance provider which used scare stories about NHS waiting lists and patients dying while awaiting surgery in a promotional mailing has had a complaint against it upheld by the Advertising Standards Authority (ASA).

1st Medical Healthplans, based in Essex, claimed the mailing was probably distributed by one of its former agents who could not now be traced.

The literature said: "Warning. This presentation pack contains reading material that may be offensive and disturbing to some people." Inside, readers were told the story of a man who died after his local NHS trust had twice cancelled his heart bypass operation. The pack also contained press articles outlining problems on NHS waiting lists and a warning that paying for one's own treatment could swallow up savings. A recipient of the material from Bedfordshire objected to the ASA, which upheld the complaint.

The company said that the campaign had not been approved and agreed that the content was inappropriate. It added that employees were forbidden from distributing promotional literature without sanction from a company director. It promised to remind its entire sales force of their obligations.