Insurance Disputes

In many cases you will be insured for claims made against you, in which case you ought to refer them to your insurer immediately. We have a niche practice representing insurance companies and business clients in relation to defending personal injury and other liability claims (please see Insurance Disputes.)

In some situations you may need to instruct us to defend a claim directly on your behalf or to deal with an insurance related claim. We have the experience and resources to deal with a wide variety of insurance issues, ranging from small claims cases that are settled without recourse to litigation, as well as high value disputes with complex points of law requiring settlement by the courts.

You may have received a claim in relation to which there is no insurance cover. There can be many reasons for this. It may be that the insurance company is unable to provide you with cover (see Cover disputes). It may be that the claim relates to an event which occurred a long time ago and you have no record of your insurance cover. This is common in claims such as those arising from asbestosis and hearing loss, but can also occur with other types of claim.

The first step in dealing with these situations is to determine whether there are any insurance policies available which may provide full or partial cover. For historical events we are able to instruct insurance archaeologists on behalf of our clients who will undertake searches to determine whether a policy was in place and, if so, with whom. There have been several instances where suitable insurance cover has been found to have existed at the time of the incident, despite the policyholder not being aware of this fact.

Alternatively, it may be the case that you simply did not purchase insurance because you had not contemplated the risk which has given rise to a claim. You may also have had insurance cover in place but there may have been a gap in that cover whereby you were not covered on the date when the event giving rise to a claim occurred.

In these situations we can advise you on your available options and we can also assist you in personally defending claims should the need arise.

If a claim has been made against you, your immediate concern will be whether your insurance policy will provide cover in order to limit your personal liability.

If you have suffered loss or damage to your vehicle or property you will be looking to ensure that your insurance policy will cover you for the repair or replacement that is required.

Hearing that your insurance policy does not cover you for a specific situation can be extremely frustrating. Many of our clients approach us for advice on how to proceed in these circumstances and to discuss the options available, including reviewing policy documents and wording of clauses.

We are seeing a rise in these types of claims, known as first party disputes, which have become increasingly important in the current economic climate. These disputes are generally between an individual or business and their own insurance company, usually over questions of indemnity when a claim is made.

Our team will thoroughly analyse the insurance contract between you and your insurer to determine whether the insurance policy should provide appropriate cover in the circumstances.

We can also consider the clauses and terms of the contract to advise you of your options in relation to the claim. Interpretation of the wording of an insurance policy can often be an important factor in whether a matter is successful or not.

Often first party dispute cases involve allegations of non-disclosure whereby indemnity is refused due to the policyholder’s failure to inform the insurer of a certain fact. These cases frequently turn on whether the alleged non-disclosure by a policyholder is material. The test is essentially that something is material if it would have influenced the judgment of a prudent insurer in fixing the premium or in deciding if it would take the risk.

Our team is comprised of skilled negotiators who are experienced in dealing with insurance matters. We ensure that we are constantly aware of the latest legal updates in relation to insurance developments and relevant case law so that we are able to provide our clients with an efficient and effective service based on a solid foundation of knowledge.

Insurer conduct

You may have concerns about the conduct of your insurer or broker in relation to the performance of the insurance contract, or in relation to the sale or suitability of the policy in the first place.

A number of our clients approach us as they feel they have been provided with an insurance policy that is either not appropriate for their requirements or unnecessary in the circumstances.

We can advise you on the processes involved in dealing with a claim of this nature and can assist in the resolution of any subsequent dispute that may arise.

We can also provide assistance to our clients who require representation before a formal organisation such as the Financial Ombudsman Service.

Cyber liability is one of the biggest issues facing the U.K. today with cyber-attacks continuing to grow in both number and size.

Cyber liability insurance is designed to cover consumers of technology services or products. More specifically it tends to be designed to cover losses that may arise from electronic activities such as trading on the internet or collecting data within an internal network. Most notably it may cover liabilities arising from data breaches when personal information is stolen by hackers who have gained access to a network.

Cyber losses often give rise to complex insurance coverage and recovery issues for which specialist insurance advice is required.

The team at Trethowans are skilled at dealing with insurance matters for insurers and business clients as well as policyholders, SMEs, their officers and directors, and other individuals in connection with insurance issues and claims.

Business interruption insurance provides cover for financial losses which arise as a consequence of property damage and which impacts on the profit, market share, growth and performance of a business. The cover is intended to aid the financial circumstances of the policyholder until it reverts to what it would have been if the claim did not occur. It should also cover continuing costs and extra costs incurred in order to mitigate losses.

Business interruption losses can be particularly problematic with difficulties arising in relation to appropriate indemnity periods, inadequacies in the sums insured and disputes over the quantification of the claim and the supporting evidence. We have links with specialist forensic accountants with whom we work as part of a team in order to deal with claims to be pursued by litigation, arbitration or some form of ADR.

Due to the complexities of business interruption cover in calculating the correct sums insured and indemnity periods and the range of different products available; under insurance or lack of insurance are common problems often leading to an investigation of a potential claim against the client’s insurance intermediary.

Business interruption cases often give rise to complex insurance coverage and recovery issues for which specialist insurance advice is required.

The team at Trethowans are skilled at dealing with insurance matters for insurers and business clients as well as policyholders, SMEs, their officers and directors, and other individuals in connection with insurance issues and claims.

If you think your previous solicitor dealt with your personal injury claim negligently you may now be able to make a claim.

Alternatively you may feel let down by the conduct of a barrister or an expert in relation to your personal injury claim.

We are well placed to help you with your case as we have specialist teams of insurance litigation and personal injury lawyers.

The following may indicate negligence:

• Failing to take full instructions from you
• Failing to consider all aspects of your claim
• Losing your claim
• Under-settling your claim
• Failing to issue your claim in time

There is a 6 year time limit from the date of any professional negligence but it is best if you contact us without delay.

As more people travel abroad, inevitably legal disputes spanning different countries are becoming increasingly common.

In some circumstances a compensation claim could be pursued through the Courts in England and Wales if the person has been injured or suffered an illness abroad.

Examples of typical claims that arise whilst abroad include:

• Accidents or illness on holiday;
• Accidents whilst working;
• Accidents on ships;
• Accidents on aircraft;
• Road Traffic accidents;
• Sports injuries.

In many cases, even though the accident itself may have occurred in a foreign country, it is still possible to bring a personal injury claim through the legal system in England and Wales (particularly if the accident occurred in the European Union).

We may also be able to act on your behalf if a claim is being pursued against you arising out of an incident abroad or travel, which is not covered by any insurance.

We may also be able to assist you in respect of any cross border insurance issues which may have arisen, such as problems with your travel insurance cover.

Whatever the nature of your problem, cross border claims can raise complex legal issues and it is therefore important to seek specialist legal advice as soon as possible. The team are experienced in dealing with these types of claim and would be happy to answer any questions or queries.

We are active members of PEOPIL (Pan European Organisation of Personal Injury Lawyers).

The team also has extensive experience of defending international claims, ranging from defending drivers involved in Road Traffic Accidents within the European Union to dealing with claims made by holiday makers.