Insurance Disputes
- Our client, a business owner in the Midlands, suffered a severe fire at their premises. The insurer alleged that the “waste warranty” had been breached because wood shavings may not have been swept up, and alleged fraud on the basis that (they said) our client had given a different version of events immediately after the fire than later. We presented our client’s case to insurers who remained intransigent and refused our request to mediate. We then referred our client’s case to the FOS and dealt with detailed submissions to the Adjudicator and Ombudsman, resulting in a Final Decision rejecting all allegations of fraud levelled at our client and directing that the insurer should pay our client’s claim in line with Policy Terms.
- We represented a lady suffering from fibromyalgia. Her income protection policy provided for payment of a lump sum sufficient to redeem her mortgage but insurers refused to pay out. We pursued a complaint to the FOS and secured an initial decision that the insurer pay out under the policy. Given the unreasonable delay in the insurer accepting our client’s diagnosis, we subsequently secured a second payment via an FOS complaint to compensate our client for the additional capital and interest paid on her mortgage since the date insurers ought to have accepted her claim.
- Under a Directors & Officers’ Policy our client, a substantial business in the waste industry, received insurers’ authorisation to incur a significant level of legal fees for representation on an Environmental Agency investigation. Part way through proceedings, insurers alleged non-disclosure, withdrew cover and demanded return of costs already paid. We successfully negotiated an acceptable resolution to the situation with insurers’ solicitors.