Successfully negotiating claims since 1867
“The insurance business, for instance, depends on the fact that insurers charge customers more than their insurance is worth; that’s fair enough, since if they didn’t do that they wouldn’t be viable as businesses. What isn’t fair is the panoply of cynical techniques that many insurers use to avoid, as far as possible, paying out when the insured-against event happens. Just ask anyone who has had a property suffer a major mishap.”
Not our words, but those of John Lanchester, financial journalist and novelist, writing in the London Review of Books. They’re words that reflect our experience. In 2012 and 2016 Parliament passed acts that give the insurance buyer much more protection against the strategies most often used by insurers to avoid paying: misrepresentation in the application, and breach of condition and warranty. But insurers are always inventive and we have noticed a disturbing trend, most often used against vulnerable policyholders, individuals and micro-businesses, who have bought directly, rather than through a broker. Now that the traditional get-outs are not available, insurers are looking for evidence of fraud to avoid claims, especially those that carry a large reserve.
The Treating the Customer Fairly (TCF) principle demands clarity and transparency in dealings. This means that policyholders interviewed by an adjuster or fraud investigator shouldn’t be asked to sign something without being told its nature or purpose and without being given a copy that they’re free to amend or withdraw. There is nothing fair or clear or transparent or in accordance with the rules of natural justice about insurers relying on phone conversations to allege fraud, the transcripts and audio files of which they refuse to disclose.
Unhappily, at Thompson and Bryan we have a number of files displaying these behaviours. Should you believe that you – or for brokers, your client – are under scrutiny in a manner you feel unfair or unreasonable, you should quickly seek professional advice. The longer you wait, the more difficult resolution of your claim becomes. Don’t commit anything in writing before doing so. Our contentious claims team will always offer advice.