Contractual and Insurance Disputes

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Third party motor insurance is mandatory for all vehicles in the UK unless you have arranged for a statutory off road notification to be filed with DVLA (SORN). When you have paid for your insurance, it can be extremely frustrating (and costly) to be told that the insurer will not pay out pursuant to the policy, either because of exclusion clauses they interpret to be applicable or because of an attempt to shift liability to a different party/insurer.

We have helped many clients fight against such injustice particularly when acquitted of a motoring offence charge such as drink driving making the exclusion clause previously relied upon redundant. The most notable pay-out we were successful in achieving being for the write off value of a brand new Aston Martin (£170k). Other non-motoring offence cases have ranged from values of between £50,000 and close to £1.5m.

Whilst the civil work we do normally has a connection to motoring or insurance disputes due to the nature of our sister firm, we are also able to assist in non-motoring or insurance matters.

Contractual disputes require a careful analytical approach to the strict wording and interpretation of the contract. To this end, we apply a collaborative approach working with barristers whose contractual know-how combined with our easy to understand strategic guidance, make the process and merits of pursuing a claim clear for our clients.

Permanent Health Insurance or Long Term Disability Payments Claims

If you have had to make a claim against a permanent health insurance policy, we understand the utter despair you probably feel if your claim has been rejected. Insurers often promise the earth when they think you will not claim against the policy but sadly, they will then use every technicality under the sun to prevent a pay out when you desperately need it.

It is not unusual for employers to offer long term disability payments as an employment benefit. These are essentially payments (normally a percentage of your salary) which you are entitled to if you are unable to work due to medical problems. These are not necessarily medical problems caused by your employment.

In almost all of these cases your employer’s payments are backed by a permanent health insurance (PHI) policy and your entitlement to payments under your employer’s scheme are linked with that PHI insurer’s liability to pay out.

It is common for employees to face considerable resistance when they attempt to make claims against these policies and for the employer and/or insurer to dispute any entitlement. Among the common grounds for dispute are:

  1. Challenges as to whether the employee has any medical condition.
  2. Arguments by insurers that the medical condition suffered by the policy holder is insufficient to require them to cease working.
  3. That the employee does not meet the criteria to receive payment.
  4. That the employee’s claim is discretionary because their employment has been terminated.
  5. That the employee is not one of the staff qualified to receive the benefit.

We help many of our clients, particularly when they suffer serious injuries, to bring claims on behalf of employees who have been denied cover under PHI for damages for breach of contract and seeking to compel the insurer to make payment.

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