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Insurance Claims Repudiated
Milestone Solicitors | City Of London


HAVE YOU HAD YOUR INSURANCE CLAIM REFUSED OR REPUDIATED BY YOUR INSURANCE COMPANY RECENTLY?

An insurance contract is one of utmost good faith and in order to accurately assess the risk the insurer relies, almost exclusively, on information provided by you, the insured. There is, therefore, a duty on the insured to disclose all material information relevant to the risk that is to be underwritten.

When a claim is submitted, the insurance company will do the following:

  • Investigate all aspects of your claim - normally conducted by independent claim/loss adjusters in order to come up with a Report/Finding on your claim.
  • Sometimes, this investigation/assessment is done by the insurance company itself.
  • The insurance company will need to rely on this Report/Finding to justify the basis of refusing/repudiating your claim.

Most common reason(s) cited for rejection/repudiation are as follows:
  • Material non-disclosure by the insured – wherein the Insurance Company now contends that had this material information been disclosed by you in the past they would have either not provided an insurance cover to you or would have quoted a much higher premium;
  • There has been a breach of a policy term by the insured which excludes liability;
  • Operation of condition or exclusion clauses within the policy which excludes liability;
  • Allegation of fraud on the part of the insured – e.g. that the entire claim is fraudulent or even in a situation where the insurance company alleges that part of the claim is fictitious/exaggerated e.g. where there is an allegation that one part of the claim amounts to “double recovery” the entire claim can be repudiated; or
  • Prior cancellation of the policy by the insured before the incident.


However, what really matters is whether legally the reasons quoted by the insurance company to refuse/repudiate a claim is valid in law. In order to ascertain whether the reasons are valid in law, a detailed analysis of the facts of your case will need to be undertaken.

OUR ROLE:

  • We have specialist solicitors who can advise you on the strength of your claim and the estimated time to conclude the matter.
  • We can provide a free initial consultation over the phone for 30 minutes and thereafter, if you have a case and if you decided to proceed with us, we can handle your matter on a Conditional Fee Agreement (CFA) together with an After-the-Event insurance taken out in your name, wherein all disbursements incurred by you may be recoverable.
  • Once engaged, we will provide you with regular updates on the progress of your case.


SOME EXAMPLES OF MATTERS HANDLED BY MEMBERS OF OUR TEAM:

Fire:
The building and contents insurer repudiated our client’s claim under the policy when the policyholder’s premises burnt down resulting in total loss due to arson. The insurer contended based on an independent Loss Adjuster’s Report that the policyholder had not disclosed his previous convictions which they alleged was material and repudiated the entire claim on this basis. A successful challenge was initiated and before trial, our client’s claim was settled in full.

Burglary:
Insurance Company repudiated the claim on the basis of Loss Adjuster’s report that certain aspects of the claim amount to double recovery due to a previous claim. A successful challenge was initiated, and the claim was settled in full.

Theft:
Theft of a motor vehicle where the insurers repudiated the claim on the allegation that it was staged based on Key Security Expert’s Report which was successfully challenged, and our client’s full claim was eventually paid out.

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