Disputes Over Insurance Coverage

Businesses and individuals acquire insurance policies with the belief that they would be shielded against the duty and expense of defending and perhaps paying a claim in the case of property damage or injury to either the policyholder or another. However, insurance firms commonly contend that the claim is not covered by the policy or that coverage has been lost due to the insured’s actions.

It’s understandable to be frustrated when an insurance denies a claim — an insurer will often refuse coverage even if an insured has paid payments for years without making a claim. We have extensive expertise assisting clients in establishing advance protocols for handling a claim or event, as well as actively defending their rights to insurance coverage when an insurer seeks to reject a claim.

How can we help?

When an event happens (whether property damage, an accident, or the filing of a claim), it is critical to notify all insurance companies immediately.

Even if your insurance has refused coverage, you are not out of luck. We have successfully contested coverage rejections via negotiations with insurers and, where required, litigation.

When Insurance Coverage Disputes occur, you’ll need someone who can assist you in obtaining a satisfying, expeditious, and cost-effective resolution. The sooner professional counsel is obtained, the better.

We can provide you with specialised guidance that is based on in-depth technical study and a practical grasp of insurance procedures.

Coverage concerns often emerge in the following areas:

  • Notification
  • Breach of precedent conditions
  • Non-disclosure, non-disclosure, materiality, deception, and avoidance are all examples of non-disclosure.
  • Mistake
  • Misrepresentation
  • Breach of the terms and conditions of the policy, Breach of claimant’s behaviour requirements.
  • Right waiver, affirmation, estoppel, and reserve.
  • All Dangers – Fortuity
  • The validity and applicability of ‘blanket’ circumstantial notifications.
  • Insurance mandated by EL and limits on policy language.
  • Exclusions from policies: their scope and purpose.
  • The effect of different ‘Minimum Terms’ professional indemnity regimes (e.g. SRA, ICAEW and RICS).
  • Issues relating to motor insurance – include the Road Traffic Act, declarations, and Article 75.

We provide guidance on the following kinds of insurance products.

  • Insurance mandated by EL and limits on policy language.
  • Exclusions from policies: their scope and purpose.
  • The effect of different ‘Minimum Terms’ professional indemnity regimes (e.g. SRA, ICAEW and RICS).
  • Issues relating to motor insurance – include the Road Traffic Act, declarations, and Article 75.
  • Coverage for your household in the event of a flood, subsidence, theft, or fire, to mention a few.
  • Critical illness insurance – in cases when insurers attempted to walk away from major diseases such as stroke and cancer.
  • Health insurance – another area where insurers attempted to imply that significant surgeries such as heart surgery or major knee surgery were not covered.
  • Life insurance is necessary in the event of an untimely death.
  • Travel insurance to instruct the insured on their duties in the event of a claim.
  • Caravan insurance policies where insurers attempted to void the coverage after a claim.

Insurance Protection Coverage disagreements may have major ramifications for both the insurer and the insured. Whether the issue is a failure to notify, a failure to disclose, or a breach of warranty, it is always prudent to obtain advice as soon as possible when the dispute arises. Given that the problem often occurs when an insured attempts to rely on the coverage, why not seek coverage guidance prior to an issue arising?