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Coverage disputes and policy interpretation

coverage disputes and policy interpretation

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When coverage disputes arise they can bring with them reputational and commercial risks. Our specialist team of coverage lawyers focus on providing clients with an early accurate assessment of the likely outcome so that only the right battles are fought.

We take a pragmatic and commercial approach to coverage investigations and advise in the context of our clients’ claims philosophies and their regulatory responsibilities.

We have considerable experience of advising insurers on policy interpretation issues that impact upon large volumes of claims across entire books of business. Our lawyers work closely with our specialist claims analysts to map potential exposure in a user friendly way so that our clients’ senior management teams can take informed decisions about strategy and reserves.

what we do...

Non-disclosure, materiality, misrepresentation and avoidance.
Validity and scope of ‘blanket’ circumstantial notifications.
Waiver, affirmation, estoppel and reservations of rights.
EL compulsory insurance and restrictions on policy wording.

Breach of claims behaviour conditions.
Scope and meaning of policy exclusions.
Impact of various professional indemnity ‘Minimum Terms’ regimes (e.g. SRA, ICAEW and RICS).
Motor insurance issues - including, Road Traffic Act, declarations, and Article 75.

related resources

Legal updates

English Commercial Court considers scope of U.S. sanctions exclusion clause

In the context of sanctions and heightened tensions in the Middle East and Russia, the recent Mamancochet judgment is important and will be of interest to insurers who insure businesses that are exposed to risks in these markets.

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Legal updates

How clear are your policy wordings?

The University of Nottingham, in collaboration with Browne Jacobson, have undertaken a detailed academic study into the readability of insurance policies, with some fascinating results.

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Legal updates

Court of Appeal rules on relevant ‘knowledge’ required under s.14A of the Limitation Act

A recent Court of Appeal judgment on 16 May 2018 considered the test for relevant ‘knowledge’ within section 14A of the Limitation Act. The Appellant was appealing against a decision granting the Respondents summary judgment on the basis that the claims against them in negligence and for breach of contract were time barred.

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Legal updates

Supreme Court rejects War Risks cover for detained vessel

Navigators Insurance Company Limited and Others v Atlasnavios-Navegacao LDA (formerly Bnavios-Navegacao LDA) (‘The B Atlantic’) [2018] UKSC 26

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what the directories say...

Undertakes defence and coverage work for professional indemnity insurers. Large volume of cases relating to solicitors, IFAs and financial services, alongside directors and officers.

Chambers 2016

They are very engaged in getting a good conclusion for their client. They think clearly and waste no time.

Chambers 2016

Browne Jacobson LLP is ‘excellent’ on the claimant and defendant side of professional negligence, and handles lender litigation against solicitors, surveyors and valuers, as well as negligence claims against letting and managing agents.

Legal 500 2013

Prominent in acting for a broad range of professionals, including recruitment consultants and letting and estate agents. Also assists commercial businesses with D&O related negligence. Impressive client list includes large insurance groups and construction companies.

Chambers 2016

They provide a very good service, strong advice at a reasonable price.

Chambers 2016

Their advice is very succinct and very easy to follow.

Chambers 2016

recent experience

Acting on behalf of our client in a coverage dispute on a claim against an MGA for breach of the terms of the binding authority and claims handling agreement.
Advising our insurer client in relation to a coverage issue with its E&O insurer relating to its own claims handling and extent of cover afforded by its policy, regarding a marine total loss.
Advising a large insurer on policy coverage matters arising out of the notification of large numbers of claims notified to a public liability policy following the discovery that a doctor had sexually abused patients at a GP surgery. The matter involved complex issues of double insurance and analysis of compliance with policy terms and conditions. The full value of all potential claims could have exceeded £10m+.
Working with our client’s underwriters and claims team to analyse over a hundred underwriting files and draw together a complex multi-faceted coverage analysis to enable our client to accurately analyse and manage their exposure to misselling of financial products across an entire book of business.
Advising a large insurer on policy coverage matters arising out of the notification of large numbers of claims notified to a public liability policy following the discovery that a doctor had sexually abused patients at a GP surgery. The matter involved complex issues of double insurance and analysis of compliance with policy terms and conditions. The full value of all potential claims could have exceeded £10m+.
Working with our client’s underwriters and claims team to analyse over a hundred underwriting files and draw together a complex multi-faceted coverage analysis to enable our client to accurately analyse and manage their exposure to mis-selling of financial products across an entire book of business.
Advising our insurer client in relation to a coverage issue with its E&O insurer relating to its own claims handling and extent of cover afforded by its policy, regarding a marine total loss.
Acting on behalf of our client in a coverage dispute on a claim against an MGA for breach of the terms of the binding authority and claims handling agreement.

our people

related opinions

Interim injunction granted to enforce restrictive covenants

The court has granted an application for an interim injunction against the claimant’s former employee to enforce non-competition restrictive covenants and confidentiality clauses in his employment contract

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Acceptance of a Part 36 did not prevent claimants from relying on its defence

The Commercial Court has refused to grant summary judgment in relation to a claim which it held had not been included in a Part 36 offer which was subsequently accepted.

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Cross undertakings as to damages: guidance on the calculation of loss

A Defendant was awarded significant damages after demonstrating that he had suffered a loss following the court’s ruling that the Claimant had obtained freezing injunctions to which it was not entitled.

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Strict interpretation of the ex turpi causa principle results in bad news for claimants

the Court of Appeal upheld a judgment that a taxi driver was not liable in negligence to two passengers, both 17 years old, when he continued to drive despite being aware that the passengers were not wearing seatbelts and one of the doors of the taxi was open.

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