Toby was in a dispute with his employer and after starting tribunal proceedings, he tried to claim for his legal expenses. But his insurer refused to pay.
Toby called his insurer’s legal helpline as he was having a dispute with this employer. They advised him to write a letter to his employer first. He agreed to do this, and to call back if the letter didn’t achieve what he wanted.
But Toby started tribunal proceedings and didn’t call the insurer back. He instructed solicitors and incurred legal costs. Toby’s solicitor told him to check if he had legal expenses insurance. He found out that he did, so went back to the insurer to make a claim.
The insurer refused to cover Toby’s costs, as they said they didn’t have enough time to properly consider the claim before Toby reached a settlement with his employer. They also said that the policy excluded costs incurred before it accepted a claim.
What we said
We looked at both sides of the story and checked what had happened. The policy gave the insurer the right to assess a claim and get input from its panel solicitors on prospects of success. The panel could decide if they would accept the claim.
It wasn’t clear if the insurer would have accepted the claim if they had been able to do this. So we were satisfied that their position had been prejudiced.
We decided not to uphold Toby’s complaint because his insurer hadn't had enough opportunity to have any control or input into the proceedings or costs incurred.
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