CLAIMS SETTLEMENT CONDITIONS 1. Consent


Our consent to pay legal expenses must be obtained in writing. Legal expenses incurred before such consent is given will not be covered. We will give the insured our consent if the insured can satisfy us that :


i) there are reasonable prospects of successfully pursuing or defending the legal proceedings; and


ii) it is reasonable in all the circumstances for legal expenses to be provided.


The decision to grant consent will take into account the advice of the insured’s appointed representative as well as that of our own advisors. We may require, at the insured’s expense, an opinion of counsel on the merits of legal proceedings. If the claim is subsequently admitted the costs of such opinions will be covered under the policy.


The insurer may discontinue indemnity if during the legal proceedings we consider that reasonable prospects of successfully pursuing or defending the legal proceedings no longer exist.


If the insured decides to commence or continue legal proceedings for which we have denied consent on ground 1(i) above and is successful, the insurer will pay legal expenses as if we had given our consent in the first instance.


2. Minimising Claims or Legal Proceedings


The insured must take all reasonable measures to minimise the risk or likelihood of claims, and the cost of legal proceedings. This includes, but is not limited to, the insured and any agent or appointed representative of the insured complying with any pre-action, costs or other protocol that applies to any legal proceedings which form the basis of a claim under this policy.


3. Arbitration


Any dispute between the insured and us in respect of this policy may be referred to a single arbitrator who shall be either a solicitor or barrister agreed upon by both parties. Failing agreement, the arbitrator shall be nominated by the President of the appropriate Law Society, Bar Council or other professional body within the territorial limits.


The party against whom the decision is made shall meet the costs of the arbitration in full. If the decision is not clearly made against either party the arbitrator shall have the power to apportion costs. If the decision is made in favour of us, the insured’s costs shall not be recoverable under this policy.


4. Fraudulent Claims


This policy shall be voidable at the discretion of the insurer if the insured makes any request for payment under this policy:


i) ii) iii) knowing it to be fraudulent or false in any way; or


in circumstances where the insured ought reasonably to have known that the claim was false or fraudulent in any way; or


where there is collusion between the parties to this dispute.


Any premiums paid shall be forfeited. 5. Insolvency of Insured


If the insured is insolvent when a claim is notified to us or becomes insolvent during the course of any legal proceedings, to which the insurer has given support, the insurer has the right to refuse to admit or immediately to withdraw its support from a claim. The insured shall be deemed insolvent upon the appointment of an office- holder within the meaning given by section 233 (1) or 372 (1) of the Insolvency Act 1986.


6. Notification of Claims


It is a condition precedent to the insurer’s liability that we must be notified in writing immediately the insured is aware of any actual or alleged act, omission or dispute which has given or may give rise to any legal proceedings involving the insured. If the insured fails to notify us of any actual or alleged act, omission or dispute during the period of insurance any claim arising from such actual or alleged act, omission or dispute will not be admitted. Where such notification has been given, the insurer agrees to treat any subsequent legal proceedings in respect of the circumstances notified as though the legal proceedings had been made or brought during the period of insurance.


SPECIAL PROCEDURE 66


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69