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Wynterhill has seen no sign of the Insurance Act 2015 reducing insurers’ willingness to take policy avoidance arguments. If anything, it has resulted in a raising of the stakes, with insurers all too keen to characterise insured’s conduct as “reckless” in order to evade the proportionate remedies introduced by the Act.

The Wynterhill team has decades of experience of keeping insurers’ investigations of alleged grounds for avoidance within sensible limits (refusing to indulge the default setting of “floorboards up” exercises in fishing for grounds for avoidance).

Our experience of the realities of the market gives us significant insight as to what allegations of breach have real substance as opposed to being opportunistic or an exercise in clutching at straws.

Some insureds have the misfortune of being wrongly suspected or accused of being dishonest. While most insurer investigations start with a legitimate focus on a genuine coverage issue others are simply overzealous from the outset. Either way, when a fraud investigation is commenced, how the insured responds will be critical to the outcome of the process and coverage generally.

Facing serious allegations, being advanced by experienced professionals, is a perilous situation for any insured, however honest, in the absence of legal advice. Insureds who simply co-operate with a fraud investigation because they, rightly, feel they have nothing to hide, may inadvertently create the impression that they have acted wrongfully often because they were unsure or unaware of the potential significance of unguarded answers. 

Our team has significant experience of representing insureds during fraud investigations, preparing for and attending formal interviews and advising on how best to respond to such assertions generally. Our objective is to ensure that insurers cannot proceed with such allegations in the absence of strong and cogent evidence of wrongdoing.

Triggering policy cover, and triggering the right policy, is foundational to claims under “claims made” policies and, as such, is something ripe for disputes. Too often policyholders are presented with “damned if you do, damned if you don’t” options.

Wynterhill is always ready to roll up its sleeves, often at short notice, to grapple with the detail that is essential to making the correct decision on notification. This is an area where experience, and the resulting alertness to and feel for nuances of fact and law, is as important as a deep understanding of the extensive authorities.

Claims made by policyholders often given rise to various points of interpretation in respect of an insuring clause or the meaning, effect and application of conditions or exclusions or endorsements. In this situation, subjective intention of either party is irrelevant and the challenge is to find the objective meaning of the words using various tools of legal construction. Unusual factual patterns can give rise to more than one interpretation of a particular term which creates uncertainty and often leads to a dispute. Some issues are easier to resolve than others whereas some issues have a wider market impact making it harder to resolve. Identifying a sensible commercial reading of a term is an art and one which requires your legal teams to understand the fundamentals.

Having been involved in so many disputes, our team is able to identify and look to correct existing flaws in policy language and anticipate problems to which wordings may give rise. We work closely with clients to ensure that their coverages match the realities of their business operations.

Policyholders find delay by Insurers in investigating clams incredibly frustrating. But, and more importantly, an Insurer’s inaction can sometimes cause a policyholder to suffer financial losses going beyond those  insured under the policy.

Insureds can now seek to recover such losses. 

Wynterhill has experience of success in bringing  claims of this kind involving a variety of factual scenarios and product lines. How and when to deploy such a claim is an important strategic consideration in all coverage disputes.

If you would like to find out more how Wynterhill can help you, please contact: