Uninsured losses ... and No Fault insurance increases

drdog_2

Two questions:

First:

What are valid uninsured losses, how do you prove them and when do you inform your insurers legal team that you out of pocket? Are there unisured losses that are unrecovarable? Are there losses that would be treated as whimsical or ones that can not have a value placed on them?

Second question:

We have become aware of the adverse effect on those who have No Fault Claims which result in no adverse effect on NCB but an increase in premium ... that strikes me as an uninsured loss ... or is that whimsical? Or has it been tested ...

vaio

First.......Any consequential cost of the accident (subject to the duty to mitigate)

Second.......Yes (and I've done it) but others disagree

thenudeone

1) you would normally inform them quite early on, as they will use their legal people to chase up the matter.
I've used it twice in 25 years of driving - once to claim from a farmer whose cattle strayed onto the A1(M):eek: and once from a council for pothole damage. In both cases the cover did exactly what it did on the tin.
The cheapest way to get legal cover is £19 for a couple through http://www.csmaclub.co.uk/ (the membership eligibility requirements are quite wide).

2) Theoretically yes, although I've never tried it.

im-lost

Going through a claim right now, and imo nothing is too trivial to claim for, absolutely nothing. Anything that you are out of pocket from due to an accident can be reclaimed laimed, providing you can 'prove' it. Although the amount of proof would obviously depend on the amount and what it's for.

Regarding future premium increases, these should be able to be claimed, but depends how hard you or your solicitors want to push it, mine are being added, although in my case it's a miniscule amount compared to the total claim.

The best person to ask what you can claim for and for what amounts, is the solicitor / insurer working on your behalf. People on here could say xx an yy are permissable, but without knowing what your claim is for, if it includes personal injury and all the extras you can claim for that, then you'll just be given bits of information. There's no set list of what you can claim.

drdog_2

Thanks for the advice - I may be back with more questions on what is reasonable to claim! To those that have claimed for increased premium - how? And surely the % uplift will apply for a number of years, though I imagine on a decreasing trend - how do you factor that in. How do you find out what the uplift is - I assume it is a % factor rather than a fixed sum.

My car was serviced less than a month [may have been a couple fo weeks or less] before the accident. As a result of the accident, I have lost the benifit of the service - to me that feels like a loss caused by the accident the value of which is not covered by my insurance. Is claimng for the valuse of the service as an uninsured loss unreasonable?

vaio

I got the non fault loading covered years ago, in my case I claimed for two or three years using the actual difference as confirmed by my insurer.

I suspect the service is just part of the normal running costs of a car and will be included in the valuation.

Have a read of http://www.financial-ombudsman.org.u...uation.html#14 it covers pretty much all you need to know.

You should get the retail/dealer figure which should be enough to go buy a replacement from a dealer

InsideInsurance

drdog wrote: »

First:
What are valid uninsured losses, how do you prove them and when do you inform your insurers legal team that you out of pocket? Are there unisured losses that are unrecovarable? Are there losses that would be treated as whimsical or ones that can not have a value placed on them?

Second question:
We have become aware of the adverse effect on those who have No Fault Claims which result in no adverse effect on NCB but an increase in premium ... that strikes me as an uninsured loss ... or is that whimsical? Or has it been tested ...

1) Anything that is directly linked and is otherwise unrecoverable. So if you had a holiday booked and couldnt cancel and had no insurance in place and due to the accident couldnt go then that would be an uninsured loss. If you had travel insurance though it would payout and thus make it unrecoverable.

Everything can have a value attached to it, otherwise Pain Suffer Loss of Amenities (PSLA) wouldnt be qualtifiable which is what injuries are paid out under. Eg compensation that you can no longer play football with your local 5 a side team.

But it has to be direct, for example if your 5 a side team claimed it didnt win the championship because you were their star striker they would be considered to distant to attempt to claim compensation for not having won (or the more common one is employers being unable to recover sick pay they had to give you)


2) Premium increases are a difficult one. In theory it is an uninsured loss however substantiating them is where the difficulty comes in.

Do you claim for 3 or 5 years losses given some insurers only consider 3 years and some consider 5 years? Some insurers dont put any loading on a single non-fault claim and do you know if one of these or one of the ones that does load will be the cheapest in 3 years time?

At the end of the day, speak to your representatives and discuss with them. You could submit Aggregator screenshots to support your case but its a bit of a long shot and you really should be realistic about the prospects

vaio

InsideInsurance wrote: »

1) ........or the more common one is employers being unable to recover sick pay they had to give you........

Employers might not be able to recover direct from the at fault party but (certainly in the LA world) there is a term in the contract of employment that means sick pay can be recovered as part of loss of earnings.

When you think about it it makes sense....if one of my guys gets injured then why should my generosity in continuing to pay his normal wage whilst he's off have the effect of reducing the "loss of earnings" part of his claim and end up with me rather then the at fault party paying.

Similarly, I'm pretty sure that any benefits paid (SSP etc) can also be recovered.

InsideInsurance

vaio wrote: »

Employers might not be able to recover direct from the at fault party but (certainly in the LA world) there is a term in the contract of employment that means sick pay can be recovered as part of loss of earnings.

When you think about it it makes sense....if one of my guys gets injured then why should my generosity in continuing to pay his normal wage whilst he's off have the effect of reducing the "loss of earnings" part of his claim and end up with me rather then the at fault party paying.

Similarly, I'm pretty sure that any benefits paid (SSP etc) can also be recovered.

Only part of SSP/ SMP etc can be recovered which generally is only after you;ve exceeded 13% of your company NIC for the period (see http://www.hmrc.gov.uk/payerti/employee/statutory-pay/ssp-calc.htm#6) so in other words only the smallest employers can unless there is a mass epidemic in a large company

Having employees carries a cost, you know that when you get into business. Who do you recover from if your employee goes down with the flu? The person on the train who was sneezing on their commute in?

I would be surprised if SSP can be recovered from an employee irrespective of what is in their contract due to its statutory nature. I suspect that any company sick pay scheme could have something in the contract to have a clawback but it is certainly uncommon outside of the civil service.

vaio

I'm maybe not making my self clear.

I earn £50k a year, if I get injured in a car accident and can't work for a year then......

If my firm pays no sick pay then I have loss of earnings of £50k which the at fault party will pay.

If I get state benefits of £20k during the year as a result of the accident then my loss of earning claim is £30k and the state can recover the £20k from the at fault party using the Social Security (Recovery of Benefits) Act 1997

If my firm is generous and pays me in full whilst I'm off then I have no loss of earnings to claim but that creates the unjust situation that my firm is £50k out of pocket as a result of the actions of the at fault party.

To avoid this injustice my OH's LA contract of employment has a term that effectively converts sick pay paid in these circumstances into a loan thus she would have a loss of earning claim of £50k which would then be used to repay the "loan" she'd had from her employer.

If any of my guys was unfortunate enough to be in the same position I'd also "lend" him a sum equivalent to his normal wage to be repaid when his loss of earnings claim was paid.

End result is employer & employee don't end up out of pocket with the at fault party picking up the bill. (as they should)

InsideInsurance

vaio wrote: »

I'm maybe not making my self clear.

I earn £50k a year, if I get injured in a car accident and can't work for a year then......

If my firm pays no sick pay then I have loss of earnings of £50k which the at fault party will pay.

If I get state benefits of £20k during the year as a result of the accident then my loss of earning claim is £30k and the state can recover the £20k from the at fault party using the Social Security (Recovery of Benefits) Act 1997

If my firm is generous and pays me in full whilst I'm off then I have no loss of earnings to claim but that creates the unjust situation that my firm is £50k out of pocket as a result of the actions of the at fault party.

To avoid this injustice my OH's LA contract of employment has a term that effectively converts sick pay paid in these circumstances into a loan thus she would have a loss of earning claim of £50k which would then be used to repay the "loan" she'd had from her employer.

If any of my guys was unfortunate enough to be in the same position I'd also "lend" him a sum equivalent to his normal wage to be repaid when his loss of earnings claim was paid.

End result is employer & employee don't end up out of pocket with the at fault party picking up the bill. (as they should)

You are clear but I am saying it is the minority not the norm.

As you say, for benefits a statute of law was required to enable them to make recoveries.

In all my days of claims handling I never once had a case where the TP claimed their contract of employment converted sick pay to a loan in any circumstances. I, unsurprisingly, dont have any of my own former employment contracts to hand to see if I have a similar clause but I am sure I'd remember if I'd read it as it would have been of interest to me.

I'd actually be interested to see the exact wordings as it could bring up a whole host of interesting questions re split liability, contributory negligence, indemnity issues, overseas accidents where indemnity laws are different or if the employee is at fault/ its self inflicted/ subsequently proven to be fraudulant etc

As to "just", I think the majority of us decided a long time ago that the world isn't just. An employer pays their call centre agent $7 an hour but earns $100 an hour profit from them, is that just? That employee goes off sick and still gets their $7 an hour but the employer earns nothing from them, is that just? Who decides exactly when it converts to a loan or not and how just is their decision and how easily can it flip statuses legally?