Insurance co stopped my ombudsman investigation

BorisThomson

Void, not avoid!

What facts are they claiming you did not disclose or misrepresented?

Please just answer that, none of the surrounding waffle.

dunstonh

I went through the Insurance company's complaints procedure and then went to the ombudsman - An option given by the insurance company's own policy.

The regulated complaints process gives you the right to refer a rejection to the FOS should you reach a deadlock. That is the same for all regulated companies.....

However 2 wks ago the insurance company issued a court claim against us asking us to declare that they were right to avoid our policy through their solicitors. They are also asking for a large court fee.

However, where there is legal action started by either party, the FOS will cease to be available as the courts trump the FOS.

It seems very strange of the Insurance company to do this - The Ombudsman investigator has also expressed surprise at the situation as they have never come across this before

It is unusual with retail insurance (consumers) but it is not uncommon on commercial insurance.

The regulations also state that a business should not start legal proceedings until it has finished.

That is cases where you are alleging a wrongdoing by the insurance company. It is not connected with the claim on the policy which is a different issue.

societys_child

Drip . . . drip . . . drip . . .

Duckiedoos

Thanks for your help.

Our complaint with the ombudsman investigation with was already in progress - the court proceedings came after so where do we stand in respect of this? I had understood that when a complaint with the ombudsman is in progress, that a business should not start legal proceedings, they should contact the ombudsman before they take any action.
I'd understood that the Ombudsman could only not act on the complaint if the court proceedings were already progress upon approaching the ombudsman.
The regs surrounding this are quite vague.
Businesses are also expected to treat consumers fairly - is there a different rule that applies to commercial clients?

Thanks

Nearlyold

I'm going to hazard a guess here, is this dispute with the insurance company because you took out legal expenses or other related liability cover after the "fraudster" tried to make a personal injury claim against your business in the hope the insurance company would pay for your defence?

antrobus

I take note of the following;

Duckiedoos wrote: »

...There is no other information I can add other than that both we and the ombudsman agreed that the insurers were probably doing this to avoid paying out to the person making a fake injury claim against our company - we know it's a fake claim, but the insurance co. aren't aware of our evidence as they were not prepared to continue to insure us so we couldn't use someone on their board of solicitors...

and

Duckiedoos wrote: »

The fraudulent claim is nothing to do with us - someone is making up an injury claim to get money from us - we have evidence to prove this but we needed our insurance cover to use legal representation to take the fraudster to court. ..

The normal course of events would be that
- third party alleges that the insured has caused them an injury
- the insured notifies their insurance company
- the insurance company responds to third party by telling them to jog off as they believe the claim is fradulent

!!!!!! is going on here? Why has the OP not supplied the insurance co with the evidence? Why are they taking the alleged fraudster to court?

P.S. I believe that the doctrine of “utmost good faith” still applies to B2B insurance contracts.

societys_child

Am I getting this right?

Wrong policy, leading to:
None disclosure. (OP claims this was the websites fault)

Someone has an accident or something, which is related to the OPs business . OP believes the accident is contrived/ false.

Policy voided when a claim is submitted.

Insurance co believe the op may be involved in the fraudulent claim?

This is before we get to the complaint about the FOS etc. and everybody taking everybody to court . . .

:huh:

antrobus

societys_child wrote: »

...Insurance co believe the op may be involved in the fraudulent claim?...

That occurred to me as well.

I wouldn't go as far as to suggest that the OP is involved. But if I was an insurance company, I would be asking that very question.