Insurance refusal to pay .....

Insuranceaggrieved

Hi,

I am keen to identify an issue I am currently having with my work insurance. For the past 18 years I have been paying into a federation scheme at work which offered me legal insurance. I have never claimed from this insurance.

In 2017, I had some allegations made against me at work which is now resulting in an employment GM hearing (yes, 2 years later!) of which I am entitled to legal representation at. My work policy for 2018 / 2019 covers up to £20,000 of legal fees however the insurance company have said because my allegations relate to matters in 2015, at that time the work policy had a legal threshold cover of £10,000 and therefore this is the amount they will honour, hence I will have to make up the additional £10,000 loss from my own money, or attend the hearing without any legal representation.
I am interested to know if an insurance company can actually do this, and whether my employers (who have willinginly taken my subscriptions for the past 18 years) hold any responsibility for this ‘error’.
Thank you in advance.

dunstonh

For most insurance, it is the terms of the policy at the point of the event that led to the claim. Some types it is the point of first being aware there may be claim.

I am interested to know if an insurance company can actually do this, and whether my employers (who have willinginly taken my subscriptions for the past 18 years) hold any responsibility for this ‘error’.

The employer is not responsible for an "error". Assuming that there is an error. There may not be. You were not paying your employer. You were paying the insurer. The employer has no liability.

If you disagree with the decision of an insurer, then you make a formal complaint. If you disagree with the outcome of a complaint then you can refer to the FOS.

Insuranceaggrieved

Thanks for this. It’s really helpful. I don’t know what the small print says because I have never been given a copy of the t & c’s. I will go looking. The point at which we knew there would be a claim was in 2018, but like I say, the allegations were made in 2017, with matters relating to 2015.
Thanks again.

AnotherJoe

Insuranceaggrieved wrote: »

Hi,

I am keen to identify an issue I am currently having with my work insurance. For the past 18 years I have been paying into a federation scheme at work which offered me legal insurance. I have never claimed from this insurance.

In 2017, I had some allegations made against me at work which is now resulting in an employment GM hearing (yes, 2 years later!) of which I am entitled to legal representation at. My work policy for 2018 / 2019 covers up to £20,000 of legal fees however the insurance company have said because my allegations relate to matters in 2015, at that time the work policy had a legal threshold cover of £10,000 and therefore this is the amount they will honour, hence I will have to make up the additional £10,000 loss from my own money, or attend the hearing without any legal representation.
I am interested to know if an insurance company can actually do this, and whether my employers (who have willinginly taken my subscriptions for the past 18 years) hold any responsibility for this ‘error’.
Thank you in advance.

Are you saying the legal fees have already been estimated at £20,000? And that you will lose? Hence the £10k loss? Though if you know you will lose better to pay up and not incur legal fees?