Dishonesty without consequences: risks and opportunities in the conduct of insurance claims
This article first appeared on the Thomson Reuters ‘Accelus Regulatory Intelligence’ website, 21.09.16
Jeremy Irving examines a recent judgement in this article which looks at 'collateral lies’ and the compliance implications of cause and effect.
In July 2016, the Supreme Court gave judgment in Versloot Dredging -v- HDI Gerling Industrie Versicherung (‘Versloot’). The judgment has profound implications for dealings between insurers, insureds and brokers. Primarily, it raises questions about the integrity of claims intermediation.
There are also implications for the ways that insurers might seek to set policy terms to govern the honesty of insureds’ or brokers’ handling of claims. Reliance on any such terms to deny claims could give rise to coverage disputes. A coverage dispute in turn can give rise to issues over conduct risk for insurers and intermediaries, such as how a policy was designed, marketed and negotiated.
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