Claims

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This Overview guides practitioners to core materials on insurance and reinsurance claims, including legislation, FCA rules, guidance and key authorities. Claims handling is central to insurers’ obligations and to policyholder recovery, engaging duties under the Insurance Act 2015 and the FCA Handbook. Practitioners must address coverage, notification and conditions precedent, policy triggers (occurrence or claims - made), causation, exclusions, warranties and terms, and fraud. The 2015 Act sets the framework for remedies for fraudulent claims and, via section 13A, implies a term to pay claims within a reasonable time, and damages for late payment. ICOBS rules require fair, prompt and efficient handling, and DISP governs complaints and access to the Financial Ombudsman Service for complainants. Limitation, privilege, reservation of rights, subrogation, contribution and double insurance are issues, alongside settlement strategy and alternative dispute resolution. Market developments, such as the Supreme Court’s decision in the FCA business interruption test case, illustrate aggregation, causation and trends clauses in practice. Reinsurance claims raise additional considerations, including follow the settlements and claims control/co - operation clauses, back - to - back coverage, and allocation across layers. The Overview signposts guidance on jurisdiction...

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