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Explore implications of Insurance Act 2015 on late payment claims in England, including remedies for breach and disputing claims. Learn about timeframes, contracting out, and potential amendments.
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Damages for Late Payment of Claims in England • AIDA Reinsurance Working Party, Paris - 2 December 2015 • Simon Cooper, Partner
Background • The Insurance Act 2015 • The legal fiction of Insurance • The Enterprise Bill 2015
Enterprise Bill • Implied term in all ‘insurance contracts’ that claims must be paid ‘within a reasonable time’ • Remedy for breach will be the usual remedies for breach of contract, including damages • The right to claim interest for late payment will remain • These new provisions will apply to all contracts entered into after this Part of the Bill comes into force
A Reasonable Time? • Includes time to investigate and assess claim • Depends on all the circumstances including: • Type of insurance • Size and complexity of the claim • Compliance with regulatory rules and guidelines • Factors outside the insurer’s control
Disputing a Claim • If insurer shows that there were reasonable grounds for disputing claim (either as to cover or amount): • Failure to pay while dispute is continuing will not be unreasonable; but • Conduct of insurer in handling claim may be a relevant factor in deciding if there has been a breach
Contracting Out • No contracting out of the implied term in consumer contracts • No contracting out of implied term in respect of ‘deliberate or reckless’ breaches in commercial contracts • Contracting out otherwise permitted in commercial contracts subject to ‘transparency provisions’ of Insurance Act 2015
Potential Amendments • Limitation issues • Privilege issues
Some Potential Claims Issues • Claims Control Clauses • Subscription markets • Layering
Reinsurance Issues • Coverage in respect of damages awarded against reinsured for late payment? • Principles and legislation • Contractual coverage
Application to Reinsurance Claims • Scope of Insurance Act 2015 • The meaning of ‘Insurance Contract’ • Loss and Damages