Breach of Insurance Claims

What is a breach of insurance?

Insurance companies are there to protect policy holders if things go wrong. For example, if a driver has a car accident and their car gets written off, they may be able to claim on their insurance to cover some of the costs. Or, a homeowner might be able to claim on their house insurance if their property is flooded, or involved in a house fire.

But, insurance companies are also there to make money, so they will often try to find a way out of making a payout to their policyholders.

Sometimes, insurance companies will use tactics to convince their non-lawyer customers that they are not entitled to a payout by quoting the technicalities of the contract. But, although this can sound convincing, sometimes it is wrong, and a breach of the insurers contract.

Protections are in place for insurance holders to ensure they get the payout they deserve, and with the help of a knowledgeable solicitor, claims can be made against your insurance company if you believe you should be entitled to a payout.

How does a breach occur?

A breach of insurance can occur when a contract has been put in place between a policy holder and an insurance company, but one of the parties involved has failed to conduct their duties stipulated within the contract.

This could mean that the insurer has refused to pay out to a policy holder despite the contract stating that they should be protected.

Property or home insurance

This is usually in place to cover risks such as fires, flooding or burst pipes. Property insurance can also be in place to cover property owners if they are a victim or theft and burglaries in the home.

Car insurance

Depending on what type of insurance you hold, car insurance can cover your vehicle – such as damage and theft, as well as the damage that you might cause to other vehicles, to the property of other drivers and to other road users generally.

Life insurance policies

Life insurance is put in place to give families financial protection if a loved-one dies. But, when taking out the insurance, a policy holder is asked a lot of personal questions including past medical history, occupations, hobbies, smoking status and alcohol consumption.

An insurance company may refuse to issue a payout if they believe the policy holder has misinformed them of their condition or situation.

When to make a claim

A breach of an insurance contract occurs when one party, either the insured (policyholder) or the insurer, fails to fulfil its contractual obligations as outlined in the insurance policy.

Insurance contracts are legal agreements that specify the terms, conditions, and obligations of both parties. But if either party fails to meet these obligations, it may be considered a breach of the insurance contract and you may be able to make a claim.

Here are common scenarios that could lead to a breach:

Failure to fulfil obligations:

Both parties in an insurance contract have certain obligations. If the insurer fails to fulfil its obligations, such as refusing to pay a valid claim covered by the policy, it could be a breach on the part of the insurer.

Cancellation without proper notice:

If the insurer cancels the policy without providing proper notice or justification, it may be considered a breach. Insurance contracts often specify the conditions under which a policy can be cancelled.

Unfair terms:

If you agreed your insurance contract after 1 October 2015 you are protected by the Consumer Rights Act 2015. This means that certain standard clauses in a contract may be challenged if they’re considered to be unfair.
For example, if an insurance company refuses to pay out because a clause in the contract states that no modifications to the car can be made. But, the policyholder, who’s car was smashed into the back of by a drunk driver, installed a CD player into their vehicle – which was then deemed by the insurer as a ‘modification’.

Frequently Asked Questions

What do I need to make a claim?

To make a breach of insurance claim you need to prove that a legally binding contract was in place, and that all or part of the contract was breached.

Here’s three things you need to consider:

The existence of a legally binding agreement was in place
The agreement was breached
There was a loss caused by the breach of contract

How do I make a claim?

If you believe that an insurance company has breached its obligations under your insurance policy, you will need to take certain steps to make a breach of insurance claim.

Here is a general guide on what you can do:

1) Review Your Policy:

Carefully review your insurance policy to understand the terms, conditions, and coverage details. This will help you determine whether the insurer has indeed breached the contract.

2) Document the Breach:

Collect evidence that supports your claim of breach. This may include letters, emails, policy documents, claim denials, or any other relevant communication. Document specific instances where you believe the insurer has failed to fulfil its obligations.

3) Contact Your Insurance Company:

Initiate contact with your insurance company to discuss your concerns. Explain why you believe there has been a breach of contract and provide the supporting documentation. It’s important to keep a record of all communications, including dates, times, and names of the individuals you speak with.

4) Request a Written Explanation:

If the insurer’s response is not satisfactory, consider requesting a written explanation for their actions or decisions. This documentation can be useful if you need to escalate the matter.

5) Follow Internal Complaint Procedures:

Many insurance companies have internal procedures for handling customer complaints. Follow these procedures, which may involve submitting a formal complaint in writing to a specific department or individual within the insurance company.

6) Seek Legal Advice:

If your efforts to resolve the issue directly with the insurance company are unsuccessful, consider seeking legal advice. A legal expert with expertise in insurance law can assess the situation, provide guidance on your rights, and help you determine the best course of action.

Why should I choose Oakwood Solicitors Ltd?

From the start of your claim until the conclusion you will have a dedicated advisor who will run your claim, assisting you in the event of any queries or issues you may have.

Regular updates will be provided by your case handler up until your claim has ended. This is to ensure the process is as stress-free and effortless as possible.

Efficient from start to finish

The team at Oakwood were professional, pragmatic and efficient throughout the process. I was kept informed of progress, next steps, and achieved the outcome that I wanted.

- Chris Needham

Oakwood has been great to work with

We work with Oakwood and she has always been easy to access, very approachable, and easy to work with. Their work is detailed and accurate and has helped us through some difficult cases with great explanations and understanding. We will continue to work with them in the future.

- Satisfied Client

Danielle Lightfoot — Solicitor and Head of Department

Danielle Lightfoot is a Director and our Head of the Financial Litigation Department. Danielle joined the firm as a Paralegal in 2011 and qualified as a solicitor in October 2014. She has acquired extensive experience in high value, complex litigation traversing numerous practice areas. Danielle is a specialist in financial miss-selling matters, with a particular interest in Pensions and Investments.

Do you have a dispute with your insurance provider?

What is a breach of insurance?

How does a breach occur?

When to make a claim

Danielle Lightfoot — Solicitor and Head of Department