Legal Expenses Insurance Fraud?

[cx500]

In 2006 my neighbour sued me - using legal expenses insurance - to build on a garden boundary that was my responsibility. She lost. My costs were enormous; most are unrecoverable (Fast Track case lasted two and a half days.)

In 2005 she sued me over a leaking - shared - flat shed roof. (Not sure how it was funded.) In my amended particulars of claim for that action I included the boundary dispute. This matter was settled via Tomlin Order with no mention of the boundary dispute.

The boundary dispute predated the 2006 action therefore it almost certainly predated my neighbours LEI. Therefore her claim must be dubious(?)

I contacted the Insurance Fraud Bureau. They sent out an (e-mail) alert but have not received a response. I have written to all LEI companies that I could find. They will not deal with me, citing the Data Protection Act.

I contacted the Insurance Ombudsman they said go to the FSA. The FSA said go to the Insurance Ombudsman. Eventually someone at the FSA said write in requesting an investigation. The FSA response to that was that I cannot request an investigation as a third party.

If anyone out there has any ideas on this matter I would be most grateful.

[GIclaimsman]

Most Home Insurance policies carry legal expenses cover of some sort so your neighbour may well have cover through them. Anyway it is your neighbours and their insurers problem not yours.

From your point of view if a court has awarded you costs and they have not been received it is far more satisfying to ask the court to recover them for you. They may instruct a bailiff, enforcement officer or you have the option to bankrupt your neighbour!

[cx500]

Thanks for replying.

Sadly it is not that my costs have not been paid it is that a case pursued via the Fast Track option limits the costs that can be recovered.

I am aware of how LEI is obtained. It is Before the Event Insurance therefore a matter that precedes the insurance (as in this case) would not be covered.

Insurance fraud is everyone's problem. My neighbour's claim amounts to more than twenty thousand pounds. If as I believe, it is illegitimate then she should not benefit from her fraud.

Nobody has to take my word on this matter it is all set out in the two sets of court papers from the two separate claims made against me by her. The problem is getting those papers to the correct individual within the appropriate company. Contacting the Insurance Ombudsman and the FSA has proved to be a waste of time.

Unfortunately this matter seems to rely entirely on the Insurance Fraud Bureau sending a round robin e-mail to numerous insurance companies in the hope that the one insurance company involved picks it up. As far as I can gather the IFB e-mail is sent to named individuals at the insurance companies. What happens if that person leaves or goes sick etc?

[GIclaimsman]

Generally it is in the small track where costs are restricted but you will no doubt have the judgement and the costs order from the judge which will clarify all that!

There is a possibility that your neighbour bought an after the event policy to cover the whole action! but you would/should have received a notice of funding from your neighbours representatives if that were the case!

Who were your neighbours solicitors?

[cx500]

Thank you again for your reply.

My barrister’s costs are limited to seven hundred and fifty pounds. My solicitor’s court costs are limited to something like two hundred and fifty pounds. Those are the costs claimable when using the Fast Track (not as a consequence of a judge's order). And those are the amounts claimable in total, not per day.

I am certain as I can be that my neighbour has Before the Event Insurance not a contingent fee agreement.

[GIclaimsman]

OK! all you can do then is alert the Insurance Fraud Bureau hotline!

As you state all they do is send around an alert but most big insurers have someone who will search their portfolio's for your neighbour!

If anyone is interested in your info then they may contact you to take a statement but you may never know what happens

Good Luck

[cx500]

Thanks for your reply.

I had hoped to find an insurance web site to discuss it in a similar manner. I might try and find a legal expenses insurance professional and run the information past him (more money).

I am going to see if I can interest the press in this matter, given that everything is documented. And particularly as I have contacted the ombudsman and the FSA both of whom appear determined to avoid any involvement.

I'm under the impression that the Insurance Fraud Bureau has never come across this situation before and that it is very limited in the action it can take. This is not a complaint against the IFB they have done what they can. There is no central database of insurance policies and therefore they are limited to the blunderbuss option.

[jjrj]

Legal Expenses Insurance is not the same as other insurance. It is sold on the back of a household insurance policy and the legal expenses insurance company has above all else to keep the household insurers sweet. A policy holder may submit a claim to the legal expenses insurance company which is not covered due to the event being pre-inception of the policy. The claim will be declined but this is not neccessarily the end of the matter. The policy holder may then make a complaint to the household insurers and threaten to move their insurance elsewhere. If they have enough policies and the household insurers are keen to keep them, or alternatively, the policy holder makes enough fuss, the household insurers will intervene on their behalf with the legal expenses insurance company and advise that they want the claim to be covered regardless of whether the incident is pre-inception. The claim will then be covered as an ex-gratia. With regard to the fraud aspect, Legal Expenses Insurance Companies are normally regulated by the Law Society as well as the FSA. This being the case you could always try a complaint to the Legal Complaints Service who deal with complaints on behalf of the Law Society.

[cx500]

Dear JJRJ,

Thank you for your reply. I will try making a complaint to the Legal Complaints Service.

CX500