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2CAT - Home Insurance Policy - Legal cover


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I have an ongoing ET claim for unfair dismissal, failure to make reasonable adjustments and disability discrimination.

I have, however, run into some difficulties trying the claim on my house insurance’s legal cover.

I have been refused cover on the grounds that my claim is out of time.

Timeline:

May 2010 – Injury

July 2011 – Home Insurance Policy started including legal cover

Dec 2011 – Dismissal

March 2012 – ET1 accepted

July 2012 – Legal cover claim (within time of policy)

The letter I received says “ As the incidents giving rise to your claim occurred prior to the date when the policy first came into force, the claim would not be covered under your policy”.

I understand what they are saying, but surely, if my dismissal and ET falls within the policy period, that is the basis of my claim.

Can anyone help me formulate a response for them to reconsider their decision?

Legal cover/solicitor wise, I do remember reading here a little while ago about if your case is not assessed as more than 51% probability, you can take it to adjudication by a barrister. Forget what it’s called exactly. Is there an equivalent process ?

Thanks in advance

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I'm afraid you cannot insure something which has already happened. I think the company are correct. (Used to work in finance before HR)

Never assume anyone on the internet is who they say they are. Only rely on advice from insured professionals you have paid for!

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Thanks for your input. I was hoping to argue that I was dismissed AFTER taking out the policy (6 months later) and consequently then had cause to bring an ET all in the required period. Irrespective of when my injury was caused.

 

And I thought Tribunal timelines were strict!

Edited by 2Cat
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Ugh, legal expenses insurers are the **** of the earth. Unfortunately, I know this as the vast majority of my cases are LEI funded!

 

Wikst they are technically correct about the disability discrimination point, you should argue that the failure to make reasonable adjustments was a continuing failure and therefore it should be covered. Furthermore, the dismissal occurred 4 months after you took out your insurance policy, therefore this should almost certainly be considered for funding.

 

In terms of the 51% point, this applies to how likely you are to succeed if funding is given to you. This doesn't apply to you right now as they're refusing to indemnify you altogether. If you manage to point out that the unfair dismissal claim should be covered and they then refuse saying you're unlikely to win, you have the right to request a barristers opinion. If it goes in your favour, the insurance company pay the cost (£350ish) but if the barrister doesn't think you have a good chance of winning, you would have to pay them.

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Hello again.

 

I've been thinking about this. Are you saying that the injury that occurred before you took out the policy led to your claim? I wonder if that's what they're focussing on?

 

HB

 

I wondered that too, but it's not a legitimate argument - if someone was paralysed in an accident but ten years later suffered discrimination, they'd have to cover it.

 

OP - it might be worth instructing a solicitor privately. I don't know if all firms are the same, but for example, I never charge my clients for any work undertaken in securing insurance funding. It can take weeks though, which means you'd probably have to pay for any work done aside from insurance correspondence to progress your claim.

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I was injured prior to taking my policy. However, I do not see how they can legitimately justify refusing cover based on the date I sustained my injury which lead to my capability dismissal, given my dismissal and ET claim fall within the policy cover. I doubt many people's employment disputes fit nicely within a policy cover period, particularly with discrimination which can take place over a number of years.

 

The precise wording of the letter:

“Legal Protection policy first came into force on 22/7/11.

Under the terms of the policy, [company] will cover the insured incident under Legal Expenses section of the policy so long as the date of occurance of the insured incident is during the period of insurance. For a civil case the date of occurrence is the date of the event which may lead to a claim; if there is more than one event arising at the same time or from the same cause, the date of occurrence is the date of the first of these events.

...

Hence the incidents that ultimately led to the respondent’s termination of your contract of employment occurred prior to 22/7/12 which was the date when your policy first came into force.

As the incidents gioving rise to your claim occurred prior to the date when the policy first came into force, the claim would not be covered under your policy.”

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