ABSTRACT
This Chapter considers some of the more important legal issues which arise in connection with the insurance claims process, from the initial presentation of a claim through to payment by the insurer. All modern policies of insurance include terms and conditions requiring the insured to give the insurer notice of claims, or of circumstances which may give rise to a claim or loss, in a particular manner and within a particular period. Insurers usually try to give notification clauses the character of conditions precedent, so that any breach, however trivial, relieves the insurer of liability to pay the claim. The Insurance Conduct of Business Rules (ICOB) require insurers to carry out claims handling promptly and fairly. Breach of the ICOB rules is actionable at the suit of a private person who suffers loss as a result of the breach, subject to the deferences and other incidents applying to actions for breach of statutory duty: Financial Services and Markets Act.
