YBC Commercial Legal Expenses Insurance Policy Wording – September 2016

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Commercial Legal Expenses Insurance Policy

About this policy

This Policy has been arranged by Qdos Broker & Underwriting Services Limited and is underwritten by UK General Insurance Limited on behalf of:

Great Lakes Reinsurance (UK) SE, Registered in England No. SE000083.

Registered Office: Plantation Place, 30 Fenchurch Street, London, EC3M
3AJ

Qdos Broker & Underwriting Services Limited and UK General Insurance Limited are authorised and regulated by the Financial Conduct Authority.

Great Lakes Reinsurance (UK) SE is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

This can be checked on the Financial Services Register at www.fca.org.uk/firms/systems-reporting/register or by contacting them on 0800 111 6768.

This is a “claims made” insurance Policy. This insurance only covers Claims notified to the Coverholder within the Period of Insurance.

The Insured has submitted a written proposal, declaration or renewal declaration to the Insurer it is agreed this shall form the basis for the issue of this Policy. The Insurer agrees in consideration of the premium to indemnify the Insured to the extent and in the manner provided within this Policy in connection with the business activities of the Insured.

Unless expressly stated nothing in this Policy will create rights pursuant to the Contract (Rights of Third Parties) Act 1999.


Legal advice

General legal advice

You can obtain telephone legal advice on UK Law by telephoning the Qdos Legal Advice Line. The telephone number is 0333 358 3677 and you will need to quote your YBC membership name and/or number.

The advice provided under these services is confidential and impartial. Please note that conversations may be recorded in the interests of quality of advice and training.

The advice lines are not empowered to give advice on the admissibility of any claim under this

Policy. If You wish to make a claim or have a query about the policy cover You must contact the Coverholder’s Claims Department.


Special conditions: Employment disputes

We will only agree to cover your Claim if you have sought and followed advice from the Qdos Legal Advice Line and obtained their authorisation:

  1. Prior to any adverse variation of the terms and conditions of employment (including alteration of place or time or hours worked or demotion or deduction from or reduction in an Employee’s remuneration);
  2. Upon notification formally or informally of a grievance from an Employee or Ex-employee;
  3. Prior to instituting a redundancy programme and prior to making an Employee redundant;
  4. Prior to carrying out any disciplinary procedure or action or suspension of an Employee;
  5. Prior to dismissal of an Employee;
  6. Immediately an Employee walks out with or without written notice;
  7. Upon receipt of an appeal from an Employee or Ex-employee against a decision taken as a result of a disciplinary or grievance procedure or a decision to dismiss.
  8. Upon notification formally or informally of a complaint of sexual, racial or religious discrimination or discrimination relating to disability, age or sexual orientation.

Making a claim

If you need to notify a potential Claim, please call 0333 358 3677 or write to:

YBC Claims Department
Qdos Broker & Underwriting Services Limited
Windsor House
Troon Way Business Centre
Humberstone Lane
Thurmaston
Leicestershire
LE4 9HA
Email: claims@qdosunderwriting.com

You should provide your YBC membership name and/or number and a description of the circumstances of the Claim. A claim form will then be provided and you should complete this and return it without delay. Please note that in certain circumstances Qdos Broker & Underwriting Services Limited will choose suitable legal representation to act upon your behalf.

For further information regarding claims please refer to the section titled ‘Claims conditions’.


Definitions

Each of the words or phrases listed below will have the same meaning wherever they appear in italics throughout this Policy.

Acts of Parliament

All Acts of Parliament referred to in this Policy shall include any subsequent amendments, re-enactments or regulations and equivalent legislation enforceable within the Territorial Limits.

Any One Claim

All Claims consequent upon the same original cause, event or circumstance.

Appointed Representatives

A solicitor, accountant or other appropriately qualified person or firm as nominated on the Policy Schedule or as approved by the Insurer who is appointed to represent the Insured in accordance with the terms of this Policy.

Awards of Compensation

Basic and Compensatory Awards and compensation for unlawful discrimination made against the Insured by an Employment Tribunal or settlement thereof subject to the consent of the  Coverholder but not including Additional Awards, Protective Awards, Interim Relief, Arrears of Pay, or Awards of Damages under the Equal Pay Act or arising out of failure to comply with awards in respect of reinstatement or re-engagement. The Insurer will not pay any fine, awards or damages incurred by deliberately avoiding a payment or liability under statutory requirements. The Insurer will not pay any redundancy payment or monies due or properly payable arising under or from a contract of employment, service agreement or related document or
from any related implied or incorporated terms of contract service.

Claim

A Claim under the Policy for Legal Expenses, Professional Expenses, Awards of Compensation, Jury Service Allowance or Witness Attendance Allowance.

Computer Virus

A set of corrupting, harmful, or otherwise unauthorised instructions or code, whether these have been introduced maliciously or otherwise, and multiply themselves through a computer system or network of whatsoever nature.

Consequential Loss

Any other costs that are directly or indirectly caused by the event which led to a claim unless specifically stated in this Policy.

Contracting Party

A person, firm or company domiciled within the Territorial Limits with whom the Insured has a direct contractual relationship.

Coverholder

Qdos Broker & Underwriting Services Limited, who administers and manages this insurance on behalf of the Insurer.

Debt Collection Service

The Debt Collection Service nominated by the Coverholder.

Due Date

The date monies owed to the Insured first become due for payment.

Electronic Data

Facts, concepts and information stored to form useable for communications, interpretations, or processing by electronic or electromechanical data processing or other electronically controlled hardware, software and other coded instructions for the processing and manipulation of data, or the direction and manipulation of such hardware.

Employee, Ex-employee

Any person under contract of service, or who was previously under a contract of service, with the Insured.

Excess

The amount specified in the Schedule the Insured must pay in respect of Legal Expenses and/or Professional Expenses and/or Awards of Compensation in respect of Any One Claim before the Insurer shall be liable to make any payment.

HMRC Investigation

(a) Business Self Assessment Full Enquiry

The investigation which takes place when an officer of HM Revenue and Customs (“HMRC”) makes a request to examine all of the Insured’s’ busines books and records and issues a formal notice under S9A or S12AC of the Taxes Management Act 1970 or under Paragraph 24(1) Schedule 18 Finance Act 1998.

(b) Employer Compliance Disputes

The enquiries which take place following an expression of dissatisfaction with the Insured’s PAYE and/or NIC affairs following an employer compliance visit by HMRC or following an expression of dissatisfaction with the Insured’s P11Ds or P9Ds.

(c) Business Self Assessment Aspect Enquiry

The enquiry which takes place when an officer of HMRC issues a formal notice under Paragraph 24(1) Schedule 18 Finance Act 1998 or S9A or S12AC of the Taxes Management Act 1970 in order to make Aspect Enquiry into only certain boxes on the Insured’s Self Assessment Return.

(d) VAT Disputes

The enquiries which take place following a written decision assessment or statement of alleged arrears made by HMRC into the Insured’s Value Added Tax Return and/or any related Value Added Tax default surcharges and misdeclaration penalties.

Injury

Identifiable physical damage to the Insured’s body or body part, which occurs during the Period of Insurance.

Insured

The Company, firm, partnership, or trading individual specified in the Schedule and, at the Insured’s request, any Employee including a director or partner of the Insured.

Insured Event

An event, act or omission giving rise to a Claim against the Policy.

Insurer

UK General Insurance Limited on behalf of Great Lakes Reinsurance (UK) SE. UK General Insurance Limited is an agent of Great Lakes Reinsurance (UK) SE and in the matters of a Claim act on their behalf.

Jury Service Allowance

The amount of money per day the Insured is liable to pay the Employee each day they attend on jury service less any recovery from the Court.

Legal Expenses

(a) Fees

Any professional fees, expenses and other disbursements reasonably incurred by the Appointed Representative with the consent of the Coverholder;
and
Any costs incurred by other parties insofar as the Insured is held liable to pay such costs under a settlement made with another party with the consent
of the Coverholder but excluding any costs which the Insured may be ordered to pay by a court of criminal jurisdiction.

(b) Witness Attendance Allowance
The amount of money per day the Insured is liable to pay the Employee each day they are required by the Appointed Representative to attend as a witness at a court or tribunal hearing. Indemnity limited to £100 per day and a maximum of £1,000 in Any One Claim.

Legal Proceedings

The pursuit or defence of Legal Proceedings in a court of suitable jurisdiction made by or brought against the Insured, including appealing or defending
an appeal against a judgment made in proceedings funded by this insurance, within the jurisdiction of a court or other body within the Territorial Limits.

Limit of Indemnity

The maximum amount payable by the Insurer in respect of Any One Claim and in aggregate for all Claims made during any Period of Insurance.

Period of Insurance

As specified in the Schedule.

Professional Expenses

Any fees, expenses and other disbursements reasonably incurred by the Appointed Representative with the consent of the Coverholder but excluding any tax or VAT, additional tax or VAT, interest or penalties demanded, assessed or required by the relevant authorities or other penalties imposed by a court of criminal jurisdiction.

Property

Land and/or buildings owned or occupied by the Insured or otherwise for which the Insured is legally responsible.

Statutory Licence

A licence or certificate of registration issued under statute, statutory instrument or Government or local authority to the Insured provided that such licence or certificate is necessary to engage in the business activities of the Insured.

Territorial Limits

The United Kingdom of Great Britain and Northern Ireland, including the Channel Islands and the Isle of Man.


This policy will cover

The sections of cover applicable are specified in the Policy Schedule.

The Insurer will indemnify the Insured against Legal Expenses incurred by the Appointed Representative when undertaking work on the Insured’s behalf in respect of an Insured Event covered by this Policy. Provided that the time of occurrence is within the Period of Insurance and provided that the Claim is notified to the Insurer during the Period of Insurance and the Claim falls within the Territorial Limits.

Section 1: Employment Disputes

The Insurer agrees to indemnify the Insured against Legal Expenses and Awards of Compensation incurred by the Insured in defending Legal Proceedings brought against the Insured by an Employee, Ex-employee or prospective Employee in respect of their contract of employment with the Insured or a breach of employment related legislation.

It is a condition precedent to the Insurer’s liability that the Insured has sought and followed all the advice from the Qdos Legal Advice Line as to the process and procedure to be adopted and has received specific authorisation from the Qdos Legal Advice Line:

  • Prior to any adverse variation of the terms and conditions of employment (including alteration of place or time or hours worked or demotion or deduction from or reduction in an Employee’s remuneration);
  • Upon notification formally or informally of a grievance from an Employee or Ex-employee;
  • Prior to instituting a redundancy programme and prior to making an Employee redundant;
  • Prior to carrying out any disciplinary procedure or action or suspension of an Employee;
  • Prior to dismissal of an Employee;
  • Immediately an Employee walks out with or without written notice;
  • Upon receipt of an appeal from an Employee or Ex-employee against a decision taken as a result of a disciplinary or grievance procedure or a decision to dismiss.
  • Upon notification formally or informally of a complaint of sexual, racial or religious discrimination or discrimination relating to disability, age or sexual orientation.

Exclusions to Section 1

The Insurer will not pay:

  1. Any defence of an action for damages in respect of personal Injury including stress related matters or loss of or damage to Property.
  2. Any awards to the extent that they relate to contractual rights accruing to the Employee, Ex-employee or prospective Employee prior to theactual or alleged breach of the actual or alleged Contract of Employment.
  3. Any award made because of the Insured’s failure to provide written reason for dismissal.
  4. Any payment due in respect of redundancy.
  5. Any benefit due under a Contract of Employment.
  6. Any compensatory award made against the Insured relating to or arising from Trade Union activities including membership or non membership.
  7. Any compensatory award specified in a re-instatement or re-engagement order.
  8. Any award made as a result of the failure of the Insured to issue the Employee with a written statement of the terms of employment or toissue the Employee with compliant written details of the employer’s disciplinary and grievance procedures.
  9. Any Claim where the Insured did not seek advice from the Qdos Legal Advice Line

Section 2: Health & Safety Prosecutions

The defence of a criminal prosecution arising from:

  1. The Carriage of Dangerous Goods Regulations provided that the Insured has appointed a qualified Dangerous Goods Safety Advisor (DGSA) as required under the Transport of Dangerous Goods (Safety Advisers) Regulations 1999.
  2. Occupational hygiene including but not limited to the COSHH and CHIP regulations.
  3. Health and safety at work and occupational hygiene including but not limited to the Health and Safety at Work etc Act 1974.
  4. Food safety hygiene and food legality including but not limited to the Food Safety Act 1990.
  5. Supply of safe goods including but not limited to the Consumer Protection Act 1987 the Food Safety Act 1990 and the Health and Safety at Work etc Act 1974.
  6. An appeal against the service of an Improvement Notice or a Prohibition Notice under the Health and Safety at Work etc Act 1974 or the Health and Safety (Northern Ireland) Order 1978 and their supporting Regulations.

Exclusions to Section 2

The Insurer will not pay Legal Expenses arising from or relating to the defence of a criminal prosecution:

  1. Relating to the ownership possession hiring or use of a motor vehicle aircraft or watercraft,
  2. Which does not arise out of the normal business activities of the Insured.
  3. Deliberately or intentionally solicited by the Insured, or where an alleged offence involves dishonesty or intentional threatened or actual violence by the Insured unless he is subsequently acquitted of such offence.
  4. Where the Insured has pleaded guilty and/or admitted liability.
  5. Disputes relating to the Corporate Manslaughter and Corporate Homicide Act 2007.
  6. including offences:
    a) Brought under Road Traffic and Transport Acts (not including the Regulations relating to dangerous goods).
    b) Brought as a result of unsafe motive power rolling stock or incidents on railway property.
    c) Relating to any substance in Class 7 (radioactive substances).
    d) Relating to workplaces on or in a ship within the meaning of S.313 (1) of the Merchant Shipping Act 1995.

 Section 3: Tax Protection

A full enquiry by H M Revenue & Customs (HMRC) into the Insured’s self-assessment return following the issue of a notice under Section 9A or Section 12AC of the Taxes Management Act 1970 or Schedule 18, paragraph 24 of the Finance Act 1998 which includes a request to examine all the
Insured’s books and records, including Legal Expenses incurred in respect of preparation and representation of the Insured at a HMRC Commissioners’ Hearing.

An aspect enquiry by HMRC which is limited to one or more specific aspects of the Insured’s self-assessment return following the issue of a notice under Section 9A or Section 12AC of the Taxes Management Act 1970 or Schedule 18, paragraph 24 of the Finance Act 1998 which does not include
a request to examine all the Insured’s books and records.

Fees incurred in respect of any challenge in writing HMRC of the accuracy or completeness of returns submitted in accordance with the PAYE regulations following a compliance review by HMRC into the operation of PAYE, including Legal Expenses incurred in respect of preparation and representation of the Insured at a HMRC Commissioners’ Hearing.

An appeal, including the local review procedure, to a VAT and Duties Tribunal, against an assessment or written decision issued by HMRC relating to the Insured’s VAT affairs.

Exclusions to Section 3

The Insurer will not pay Legal Expenses arising from or relating to:

  1. Any criminal prosecution.
  2. Any dispute or enquiry where the accounts submitted are being investigated solely because earlier books, records or returns have been investigated or are already under enquiry.
  3. The Insured’s actual or alleged misstatement with intent to deceive contained in any relevant business books, records or returns. If such intent is shown the Insurer shall be entitled to recover such indemnity as it has actually provided.
  4. Any dispute or enquiry that commenced prior to the inception of this policy.
  5. Any tax avoidance scheme undertaken by the Insured.
  6. An enquiry undertaken under Section 60 or 61 of the VAT Act 1994 or enquiry by the Investigations Division, the Board’s Investigation Office or the Special Compliance Offices of HMRC.
  7. Any work in connection with the normal reconciliation of the annual accounts and VAT returns where such reconciliation has not been undertaken prior to the dispute or enquiry arising.
  8. Any issue of law practice or procedure not directly connected with the particular enquiry or dispute which is the subject of the Claim.
  9. Any Claim arising from an enquiry into an Insured’s tax return or an amendment to an Insured’s tax return or any other statutory return that was not submitted within the statutory time limits. In order for the statutory return to be regarded as having been submitted within the statutory time limits, HMRC must have deemed this to be the case and the filing date must not allow HMRC the right to extend their enquiry window beyond the normal time limit of 12 months after the due filing date. Where an amendment to a Insured’s tax return or an amendment to any other statutory return is submitted within the 12 months after the due filing date and HMRC execute an enquiry into the return within that 12 months period then this exclusion will not apply.
  10. Any dispute or enquiry where dishonesty, fraud or fraudulent intent is alleged unless, at the culmination of such dispute or enquiry, it is proved that the Insured was found not guilty of dishonesty, fraud or fraudulent intent.

Section 4: Criminal Prosecution Defence

The Insurer agrees to indemnify the Insured against Legal Expenses incurred in:

  1. Defending a prosecution against the Insured in a court of criminal jurisdiction;
  2. An appeal by the Insured against the service of an Improvement or Prohibition Notice under the Health & Safety at Work etc Act 1974 or the Food Safety Act 1990.

Exclusions to Section 4

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with:

  1. Any legal proceedings where the Insured has pleaded guilty and/or admitted liability;
  2. Any prosecution for non-endorsable road traffic offences except tachograph prosecutions and weight prosecutions;
  3. Failure to insure a motor vehicle as required by law;
  4. Any prosecution relating to or arising from investigations by HMRC;
  5. Any prosecution for criminal damage;
  6. Any prosecution for offences against the person, including offences of a sexual nature;
  7. Any prosecution alleging dishonesty;
  8. An allegation of speeding or driving whilst under the influence of alcohol and or drugs;
  9. Any alleged deliberate or intentional act unless the charges are dismissed or the Insured is acquitted;
  10. Any proceedings, which do not relate to the business activities of the Insured.

Section 5: Statutory Licence Protection

An appeal or representation to the relevant statutory or regulatory Licence Protection authority, Court, Tribunal or other mandatory body following an act, or omission or alleged act or omission which leads to the suspending, revoking, altering the terms of or refusing to renew any of the Insured’s licences.

Exclusions to Section 5

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with:

  1. Driving licences;
  2. Any Claim relating to an original application or renewal or in respect of which an appeal or representation was made in the 12 months immediately preceding the inception of this insurance, except in the case of renewal or continuation of existing insurance arrangements
  3. Any disciplinary or internal procedures conducted by authorities charged with the regulation of the Insured in the performance of their business activities or for any appeal following such procedures;
  4. Any costs incurred to comply with a notice or order;
  5. An alteration or refusal to renew a Statutory Licence which is imposed by an Act of Parliament.

Section 6: Jury Service Allowance

The Insurer agrees to indemnify the income, salary or wages of the Insured or any director of, partners in or Employee of the Insured, in respect of that individual’s obligations to attend court for jury service insofar as it is not recoverable from the relevant Court up to a maximum of £100 per day and limited to a maximum of £1,000 for Any One Claim.

Exclusions to Section 6

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with any Claim arising from a jury service request served prior to the commencement of this insurance or where the juror has received such a request within the two years immediately preceding this insurance and has been able to postpone the effect of the jury service request except in the case of a renewal or continuation of existing insurance arrangements.

Section 7: Property Disputes

The Insurer agrees to indemnify the Insured against Legal Expenses Incurred in any dispute or Legal Proceedings made by or brought against the Insured:

Over the physical possession of the Property provided that all statutory and contractual notices have been correctly served by the Insured;

Over the terms of a tenancy agreement between the Insured and a Contracting Party relating to the use or maintenance of the Property including dilapidations;

Other than with a tenant over the actual or alleged negligence, damage or nuisance to the Property;
provided that the Insured will suffer financial loss if the Insured fails to pursue or defend the dispute or Legal Proceedings.

Exclusions to Section 7

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with:

  1. Any dispute relating to the payment of rent, service charges or any other payments due under the terms of the lease, licence or tenancy agreement between the Insured and his landlord;
  2. The renewal of the lease, licence or tenancy agreement between the Insured and his landlord or any dispute arising during a rent review period;
  3. Any dispute relating to planning or building regulations or decisions or compulsory purchase orders or any actual, planned or proposed works by or under the order of any government or public or local authority;
  4. Any dispute where the Insured has failed to maintain in full force and effect during a tenancy agreement buildings insurance covering the standard range of perils if the Insured was contractually obligated to have such insurance in force;
  5. A contract dispute other than that of a tenancy agreement with a Contracting Party;
  6. A dispute over subsidence or heave howsoever caused.

 

Section 8: Data Protection

The Insurer agrees to indemnify the Insured against any Legal Expenses incurred in defending any civil proceedings brought against the Insured for compensation under Section 13 of the Data Protection Act 1998 provided that the Insured is already registered with the Data Protection Commissioner.

Exclusions to Section 8

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with any legal action concerning the grant and/or execution of a warrant of entry.

Section 9: Personal Injury

The Insurer agrees to indemnify the Insured against any Legal Expenses incurred in pursuit of Legal Proceedings to recover damages for death of, or bodily Injury to that of the Insured or any director of, partner in or Employee of the Insured.

Exclusions to Section 9

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with any Claim alleging clinical negligence or any illness, naturally occurring condition or degenerative process, which develops gradually and is not caused by a specific sudden accident.

Section 10: Debt Recovery

The Insurer agrees to indemnify the Insured against any Legal Expenses incurred in the pursuit of Legal Proceedings arising from a dispute with a customer in respect of an uncontested debt that arises from the sale or provision of goods or services, provided that:

  1. The amount in dispute exceeds £500;
  2. The Insurer is notified of the Claim within three months of the debt becoming due and payable;
  3. The Insured has exhausted all reasonable credit control and accounting procedures;
  4. The Insured agrees to appoint our nominated debt recovery service as the Appointed Representative;
  5. The Insurer has the right to select the method of enforcement;
  6. The Insurer is satisfied that the defendant has sufficient assets to satisfy any judgment debt;
  7. The number of Claims that can be notified during the Period of Insurance is limited to five.

Exclusions to Section 10

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with:

  1. The recovery of a disputed debt;
  2. A lease or tenancy of land or buildings;
  3. The ownership, possession, hiring or use of a motor vehicle, aircraft or watercraft.

Section 11: Contract Cover

The Insurer agrees to indemnify the Insured against Legal Expenses incurred in the pursuit or defence of any Legal Proceedings made by or brought against the Insured in a contractual dispute with a Contracting Party over a contract for the sale of goods or a contract for the hire of goods or a
contract for the supply of a service within the meaning laid down in the Sales of Goods Act 1979, and or the Supply of Goods Act 1982 provided that

  1. Legal Expenses incurred in the pursuit of any proceedings be limited to 75% of the amount in dispute;
  2. The amount in dispute exceeds £1000;
  3. Where the dispute relates to monies owed to the Insured and such liability is not contested the Insured refers the debt to the Debt Collection Service within 30 days of the Due Date and agrees use of the service shall be paid for by the Insured and not indemnified by the Insurer. Should the Debt Collection Service exhaust its normal recovery process and recommends that legal proceeding should take place, the Insured will immediately notify a Claim under this Section of Cover.

Exclusions to Section 11

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with:

  1. An undisputed debt owed to the Insured;
  2. Any licence or franchise agreement;
  3. A dispute about either the amount an insurance company should pay to settle an insurance Claim or the way a Claim should be settled;
  4. The letting or tenancy of a Property;
  5. The construction, extension, alteration, demolition, repair, renovation or refurbishment of any Property;
  6. The ownership, possession, hiring or use of a motor vehicle, aircraft or watercraft.

Section 12: Restrictive Covenants

The Insurer agrees to indemnify the Insured against Legal Expenses incurred in the pursuit of Legal Proceedings against an Employee or former Employee who is in breach of restrictions contained within a written contract of employment signed by the Employee.

Section 13: Motor Disputes

The Insurer agrees to indemnify the Insured against Legal Expenses incurred in the pursuit or defence of Legal Proceedings;

  1. Between the Insured and a customer or supplier in respect of a contract for the sale, purchase, hire, lease, hire purchase, service, repair or test of a motor vehicle owned by the Insured or for which the Insured is legally responsible;
  2. The pursuit of Legal Proceedings by the Insured to recover damages, including damages for personal Injury, suffered by the Insured any director of, partner in or Employee of the Insured, following a road traffic accident, provided that the motor vehicle in which the director of, partner in or Employee of the Insured was travelling is properly Insured as required by law at the time of occurrence.

Exclusions to Section 13

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with any criminal prosecution relating to the ownership or use of a motor vehicle.

Section 14: Insolvency Fees

The Insurer agrees to indemnify the Insured against payment of the fees of an insolvency practitioner acting as an insolvency office holder who has been appointed following the insolvency of the Insured where there are insufficient assets of the Insured to meet such costs.

Cover is limited to a maximum of:

  1. Personal Insolvency 50% of Nominees’ Fees in a Voluntary Arrangement;
  2. Limited Company Insolvency to a maximum of £10,000 with an Excess of £1,500.

Exclusions to Section 14

The Insurer will not be liable to indemnify the Insured in respect of Claims arising out of or in connection with:

  1. A bankruptcy;
  2. A Compulsory Liquidation;
  3. An insolvency involving of a Insured who is outside the Territorial Limits of England & Wales;
  4. The payment of fees to an insolvency practitioner not approved by the Insurer;
  5. The Insurer will not pay the fees of the insolvency practitioner where there is an indication that the directors or proprietors of the Insured have acted illegally.

Section 15: Wrongful Arrest Defence

The Insurer agrees to indemnify against Legal Expenses incurred in defending civil proceedings against the Insured with regard to allegations of wrongful arrests or malicious prosecution.

Exclusions to Section 15

The Insurer shall not be liable to indemnify the Insured in the respect of any Claim arising out of or in connection with allegations made by or against or on behalf of an Employee or Ex-Employee or any other person working or contracting for the Insured whether or not an Employee.


This policy will not cover

The Insurer shall not be liable to indemnify the Insured in respect of:

  1. Any dispute arising during the first 90 days of the first Period of Insurance, or during the first 30 days of the first Period of Insurance in respect of HMRC Investigations, unless it can be evidenced that the Insured previously held legal expenses cover with another insurer immediately prior to inception of this Policy.
  2. An Insured Event reported more than 90 days after its time of occurrence.
  3. An Insured Event reported outside the Period of Insurance.
  4. Any dispute, Legal Proceedings or HMRC Investigation made, brought or commenced outside the Territorial Limits.
  5. Any Claim relating to or arising from any cause event or circumstance occurring prior to or existing at inception of this Policy and which has or which the Insured knew or ought reasonably to have known may give rise to a dispute, Legal Proceedings or HMRC Investigation by or
    against the Insured.
  6. Fees costs and disbursements incurred prior to the written acceptance of a Claim.
  7. Patents, copyrights, trademarks, merchandise marks, registered designs, intellectual property, secrecy and confidentiality agreements.
  8. any loss, liability, cost or expense, or any other amount incurred by or accruing to the insured, directly or indirectly and regardless of any other cause contributing concurrently or in any sequence, originating from, caused by, arising out of, contributed to by, resulting from, or
    otherwise in connection with:
    i. irradiation or contamination by nuclear material; or
    ii. the radioactive, toxic, explosive or other hazardous or contaminating properties of any radioactive matter; or
    iii. any device or weapon employing atomic or nuclear fission and / or fusion or other like reaction or radioactive force or matter
  9. Legal Expenses arising directly or indirectly from the failure of computer, data processing and any other electrical equipment or component, including microchips, integrated circuits and similar devices and or any software to recognize, interpret or process any data as its true calendar date.
  10. Any consequence, howsoever caused, including but not limited to Computer Virus in Electronic Data being lost, destroyed, distorted, altered, or otherwise corrupted.
  11. Disputes relating to written or verbal remarks, which damage the Insured’s reputation.
  12. Causes of action intentionally brought about by the Insured.
  13. Any Claim which, in the Insurer’s opinion, or the Appointed Representative’s opinion, is believed not to have reasonable prospects of achieving the result for which Legal Proceedings are contemplated.
  14. Legal Expenses incurred before the Insurer agrees to pay them or where the Insured pursues or defends a case without the agreement of the Insurer or in a different manner to or against the advice of the Appointed Representative or fails to give proper instructions in due time to the Insurer, Appointed Representative or to Counsel or other persons instructed by the Appointed Representative or where the Appointed Representative refuses to act on behalf of the Insured for any reason other than a conflict of interest or in respect of witnesses, experts or agents interviewed, engaged or called on as witness without the prior written approval of the Insurer
  15. Any Claim where the Insured, in the reasonable opinion of the Insurer, acts in a manner which is prejudicial to the case, including being responsible for any unreasonable delay, withdrawing instructions from the Appointed Representative or withdrawing from the case.
  16. Legal Expenses which can be recovered by the Insured under any other insurance or which would have been covered if this policy did not exist except for any amount in Excess of that which would have been payable under such other insurance.
  17. Fines, damages or other penalties, which the Insured is ordered to pay by a Court or other authority.
  18. Legal Expenses relating to any judicial review.
  19. Any Claim for Legal Expenses when the Insured is bankrupt, or in receivership, liquidation, administration, has made an arrangement with creditors, has entered into a Deed of Arrangement or part or all of the Insured’s affairs or property are in the care or control of a receiver or an administrator with the exception of a Claim made in respect of Section 14 Insolvency Fees.
  20. Any dispute with the Insurer,Qdos or Your Business Community.
  21. Please note that the rights conferred by the Third Parties (Rights Against Insurers Act) 1930 are specifically excluded from applying to this policy.
  22. The defence of the Insured in civil Legal Proceedings arising from:
    a) Injury or disease including psychiatric Injury or stress;
    b) Loss, destruction, or damage of or to Property;
    c) Alleged breach of professional duty;
    d) Any tortuous liability (other than specified in Section 7. Property disputes.)
  23. Disputes relating to the Corporate Manslaughter and Corporate Homicide Act 2007.
  24. any loss or damage directly or indirectly occasioned by, happening through or in consequence of war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition or destruction of or damage to property by or under the order of any government or public or local authority;
  25. Any direct or indirect consequence of terrorism as defined by the Terrorism Act 2000 and any amending or substituting legislation. We will, however, cover any loss or damage (but not related cost or expense, caused by any act of terrorism provided that such act did not happen directly or indirectly because of biological, chemical, radioactive or nuclear pollution or contamination or explosion.

General conditions

Arbitration

Any dispute or difference of any kind between the Insurer and the Insured will be referred to arbitration by a single arbitrator who will be either a barrister or solicitor. If the parties are unable to agree on the appointment of an arbitrator, all parties agree to accept an arbitrator nominated by the Law Society, the Bar Council or appropriate professional body within England and Wales. The apportionment of costs shall be determined by the arbitrator and their decision will be final and binding on all parties.

Cancellation

If You decide that for any reason that this policy does not meet Your insurance needs, then please return it to the insurance broker or agent who provided this policy to You within 14 days from the day of purchase or on the day you receive your policy documentation, whichever is the later. On
the condition that no claims have been made or are pending, We will then refund Your premium in full. If You wish to cancel your policy after 14 days You will not be entitled to a refund.
The Insurer shall not be bound to accept renewal of any insurance and may at any time cancel any insurance document by giving 30 days’ notice in writing where there is a valid reason for doing so. A cancellation letter will be sent to You at Your last known address. Valid reasons may include but
are not limited to:

  1. Threatening and abusive behaviour
  2. Fraud
  3. Non-payment of premium
  4. Non-compliance with policy terms and conditions

Provided the premium has been paid in full You will be entitled to a proportionate rebate of premium in respect of the unexpired period showing on the
insurance.

Insured’s Responsibilities

The Insured must notify the Insurer as soon as is reasonably possible of any change in the information given to them which may affect this insurance or any circumstances which may give rise to a Claim. Failure to do so may invalidate the Insured’s insurance or may result in cover not operating fully. The Insurer reserves the right to alter the terms, charge an additional premium or cancel this insurance should they become aware of any fact, which may affect the cover provided by this insurance. The Insured must:

  1. Try to prevent any incident that may give rise to a Claim.
  2. Observe the terms and conditions of this insurance.
  3. Take all reasonable steps to minimise the amount payable by the Insurer.

Assignment

This Policy of insurance is between and binding upon the Insurer and the Insured and their respective successors in title, however the Policy may not
be otherwise assigned by the Insured without prior written consent.

Waiver

If the Insurer fails to exercise or enforce any rights conferred on them by this insurance, the failure to do so will not be deemed to be a waiver, nor will it bar the exercise or enforcement of such rights at any such time.

Governing Law

Unless some other law is agreed in writing, this policy is governed by English law. If there is a dispute, it will only be dealt with in the courts of England or of the country within the United Kingdom in which your main residence is situated.


Claims conditions

1. Reporting a Claim

The Insurer should, as soon as possible be notified in writing of any potential Claim and be provided with any written or other evidence relevant to the issues giving rise to the Claim. The Insured will be required to provide the names of any possible witnesses and details, of any costs incurred prior to
the Insurer accepting the Claim, including any action already taken.

Claims should be made by contacting the Claims Department as soon as is reasonably practical on 01455 852100, or by writing to:

Claims Department
Qdos Broker & Underwriting Services Limited
Windsor House
Troon Way Business Centre
Humberstone Lane
Thurmaston
Leicestershire
LE4 9HA

Email: claims@qdosunderwriting.com

2. Coverholder’s Consent

It is a condition precedent to the liability of the Insurer that their consent to incur Legal Expenses or Professional Expenses must firstly be obtained in writing. This consent will be given by the Coverholder on behalf of the Insurer, if the Insured can satisfy the Coverholder that:

1. It is reasonable to incur Legal Expenses or Professional Expenses having regard to the proportionality between remedy claimed and the Legal Expenses or Professional Expenses to be incurred;

2.
a) Where the Insured is pursuing, there are reasonable prospects of proving the other party’s legal liability and of recovering the damages claimed or other legal remedies sought; or,
b) Where the Insured is defending, the other party does not have reasonable prospects of proving the Insured’s legal liability; or,
c) In respect of criminal prosecution and where the Insured pleads guilty there is a reasonable prospect of significant mitigation of the Insured’s sentence or fine.

Should during the course of a Claim the Insured ceases to satisfy the Coverholder in respect of 1 and 2 of Coverholder’s Consent indemnity will be withdrawn. For a decision to be made on granting or withholding consent the following must be received by the Coverholder:

  • Any advice the Coverholder may deem necessary to take;
  • A completed insurance Claim form;
  • The documentation and information reasonably requested by the Coverholder;
  • A legal opinion from the Appointed Representative as to 1 and 2 of Coverholder’s Consent.

The Coverholder reserves the right to limit its consent by time and or financial amount of Legal Expenses or Professional Expenses and or stage of proceedings to allow for a review of their continued consent.

The Coverholder at its discretion may require the Insured to seek an opinion from counsel, at the Insured’s expense, as to the merits of the Claim. Such opinion is to have regard to the same issues that the Coverholder has in assessing the merits of any legal action. If based upon such an opinion
the Coverholder is satisfied in respect of 1 and 2 of Coverholder’s Consent the Legal Expenses and Professional Expenses in obtaining that opinion will be paid by the Insurer within the Limits of Insurer’s Liability.

If after consent has been granted it is shown that the particular Claim or Legal Proceedings have not been brought within the terms and conditions of this Policy and its Schedule the Coverholder’s consent will be withdrawn and no indemnity shall be provided. The Insurer shall be entitled to recover
any Legal Expenses, Professional Expenses, Awards of Compensation and any other Allowances previously paid.

If the Insured elects to proceed with the pursuit or defence of a Claim or Legal Proceedings to which the Coverholder’s consent has been refused through lack of reasonable prospects as required in 1 and 2 of Coverholder’s Consent and if the Insured is successful in such pursuit or defence, the
Insurer will pay Legal Expenses or Professional Expenses incurred after such consent had been refused subject to the terms conditions of this Policy.

In granting its consent the Insurer undertakes to provide indemnity to the Insured subject to the terms and conditions of this Policy and its Schedule but such consent does not imply that all Legal Expenses or Professional Expenses or Awards of Compensation will be paid.

In particular Legal Expenses or Professional Expenses for matters that go beyond the immediate scope of the Claim or Legal Proceedings shall be deemed by the Insurer to fall outside the indemnity provided by this Policy.

3. Choice of Appointed Representative and Counsel

The Coverholder will choose an Appointed Representative to act on behalf of the Insured in any Claim under certain Sections as specified in the Schedule.

Where recourse is necessary to a lawyer and proceedings are issued, the Insured is free to choose an Appointed Representative to act in the name of and on behalf of the Insured in any Legal Proceedings to which Qdos has consented. The name and address of the Appointed Representative the Insured proposes to instruct, must be notified to Qdos in writing. Qdos will accept such nomination provided Qdos is satisfied the proposed Appointed Representative will cooperate and enable the Insured to comply with the terms and conditions of this policy. Where the Insured chooses to appoint a
non-panel Appointed Representative the Legal Expenses payable under this Policy shall be restricted to those detailed in Qdos’ standard terms of appointment for panel representatives and always subject to the Limit of Indemnity. A copy of the standard terms of appointment for panel representatives is available on request by contacting Qdos using the details shown in the section of this Policy titled ‘Claims’.

A dispute arising from the Insured’s choice may be referred to Arbitration in accordance with General Condition A. The Insured must not, without thewritten consent of the Coverholder, enter into any agreement with the Appointed Representative as to the basis of calculation of Legal Expenses. The
Coverholder may withdraw consent previously given at any time.

In selecting the Appointed Representative the Insured shall have regard to its duty to minimise the cost of any Claim or Legal Proceedings. In all cases the Appointed Representative shall be appointed in the name of and on behalf of the Insured. If in the course of any Claim or Legal Proceedings the Appointed Representative wishes to instruct Counsel or an expert, Counsel’s or the expert’s name and an explanation of the necessity for such instruction must be submitted to the Coverholder for consent to the proposed instruction which will not be unreasonably withheld.

4. Disclosure

It is a condition precedent to the Insurer’s liability that:

  1. The Insured must give to the Appointed Representative and the Coverholder all necessary help and information including a complete and truthful account of the facts of the case and all relevant documentary or other evidence in the Insured’s possession. The Insured must provide, obtain or execute all documents as necessary and attend meetings or conferences as requested.
  2. The Coverholder is entitled to receive from the Appointed Representative and Insured any information, documentation or advice in connection with any Claim or Legal Proceedings even if privileged. In addition the Insured must instruct the Appointed Representative to provide the Coverholder with regular updates on the progress of any Claim or Legal Proceedings and inform the Coverholder immediately if and when any circumstance adversely impacts the factors taken into account in granting Coverholder’s consent. On request the Insured will give to the Appointed Representative any instructions necessary to secure the required access.

Cover may be withdrawn if the Insured fails to co-operate at all or within a reasonable time with the Coverholder’s or the  Appointed Representative’s requests.

5. Offer of Settlement

It is a condition precedent to the liability of the Insurer that the Insured must inform the Coverholder in writing as soon as an offer to settle a Claim or Legal Proceedings is received and or the Insured proposes to make an offer of settlement. In any settlement, the Insured must have regard to Legal
Expenses or Professional Expenses incurred or likely to be incurred by the Insurer and the recovery thereof. No indemnity will be provided if the Insured enters into any agreement to settle without the prior written consent of the Coverholder (such consent not to be unreasonably withheld) and
the Insurer shall be entitled to recover any Legal Expenses, Professional Expenses or Awards of Compensation previously paid. If the Insured unreasonably rejects an offer of settlement which the Coverholder recommends acceptance of or makes an offer which the Coverholder does not
agree no further indemnity shall be provided.

The Insurer may at its absolute discretion decide to pay the Insured the amount of damages that the Insured is claiming or is being claimed against the Insured instead of indemnifying the Insured for Legal Expenses Professional Expenses or Awards of Compensation. Where the Insurer exercises
this discretion the Insurer will cease to be liable for any further Legal Expenses, Professional Expenses or Awards of Compensation.

6. Payment of Legal Expenses, Professional Expenses and Awards of Compensation

All bills relating to any Claim or Legal Proceedings which the Insured receives from the Appointed Representative should be forwarded to the Coverholder without delay. If the Coverholder so requires the Insured must ask the Appointed Representative to submit the bill of costs for assessment
or certification by the appropriate Law Society, court or tribunal.

The Insured is responsible for payment of all Legal Expenses or Professional Expenses or Awards of Compensation. The Insurer may settle these directly if requested by the Insured to do so. The payment of some Legal Expenses or Professional Expenses does not imply that all Legal Expenses
or Professional Expenses or Awards of Compensation will be paid.

7. Appeal Procedure

If, following Legal Proceedings to which the Coverholder has consented, the Insured wishes to appeal against the judgment or decision of a court or tribunal, the grounds for such appeal must be submitted to the Coverholder through the Appointed Representative immediately or as soon as practicable so that the Coverholder may consider whether to consent to such further action. If an appeal is lodged against a judgment or decision of a court or tribunal made in favour of the Insured following Legal Proceedings to which the Coverholder has consented, the Insured must notify the Coverholder immediately in order that cover shall continue. The Coverholder will inform the Appointed Representative of its decision. If, the Coverholder so requires it the Insured must co-operate in an appeal against the judgment or decision of a Court or Tribunal.

8. Recovery of Costs

Whenever the Insured is awarded costs or under the terms of any settlement where costs are included, those costs are to be repaid to the Insurer.

The Insured and their Appointed Representative must make every effort to make a full recovery of costs. Where a settlement purports to be a global or a without costs settlement or where costs are awarded but not recovered, the Insured agrees that a fair and reasonable proportion of that settlement
will be deemed costs and due to the Insurer. Where such a settlement is paid in instalments all costs to the Insurer shall be paid first.

9. Fraudulent Claims

If the Insured makes any request for payment under this Policy knowing it to be fraudulent or false in any respect or ought reasonably in the circumstances to know it to be fraudulent or false or where there is collusion between any parties to the dispute, this Policy shall become void and any
premiums paid hereunder shall be forfeited and the Insurer shall be entitled to recover any Legal Expenses or Professional Expenses or Awards of Compensation previously paid. This information may also be shared with the appropriate law enforcement authorities.

10. Insolvency or Liquidation of the Insured

If the Insured becomes insolvent or is placed in liquidation during the course of any Claim or Legal Proceedings to which the Coverholder’s consent has been given the Coverholder reserves the right to withdraw that consent. The Insured shall be deemed insolvent or in liquidation upon the appointment of an office holder within the meaning given by the Insolvency Act 1986 or upon the appointment of a receiver within the meaning laid down in the Companies Act 1985.

11. Duty to Minimise

The Insured must:

  1. Take all reasonable precautions to avoid and prevent Claims, Legal Proceedings and disputes; and
  2. Use every endeavour and take all reasonable measures to minimise the cost and effect of any Claim or Legal Proceedings under this Policy

12. Value Added Tax

If the Insured is registered for VAT, the Insurer will not pay the VAT element of any Legal Expenses or Professional Expenses.


Complaints

It is the intention to give you the best possible service but if You do have any questions or concerns about this insurance or the handling of a claim

You should follow the Complaints Procedure below:

  1. Complaints regarding the sale of the policy:
    Please contact your agent who arranged the Insurance on Your behalf.
  2. Complaints regarding claims:
    Please contact in the first instance:
    The Nominated Complaints Handler
    Qdos Broker & Underwriting Services Limited
    Windsor House
    Troon Way Business Centre
    Humberstone Lane
    Thurmaston
    Leicestershire
    LE4 9HA
    Tel: 01455 852050
    Email: feedback@qdosunderwriting.com

If your complaint in either case cannot be resolved by the end of the next working day it may be referred to the underwriters of this policy UK General Insurance Limited on behalf of Great Lakes Reinsurance (UK) SE at Cast House, Old Mill Business Park, Gibraltar Island Road, Leeds, LS10 1RJ,
email: customerrelations@ukgeneral.co.uk. Tel: 0345 218 2685

If it is not possible to reach an agreement, you have the right to make an appeal to the Financial Ombudsman Service. This also applies if you are insured in a business capacity and have an annual turnover of less than €2 million and fewer than ten staff. You may contact the Financial Ombudsman Service at:

The Financial Ombudsman Service
Exchange Tower
London
E14 9SR
Tel: 0300 123 9 123 or 0800 023 4 567
Email: complaint.info@financial-ombudsman.org.uk
Website: http://www.financial-ombudsman.org.uk/

The above complaints procedure is in addition to your statutory rights as a consumer. For further information about your statutory rights contact your local authority Trading Standards Service or Citizens Advice Bureau.


Financial Services Compensation Scheme

Great Lakes Reinsurance (UK) SE is covered by the Financial Services Compensation Scheme. You may be entitled to compensation from the scheme in the unlikely event that Great Lakes Reinsurance (UK) SE cannot meet its financial responsibilities. This depends on the type of business and the
circumstances of the claim. Most insurance contracts are covered for 90% of the claim with no upper limit. You can obtain further information about compensation scheme arrangements from the FSCS by visiting www.fscs.org.uk.


Data Protection Act 1998

Please note that any information provided to us will be processed by us and our agents in compliance with the provisions of the Data Protection Act 1998, for the purpose of providing insurance and handling claims, if any, which may necessitate providing such information to third parties. We may
also send the information in confidence for process to other companies acting on their instructions including those located outside the European Economic Area.


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