Not upheld: Unknown / needs review complaint against Markel International Insurance Company Limited

Decision detail

Summary

Mr T made a claim on his Markel landlord's legal expenses insurance policy for costs relating to a tenant dispute. Although Markel sent him a claim form in May 2023, Mr T did not return it until February 2024, by which time he had already incurred legal costs by instructing his own Solicitors. Markel declined the claim citing the policy exclusion for costs incurred without their written consent. The ombudsman upheld Markel's decision, finding that the exclusion is standard and fair, and that Markel was clearly prejudiced by being unable to validate policy conditions, assess prospects of success, or influence the claim's conduct before costs were incurred.

The Ombudsman's reasoning

The policy terms explicitly exclude cover for costs incurred without Markel's written consent, which is a standard and fair exclusion in legal expenses insurance. Markel was entitled to validate policy conditions before agreeing to fund costs. By incurring costs before submitting a claim, Mr T prevented Markel from establishing whether cover was available, whether policy conditions were met, whether reasonable prospects of success existed, and from influencing how the claim was conducted. This constitutes clear prejudice to Markel as a funder.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website