Not upheld: Service failures generally complaint against AmTrust Specialty Limited

Decision detail

Summary

Mr P complained about AmTrust's handling of his clinical negligence insurance claim, arguing that AmTrust failed to properly assess his claim and that its reliance on panel solicitors' negative prospects assessments was unfair. AmTrust instructed multiple panel solicitors who all concluded the claim lacked reasonable prospects of success, with the limitation period expiring in December 2022. When Mr P later instructed his own solicitor, counsel ultimately confirmed the case was time-barred with extremely small prospects. The ombudsman found AmTrust acted fairly by obtaining detailed legal advice from qualified lawyers and was entitled to rely on that advice, and that Mr P was adequately informed of the limitation deadline.

The Ombudsman's reasoning

The ombudsman found that AmTrust was entitled to rely on the legal advice from qualified panel solicitors regarding prospects of success. The ombudsman noted that where an insurer declines funding based on legal advice, the FOS does not evaluate the underlying claim merits but rather whether the insurer acted fairly in relying on suitably qualified legal advice. L's letter clearly explained the limitation period and its consequences, making Mr P aware of the deadlines. The ombudsman found no evidence that AmTrust's claim handling caused the claim to become time-barred, as this was Mr P's responsibility to manage once informed of the deadlines.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website