This case is only the second policyholder disclosure dispute in the context of the Consumer Insurance (Disclosure and Reporting) Act 2012 (CIDRA).
The court found that if the insured, Christopher Jones, had made a prior claim in insuring his watch for £ 190,000, the coverage would likely have been denied and therefore Zurich Insurance had the right to waive the policy covering Rolex.
Jones filed an insurance claim after allegedly losing his Rolex Tropical while skiing in Aspen in 2019. Zurich tried to avoid paying out on the watch’s insurance policy, as it stated that Jones had been unable to disclose the loss of a £ 15,000 diamond from an antique ring. when he applied for watch insurance.
In 2016, Jones filed a lawsuit over a diamond that was set in a ring worn by his then girlfriend, but indicated in his watch insurance filing that he had not had any losses or claims in the previous five years.
In his testimony in court, Zurich-based insurer Michael Green said that he had offered to increase the premium for the watch due to Jones’ age (27) and other risk factors, but also that he would have waived the watch if he knew of a previous diamond claim. …
The judge said that the agreed position of the insurance experts who testified was that the diamond claim was material information that a reasonable insurer should consider and should be disclosed. The claims history will inform the insurer of how careful and honest the insured was.
“This is sufficient to establish that the misrepresentation was a qualified misrepresentation because, based on the evidence, I believed that Mr Green would probably have waived the risk if a previous loss had been disclosed,” Judge Pelling said. QC.
Financial services dispute expert Charlotte Pope-Williams of Pinsent Masons, the law firm behind Out-Law, said the case served as a warning to consumers when they sign up for insurance policies to fully disclose prior claims and any other issues. relevant to the risk assessment of the policy.
“It will be interesting to see how this interacts with the FSA. vulnerability guide, as there may be people who, because of their vulnerability, do not fully understand the duty under CIDRA section 2.2 to exercise reasonable care not to be misled, or because of their vulnerability, sincerely believe that they have done their duty. ”- Pope – Williams said.
“This case appears to be a triumph of common sense, in the sense that significant attention has been paid to the underwriter’s expert testimony in an attempt to establish the effect of misrepresentation on an underwriter’s decision in relation to an insurer’s ability to evade policy under CIDRA,” said Pope. Williams. …
The judge also commented on the forensic approach to verifying oral evidence. He noted that the first problem between Jones and Zurich was how the watch was lost, which depended on Jones’ oral testimony.
The judge said he could not accept Jones’ oral testimony “unless it is confirmed, contrary to his interests, or accepted.” He added that he compared the oral testimony of each witness with modern documents, recognized and irreversible facts and internal probabilities, and said that this was “a completely traditional approach.”
Pope-Williams said the judge’s comment on this would generally be appropriate in the broader context of civil proceedings.