在最近的 Ted Baker v AXA [2017] EWCA Civ 4097 一案中，上诉法院首次考虑，在理赔处理期间，保险人是否或在什么情况下有责任澄清(speak)的问题，也就是，保险人必须清晰表明立场，从而避免禁止反言，不得做程序性辩护。实际情况是，保险人指派的理赔师按照惯例，要求类似“购物清单”的文件，用以证明索赔金额的组成和理由。保险人随后保持沉默，之后又提出程序性辩护。
详细信息请参阅附件。
Insurer’s silence can go against them and clients should use it against them!
In a recent case Ted Baker v AXA [2017] EWCA Civ 4097, the Court of Appeal has for the first time considered the issue of whether and in what circumstances an insurer might be under a duty to speak during the claims process, that is, is required to make its position plain in order to avoid being estopped from running certain procedural defences in due course. The factual scenario was that the loss adjuster appointed by insurers had, as was routine, requested a ‘shopping list’ of documentation which he required to substantiate the claimed quantum. The insurers remain silent subsequently and then raised the procedural defence.
See attached file:
ALCO20170011 ALCO20170011 Insurer’s silence can go against them and clients should use it against them!.pdf
