Insurance - what makes it invalid?

[kevinjohnsonmbe]

8 hours ago, Justme said:

Insurance will pay out & then seek to cover its loses from the company.

Found this - "...If your insurer believes that you have failed to meet your legal responsibilities for the health and safety of your employees and that this has led to the claim, the policy may enable the insurer to sue you to reclaim the cost of the compensation..."

 

Pretty sure they would too!

 

http://www.hse.gov.uk/pubns/hse40.pdf

 

 

 

 

 

 

 

Edited November 25, 2017 by kevinjohnsonmbe

[Justme]

13 minutes ago, kevinjohnsonmbe said:

Found this - "...If your insurer believes that you have failed to meet your legal responsibilities for the health and safety of your employees and that this has led to the claim, the policy may enable the insurer to sue you to reclaim the cost of the compensation..."

 

Pretty sure they would too!

 

http://www.hse.gov.uk/pubns/hse40.pdf

 

 

 

 

 

 

 

As I said lol.

They can't just cancel / invalidate insurance. They have to serve notice.

[daltontrees]

What is a 'system audit' scenario? If you have responsibility of the actions or omissions of this organisation, you are exposed. Pointing out their deficiiencies could or could not be enough to remove your exposure to a claim by one of their employees, but only for a short while.

 

Standard stuff in ELI is the insurer indemnified insured against injury compensation claims from employees, but it is also standard that insurer shall take reasonable precautions to prevent accidents and disease and shall comply with all statutory obligations. It is also standard that the due observance and fulfillment of the terms of the policy in so far as they relate to anything to be done or not to be done by the Insured shall be conditions precedent to any liability of the Company to make any payment under this Policy.

 

What that means is, the insurance is worthless if the insured hasn't complied with H&S basics, and the insurer won't pay out. So if there is a H&S deficiency and an employee is injured without contributory negligence by him, the employee sues successfully, liability is established, the insurer ducks and the employer has to pay up. His directors will probably be liable personally, and so might anyone having collective responsibility.

 

H&S legislation, aparallel but separate matter, is there to encourage the prevention of accidents and to punish failures to look after employees. ELI is instead there to protect the employer and to some degree the employees. What it is not is a viable alternative to looking out for them.

 

Depending what your 'system audit' scenario is, you may not have the option just to get peeved about this, and reporting to the co to HSE would not be a substitute for putting fresh air between you and them (legally, that is). Oh and not being in any of their dodgy workplaces, from a personal wellbeing perspective.

Edited November 25, 2017 by daltontrees

[kevinjohnsonmbe]

1 hour ago, daltontrees said:

What is a 'system audit' scenario? If you have responsibility of the actions or omissions of this organisation, you are exposed. Pointing out their deficiiencies could or could not be enough to remove your exposure to a claim by one of their employees, but only for a short while.

 

Standard stuff in ELI is the insurer indemnified insured against injury compensation claims from employees, but it is also standard that insurer shall take reasonable precautions to prevent accidents and disease and shall comply with all statutory obligations. It is also standard that the due observance and fulfillment of the terms of the policy in so far as they relate to anything to be done or not to be done by the Insured shall be conditions precedent to any liability of the Company to make any payment under this Policy.

 

What that means is, the insurance is worthless if the insured hasn't complied with H&S basics, and the insurer won't pay out. So if there is a H&S deficiency and an employee is injured without contributory negligence by him, the employee sues successfully, liability is established, the insurer ducks and the employer has to pay up. His directors will probably be liable personally, and so might anyone having collective responsibility.

 

H&S legislation, aparallel but separate matter, is there to encourage the prevention of accidents and to punish failures to look after employees. ELI is instead there to protect the employer and to some degree the employees. What it is not is a viable alternative to looking out for them.

 

Depending what your 'system audit' scenario is, you may not have the option just to get peeved about this, and reporting to the co to HSE would not be a substitute for putting fresh air between you and them (legally, that is). Oh and not being in any of their dodgy workplaces, from a personal wellbeing perspective.

email on way 

[monkeybusiness]

6 hours ago, devon TWiG said:

One thing with insurance that seems odd to me is ...say for example I was pissed and crashed my car in to another car the insurers pay out to the 3rd parties car but not mine ... this is not the reason I do not drink and drive !!!!

I’m pretty sure in an employee/public liability claim (ie a third party affected by the actions of the ‘insured company’) the insurers would have to pay out for whatever they were insuring, whether the company met their conditions of insurance or not. The insurers would subsequently look to recover what they could from whoever hadn’t done what they should have.

 

The reason I quoted the post above is because my sister wrote off her car when drunk (into a field, nobody else involved, no injuries). She reported herself to the police (incredibly) and the car was recovered while she was arrested (and later charged). The insurance paid out the value of the car/recovery/3rd party damage. Seemed bonkers to me but there you go!

[daltontrees]

12 hours ago, monkeybusiness said:

I’m pretty sure in an employee/public liability claim (ie a third party affected by the actions of the ‘insured company’) the insurers would have to pay out for whatever they were insuring, whether the company met their conditions of insurance or not. The insurers would subsequently look to recover what they could from whoever hadn’t done what they should have.

 

I wouldn't bet on it. What I posted last night was taken from the model conditions of ELI insurance from a household name insurer in the UK. It clearly says that if you don't comply with conditions like H&S, the insurer doesn't have to pay out.

 

Car insurance may be different.

[kevinjohnsonmbe]

I wouldn't bet on it. What I posted last night was taken from the model conditions of ELI insurance from a household name insurer in the UK. It clearly says that if you don't comply with conditions like H&S, the insurer doesn't have to pay out.
 
Car insurance may be different.

That appears to be in direct contradiction with the content of HSE guidance note I posted in No. 11 Jules.

It’s perhaps a bit academic either way, HSE appears to suggest an insurer must pay the claimant but may be at liberty to recover costs + from the insured where conditions aren’t satisfied.

Net result - conditions not satisfied, risk of non payment of claim or risk of claim costs being recovered from the insured party (+ costs + the money wasted on policy premiums)

[daltontrees]

Thanks, true, but it doesn't protect the emplyer because, as the HSE guidance says "If your insurer believes that you have failed to meet your legal responsibilities for the health and safety of your employees and that this has led to the claim, the policy may enable the insurer to sue you to reclaim the cost of the compensation."

 

The requirement to insure comes from the '69 Act, and the prohibition on not paying out comes from Regulations in 1984. And so it appears that the condition contained in the model ELI policy published by Sun General Insurance I looked at last night is either unlawful or voidable.

 

I suppose the legislation makes sense as it should be there to encourage the prevention of accidents and to compensate employees.  But when the dust settles, the outcome would be the same, employee does not need to sue to get compensated, instead insurer sues employer to get the money back.