Case Studies
Sets And Pairs Clauses
A middle aged lady draws up outside her house in Hampstead. She steps out of the car and as she is about to unlock her front door, she is grabbed from behind. Two masked men make it clear what they are there for and wisely she does not resist their attempt to rob her. Swiftly one removes her necklace and earrings whilst the other takes three rings off her fingers and grabs the handbag. The car keys are together with the house keys and as one of the thieves tries to unlock the house door, the alarm goes off. The thieves panic, drop the keys and run. In the meantime their outing has not been a total failure since they have some very nice pieces of jewellery.
Once the trauma of the event has subsided she realizes that most of her best pieces of jewellery have been stolen and that she needs to make a claim on her domestic Insurance policy. She speaks to a friend for whom we acted in the matter of a theft loss some years ago and she calls us.
The first thing we do is look at the policy in order to establish exactly what is covered and how best to formulate the claim. Most of the stolen items were shown to be specified items on the policy. Amongst the items stolen which were not specified was a pair of diamond earrings for which the client had a two-year old valuation which showed them to be worth £5,000. We obtained a current valuation which showed that today's replacement value was £6,000. Apart from the specified items which were stolen the unspecified items totalled £8,000 which was well within the total sum insured for unspecified valuable and portable possessions of £10,000. The sticking point was going to be the single article limit (within the unspecified items) which was £3,000.
When we presented the claim to Insurers, after a bit of negotiation, they agreed to our values, save for the earrings. They argued that the extent of their liability for the earrings was the single article limit of £3,000. We argued that, since there were two items comprising the pair, the single article limit applied to each piece and not the pair. We suggested that if only one of the pair had been stolen, Insurers would not pay for the replacement of both parts of the pair but only one. We agreed that the claim should not be held up whilst we argued the matter of the earrings and Insurers settled the undisputed part of the claim.
As adamant as Insurers were that they should pay out only £3,000 for the earrings, we contended that the policy wording – their policy wording – made no provision for the claim to be limited in this way. Two items had been stolen, each with a value within the single article limit and therefore we wanted £6,000. We threatened to take the matter to the Insurance Ombudsman and eventually after several weeks' wrangling and an interesting exchange of correspondence we received a cheque for £6,000. Insurers never admitted that we were right, which would have been the "icing on the cake" but we did get the satisfaction of knowing that the client received £3,000 more than Insurers had said they would pay.
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You can contact us at any point in the claim process, but remember that the way a claim is presented is as important as the way it is negotiated, so the earlier you contact us the better. Contact us now for a free consultation.
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