An Analysis of the Recent Developments in litigation on Insurance Act 2015 Relating to Fraudulent Claims and Late Payment of Claims

This article considers the recent developments in litigation on Insurance Act 2015 in relation to fraudulent claims and late payment of claims. It examines the pivotal Commercial Court decision in Malhotra, focusing on the legal threshold for proving fraud in insurance claims. The court rejected the insurer’s allegations and stressing that fraudulent allegations must be supported by compelling, direct evidence rather than circumstantial inconsistencies. The analysis explores the court's strict approach to proving fraud. As regards damages for late payment of claims, in both case of Quadra and Delos, The Court ruled against the insureds in respect of their claim for damages under s.13A of 2015 Act. The Court’s decisions in Quadra show that a claim for damages for late payment of insurance claim is highly fact specific, but in circumstances where there are significant complicating factors, a “reasonable time” of no more than a year to investigate and pay a claim appears to be a positive decision for insureds. The Court confirmed that there are two limbs to the test for a breach of the implied term under s.13A. The first is for the insured to demonstrate what a reasonable time is for an insurer to pay sums due; the second is for the insurer to prove there were reasonable grounds for it to dispute the claim. Insurers who have good reasons for not paying on time should not be liable for damages provided they have acted reasonably. Nevertheless, the Court confirms that an insured who has suffered consequential losses where the insurer has refused to pay a valid insurance claim or has only paid after considerable delay will now be entitled to damages under s.13A.