“If and when all the remedies against Mr Ward and/or claims for payment out of the FCSC have been exhausted, but not before, then the Claimants agree that all further proceedings against the Defendant [Mr Channon] will be stayed save for carrying into effect an agreement that Mr Channon will pay a contribution of up to£85,000 towards the Claimants then remaining outstanding losses, costs for the claim against the Defendant and in respect of the costs incurred in pursuing the claims against Mr Ward and/or claims for payment out of the FCSC giving credit for the sums already paid on account with payment by further annual instalments of£10,714.28 .”
“In any dispute in connection with the cover, conditions, exceptions, or limits of this policy, it is specifically understood and agreed that the cover, conditions, exceptions and limits of the Approved Wording shall take precedence over any cover, conditions, exceptions or limits contained herein which are less favourable to You.”
“We will indemnify you in respect of any Claim arising out of the conduct of Your Business, first made against You and notified to Us during the Period of Insurance”... “Your Business” is defined as: “(1) The provision of advice or Services by You or on Your behalf as declared to Us in the Proposal or shown in the Schedule as the Business. (2) Any individual personal appointment (other than as company secretary or registrar or director) held by You but only in respect of advice or Services shown in (1) above. (3) Any individual personal appointment as company secretary or registrar or director, but only in relation to the performance of Services.” “Services” is defined as: “All services performed or advice given by You in connection with tax matters, secretarial work, share registration, financial advice to management, book-keeping, management accounting, financial investigation and reports, financial claims (including their negotiation and settlement), company formations, investment advice, insurance and pension scheme advice and computer consultancy.”
“(1) The provision of advice or Services by You or on Your behalf as declared to Us in the Proposal or shown in the Schedule as the Business. (2) Any individual personal appointment (other than as company secretary or registrar or director) held by You but only in respect of advice or Services shown in (1) above. (3) Any individual personal appointment as company secretary or registrar or director, but only in relation to the performance of Services.” “Services” is defined as: “All services performed or advice given by You in connection with tax matters, secretarial work, share registration, financial advice to management, book-keeping, management accounting, financial investigation and reports, financial claims (including their negotiation and settlement), company formations, investment advice, insurance and pension scheme advice and computer consultancy.”
“All costs and expenses incurred in the investigation, defence or settlement of any Claim insofar as those costs and expenses have been incurred with Our written consent.”
“We will not provide indemnity in respect of any Claim . . . (3) or loss arising from any express or implied warranty or guarantee relating to the financial return of any investment or portfolio of investments. . . . (4) or loss arising from any trading losses or trading liabilities incurred by any business managed by or carried on by You.”
“his overarching position as presented to any insurer would have been that these were wholly unmeritorious.”
“(c) He would have pressed the insurer to defend the proceedings on the basis that he had not provided investment advice or at any stage acted in his professional role as an accountant (see paragraph 3 of his witness statement of24th November 2014 ). As I have set out he only reluctantly compromised what he believed were unmeritorious claims as he had not got the funds to defend them. I find as fact that his instructions would never have wavered. He would have told any representative of an insurer (including any lawyer) that the claims arose out of disappointment at the losses of a trading company of which he was a director and were nothing to do with his role as an accountant for Channon & Co.”
“155. I treated the burden as on the Defendant throughout to establish that the insurer would have refused to indemnify or assist and that this would have not been the subject of challenge and that as a result the chances that the insurers have provided an indemnity and/or assistance were no more than speculative. That burden has been successfully carried and the test met.”
“(i) the insurer would have approached these cases with considerable caution not just because of the value but also because of a sense that all was far from right with the claims and/or the facts underlying the claims. (ii) that given all available information the insurer would be looking to avoid liability to indemnify, would have queried why these claims were considered covered by professional indemnity insurance and the “first reaction would be to avoid it” ( per Mr Black). (iii) The experts did not seem to attach any real weight to Mr Adams’ suggestion (that he repeated in closing submissions) that the reputation of insurer would be a very relevant consideration i.e. that an insurer would not want a reputation for refusing to indemnify. It may well be that this has to be seen in light of the first two points and in contra distinction to where a view could be taken that an insurer was taking a technical point to avoid indemnifying in an otherwise straightforward case. In any event neither expert supported Mr Adams' submission. Mr Dowlen stated “reputation is not that important when it comes down to the insurer’s product.” (iii) the insurer would have taken time to consider the claims as presented and would not have reached a snap judgment. In the interim it may have given some advice to the Claimant as to how to protect his position. (iv) the issue of whether indemnity could or would have been refused because the Claimant was not acting in the course of his business for the purposes of the policy was a difficult one to assess. Whilst the Claimant was adamant that he was not so doing and had evidence to support his case, the allegations in the claim were that he was. Had the issue of whether the Claimant was acting in the course of his business been the sole issue for the insurer it would probably have continued to provide assistance, whilst preserving its position as regards indemnity; although this would have been difficult to achieve it was a path sometimes taken. (v) The insurer would not have relied on the exception at clause 5. (vi) the insurer, indeed even a novice insurer, would have raised and sought to rely on exemption clauses 3 and 6. Both experts had considerable experience of how the insurance business works and they were both of this view (albeit that Mr Black had failed to deal with clause 3 in any significant way, or clause 6 at all, in his expert report). As regards clause 6, Mr Dowlen stated that he had some experience of this clause, that it must be remembered that it is a professional indemnity insurance policy and that in simple terms the clause was present because the policy was not intended to “(be) there to cover where there is a muck up on (his) own business”
“86. So it was Mr Dowlen’s clear opinion that the insurer would have refused indemnity in this matter on at least two and probably three grounds; the two exemptions and also that the Claimant was not acting in the course of his business. He conceded that the insurer would face a “theoretical risk” (he had no experience of such a scenario) that if it relied on the argument that the Claimant was not acting qua accountant and it was found at trial that he had been that the insurer could then face a liability. However the thrust of his evidence was that the insurer would have relied on this argument in addition to the exemptions.”
“87. Having carefully considered these areas of agreement between the experts, as further expanded upon by Mr Dowlen, I accept that they accurately reflect what would have been the view of an insurer. This means I find that the insurer would certainly have sought to rely on exemptions 3 and 6. 88. I also find that in all probability the insurer would also have relied upon an argument that the Claimant was not acting in the course of his business. In so doing I have found the submissions of Mr Dyson at paragraphs 71-73 above to have force. Whilst that may have been a stance taken on less certain ground I take the view that it would have been used, at the very least, to add ballast or as Mr Adams described (in a slightly different context as I shall set out) as an additional “lever”. 89. So it is my finding of fact that the insurer would certainly have been set to refuse indemnity or any further assistance.”
“142. My distinction (sic) impression is that he would have had some sympathy with the insurer if it had relied on the approach which I believe would have been taken, as it was consistent with his own view of the claims i.e. they were a device to try get around the problem of the company having no money and to get to his professional insurance cover, whereas the true dispute solely concerned what he did or do not do on behalf of a separate company when acting as a director.”
“150. Underlying and colouring my assessment of the evidence and what inferences can be taken from it was the Claimant’s consistent belief that the claims were unmeritorious, a device, and did not truly concern his practice as an accountant rather his other life as a property developer. Of course if help was available from an Insurer he would have gladly taken it, but it seems to me that the overwhelming likelihood is that he would not have so strongly thought that it was his right as to risk litigation against his insurer if it was refused.”
“152. These findings are not just on mere balance of probabilities leaving a significant possibility that matters would have progressed otherwise. Returning to the issue as framed by Mr Adams I do not find that there is a substantial and not merely speculative chance that the end result would have been different had insurance been in place. I am not persuaded by the proposition that there is a substantial chance that an insurer would have provided an indemnity or such a significant contribution as to costs as significantly alter the position that the Claimant found himself in when he was, on his account, effectively forced into a position where he had to compromise the claims of the investors.”
“95. I had no direct evidence on the issue of legal advice would have been taken or not. Mr Black opined that once initial conclusions had been reached there would probably be a conference between solicitors and insurers to agree on a common response and reasoning (report paragraph 3.64). 96. Mr Dowlen stated that in practice with claims such as these the insurers would consider the matter carefully, and may take time to do so, but once a decision had been taken the insurer would stick with it. However he stated that it would go to a senior person; the claims director. 97. In the absence of direct evidence from Aviva (which is a very large organisation with no doubt many very experienced insurance practitioners) I am not persuaded that Mr Black’s opinion is right, as the insurer is likely to have considered that the clauses were sufficiently clear and it was on sufficiently strong ground that this was not needed. I also did not see (and neither expert saw) inconsistency with the balance of the policy or any in-built restriction within the clause that raised a question requiring expert legal interpretation. 98. I also find that the reasons why they were relied upon would have been easily communicated to and understood by the Claimant; there was no need for great care in the wording of any letter such that legal input was needed.”
“Mr Dowlen You’re making lots of assumptions there. I think broadly what happened . . . well I know what happens in the insurance world. The insurers will not say anything much. They will reserve their rights. They will actually not admit liability to the insured, and the insured may find that they are having to deal with the matter themselves because the insurers won’t step up to the plate, if I use a metaphor from sport. So the insurers can actually hang back and not give a firm opinion on their liability to indemnify for quite a long time. Mr Adams And you’re saying that would have happened in this case? Mr Dowlen I think it would have happened in that case. That’s my opinion. That they would have waited and probably looked very carefully at the papers. They would not rush to issue a denial of liability, or repudiation, and nor would they necessarily have rushed to give Mr Channon lots of help and defence costs and appoint lawyers. The insurers would probably appoint their own lawyers, they usually do in a fairly significant matter, to review the papers with them so that they have a legal fall back.”
“You shall not be required (a) To contest any legal proceedings . . . unless a senior barrister (to be mutually agreed upon between You and Us) shall advise that such action has a reasonable prospect of success.”
“The Insured shall . . . Nevertheless neither the Insured nor the Insurers shall be required to contest any legal proceedings unless a Queen’s Counsel or in the Republic of Ireland a Senior Counsel (to be mutually agreed upon by the Insured and Insurers or failing agreement to be appointed by the President of the Institute of Chartered Accountants in England and Wales/of Scotland/in Ireland as applicable) shall advise that, taking due account of the interests of both Insurer and Insured, such proceedings should be contested.”