“Among the more difficult of our clients is GCF, who, because they are a sister GE company and because of the personality involved are aggressively demanding and unreasonably intolerant at times.”
“A.1.(iii) ensure as far as possible that the policy proposed is suitable to the needs and resources of the prospective policyholder”… B(i) identify the insurance company; (ii) explain all the essential provisions of the cover afforded by the policy, or policies, which he is recommending, so as to ensure as far as possible that the prospective policyholder understands what he is buying; (iii) draw attention to any restrictions and exclusions applying to the policy.”
“Insurerswill comply with the [ABI Code]. The Code provides a framework of general principles within which all general insurance products should be provided… The specific requirements of the Code vary according to the type of insurance and circumstances of the prospective insured person. However, in all cases providers will ensure as far as is reasonable that the policy proposed is suitable to their needs and resources. Providers will give sufficient detail of the essential provisions of the cover afforded by the policy so as to ensure, as far as possible, that the prospective insured person understand what he/she is buying. In particular: • the suitability of a contract will be explained to those who are self-employed, those on contract or part time work, and those with pre-existing medical conditions; • details of the main features of the cover as well as important and relevant restrictions will be made available and highlighted at the time the insurance is taken out with full details being sent afterwards; • all written material will be clear and not misleading; • full details of the cover will be provided as soon as possible after completion of the contract.”
“The policy will make it clear that change in the insured person’s status, for example from permanent salaried employment to self-employment, or fixed-term contract or temporary work could significantly alter entitlement to benefit. The policy will define when the insured person will receive benefit. Any conditions relating to payment of benefits will be clearly displayed in marketing material and policy documentation. Insurers will set out clearly any variations or restrictions in cover for insured persons who are self-employed or on contract or part-time work. These terms will be clearly defined in the policy. Similarly, the effect of pre-existing medical conditions upon the extent of cover will be explained…” • the suitability of a contract will be explained to those who are self-employed, those on contract or part time work, and those with pre-existing medical conditions; • details of the main features of the cover as well as important and relevant restrictions will be made available and highlighted at the time the insurance is taken out with full details being sent afterwards; • all written material will be clear and not misleading; • full details of the cover will be provided as soon as possible after completion of the contract.”
“The revised ABI Code was introduced in 1989 to improve consumer protection in the selling of general insurance. It is designed to ensure that people are clear about the terms and conditions of the policy and the status of the intermediary with whom they deal. The Code is mandatory for business sold by ABI members in the UK. … What the Code Requires The Code provides a framework of general principles within which companies should sell general insurance. The interpretation of the requirements varies according to the particular type of insurance and the circumstances of the customer. ABI members, rather than intermediaries, are responsible for enforcing the Code. Members undertake to use all reasonable and practical efforts to ensure that they themselves and those selling their products comply… Complaints Handling. ABI recommends strongly that member companies join a recognised adjudication scheme such as the Insurance Ombudsman Bureau (IOB) or the Personal Insurance Arbitration Services (PIAS). Membership of these organisations can achieve the overall consumer protection which is central to the successful operation of the Code. …”
“Interpreting the Code ABI has prepared guidance on how insurers should interpret the key requirements of the Code regarding “best endeavours”, “explain all the essential provisions” and “draw attention to any restrictions and exclusions”
“4.2 Details of the major items of cover and exclusions under credit protection insurance policies arranged bythe member, including eligibility criteria, shall be set out both clearly and prominently in appropriate literature. Customers shall be given this information, together with the cost of the cover, prior to making a decision to apply for insurance or at the time that an application for insurance is being made.”
“3.2 Before or at the time you take out insurance, we will provide you with sufficient information to explain both clearly and prominently what the product is, the costs, and the key benefits, exclusions and eligibility criteria of your policy.”
“1. Santander and Genworth to sign an agreement setting out their agreement on liability and the management of complaints. It was agreed that Genworth would prepare the first draft of this. 2. Santander to obtain FOS agreement to FOS contacting Santander about complaints rather than Genworth. It was agreed that SP would speak to FOS about this at his meeting with FOS later that day. DH would update JR on this. Genworth and Santander would need to agree with FOS the on going process for managing existing complaints and future ones. 3. Santander and Genworth to agree a reconciliation of the amounts owing to each in order to settle any outstanding amount. 4. Genworth to restart its discussions with NewDay with a view to commencing profit share payments to NewDay once the appropriate agreement had been signed. The obligation to pay profit share to New Day would not be retrospective and would only apply to payments after an agreed date. It was agreed that Genworth would not be responsible for any profit share payments to NewDay prior to the agreed date as these would be settled by Santander.”
“Our view as the insurer was the summary of cover was such an important part of the sales process in terms of the information that the customer needed, so we wanted the salesperson − the salesperson would be expected to mention the product, limitations applied – Q. What do you mean by mention the product, let's just break this down? A. It covers you [for] life, [the] life so that if you die it pays off the balance. It covers accident, sickness and unemployment. So it pays a monthly instalment if you are out of work for those reasons. There are limitations both in terms of time and money. There are policy exclusions which apply. All of those are detailed in the summary of cover, please read the summary of cover, and the summary of cover to the insurer was such an important part of the process because it covers everything and without in any way wishing to undermine the sales process, we wanted the salesperson, whether it was in a branch or a retail store , to provide context within which that summary of cover would more likely be read, i.e. mentioning it covers these things, but all the detail was in the summary of cover. To merely hand the summary of cover to the customer and not say anything would not have been acceptable because you are not providing a context in which that summary of cover might be read.”
“Prior to January 2005, the General Insurance Standards Council (GISC) Code and, prior to the GISC Code, the Association of British Insurers (ABI) Code, constituted the industry codes of good practice in relation to the sale of insurance. In addition, the provisions in common law such as the general duty of utmost good faith in insurance contracts and misrepresentation would also have been relevant at that time. GISC members signed up to a series of commitments set out in the Code, which in our view had a similar effect to the obligations set out in the current regulatory system. For example, paragraph 1.1 of the Code set out that GISC members promise to ‘act fairly and reasonably’ when dealing with customers. This is similar to FSA Principle 6 (treating customers fairly). Applying pressure to a customer to take PPI (failing 1) is undoubtedly a failure to act fairly and reasonably and as such is contrary to paragraph 1.1 of the Code as well as a breach of FSA Principle 6. Another example is paragraph 1.3 of the Code which set out the GISC members’ promise to ‘give customers enough information and help so customers could make an informed decision before they made a final commitment to buy an insurance policy.’ This is similar in effect to FSA Principle 7, and also ICOB 2.2.3R, ICOBS 2.2.2R (which are the clear, fair and not misleading rules) and ICOBS 6.1.5R (ensuring customers can make an informed decision). Providing misleading or inaccurate information about the policy to the customer most likely would be in breach of GISC paragraph 1.3 in the same way that it would be a breach under the relevant provisions after January 2005. In addition, this could also amount to a misrepresentation under the general law, for example. There will, however, be more specific failings that will not have a corresponding commitment in the GISC Code, for example, the failure to disclose ‘price information calculated in a way to enable the customer to relate it to a regular budget’. The GISC Code has commitments regarding provision of information on costs. However, they do not descend to this level of detail. The same applies for the general law, which may not necessarily require information on price in the specific manner described in this failing.”
“This initiative is in response to concerns which have been raised, most recently by the Insurance Ombudsman, over sales people's over-reliance on using written, rather than oral, communication of PPI's features and benefits and, more particularly, conditions & exclusions, at the point of sale. The idea behind the laminated card is that it should be available to, & used with, the prospective customer to raise their awareness of the duties of the seller under the ABI Code of Practice to ensure that the policy being offered suits as far as possible their particular circumstances.”
“Despite the requirements of the ABI General Business Code of Practice, and the more recently introduced ABI Statement of Best Practice for Payment Protection Insurance, customers in many instances are not given the marketing material, and if they are they rarely read it. This is particularly prevalent in the retail market where finance companies rely heavily on third party introduced business. … The purpose of the letter would be to thank the customer for taking out the cover in a customer-friendly way, and would then go on to reiterate the eligibility criteria and any particular pertinent aspects of the cover such as self-employed exclusions which should be brought to the customer’s attention… This is a belts and braces procedure which in no way detracts from the obligation of point-of-sale personnel to explain the essential terms and conditions of the policy, and in particular the eligibility criteria…”
“I need to draw your attention to the GISC rulebook, and in particular the Private Customer Code, section 3 'How you find insurance to meet your needs'. This clearly states that when selling any general insurance, the customer must be made aware of what they are buying before signing up to this… The Summary of Cover we provide at application does gives the amount of information we need to provide at the time a policy is sold. As nobody can be 100% confident about giving a leaflet out with the application form, we could be liable for breaching the rules. As members of GISC, GEIH will not allow us to put ourselves in this position. General insurance is increasingly coming under the spotlight, and I don't want to take this retrograde step now, especially as there are plans for the FSA to regulate in January 2005.”
“(a) provide GECB with such market research, marketing and technical assistance as [FICL/FACL] think necessary to assist GECB with the marketing and sale of the Insurance; (b) provide GECBwith such specialised training in relation to the Insurance and the marketing and sale thereof as [FICL/FACL] determine in their reasonable discretion is necessary to enable GECB to comply with its obligations under this agreement, limited to 50 days annually.”
“In the case of an oral agreement, unless a recording was made, the court cannot know the exact words spoken nor the tone in which they were spoken, nor the facial expressions and body language of those involved. In these circumstances, the parties’ subjective understanding may be a good guide to how, in their context, the words used would reasonably have been understood. It is for that reason that the House of Lords in Carmichael v National Power Plc[1999] 1 WLR 2042 held that evidence of the subjective understanding of the parties is admissible in deciding what obligations were established by an oral agreement.”
“1.1 GE-CB has prior to the date of this agreement acted as the Insurers' agent in respect of the marketing and sale of the Insurance. The parties now wish to record the terms and conditions on which GE-CB shall continue to act as the Insurers' agent. 1.2 Unless otherwise stated herein, the parties agree that, notwithstanding clause 3, this agreement shall apply to and govern the marketing and sale of the Insurance under all of the Schemes (including the Schemes set out in schedule 4 in respect of which there are in existence at the date of this agreement Existing On-Risk Policies), the ongoing administration of all Existing On-Risk Policies and New Policies entered into between insured customers and the Insurers pursuant to such Schemes and the parties respective rights and obligations in respect thereof.”
“DISP 1.4 Complaints resolution rules DISP 1.4.1 R Once a complaint has been received by a respondent, it must: (1) investigate the complaint competently, diligently and impartially; (2) assess fairly, consistently and promptly: (a) the subject matter of the complaint; (b) whether the complaint should be upheld; (c) what remedial action or redress (or both) may be appropriate; (d) if appropriate, whether it has reasonable grounds to be satisfied that another respondent may be solely or jointly responsible for the matter alleged in the complaint; taking into account all relevant factors; (3) offer redress or remedial action when it decides this is appropriate; … (4) comply promptly with any offer of remedial action or redress accepted by the complainant. DISP 1.4.1 R Once a complaint has been received by a respondent, it must: (a) the subject matter of the complaint; (b) whether the complaint should be upheld; (c) what remedial action or redress (or both) may be appropriate; (d) if appropriate, whether it has reasonable grounds to be satisfied that another respondent may be solely or jointly responsible for the matter alleged in the complaint; … DISP 1.4.4 R 317. Where a complaint against a respondent is referred to the Financial Ombudsman Service, the respondent must cooperate fully with the Financial Ombudsman Service and comply promptly with any settlements or awards made by it.”
“1 Entitlement to contribution. (1) Subject to the following provisions of this section, any person liable in respect of any damage suffered by another person may recover contribution from any other person liable in respect of the same damage (whether jointly with him or otherwise). (2) A person shall be entitled to recover contribution by virtue of subsection (1) above notwithstanding that he has ceased to be liable in respect of the damage in question since the time when the damage occurred, provided that he was so liable immediately before he made or was ordered or agreed to make the payment in respect of which the contribution is sought. (3) A person shall be liable to make contribution by virtue of subsection (1) above notwithstanding that he has ceased to be liable in respect of the damage in question since the time when the damage occurred, unless he ceased to be liable by virtue of the expiry of a period of limitation or prescription which extinguished the right on which the claim against him in respect of the damage was based. (4) A person who has made or agreed to make any payment in bona fide settlement or compromise of any claim made against him in respect of any damage (including a payment into court which has been accepted) shall be entitled to recover contribution in accordance with this section without regard to whether or not he himself is or ever was liable in respect of the damage, provided, however, that he would have been liable assuming that the factual basis of the claim against him could be established. … (6) References in this section to a person’s liability in respect of any damage are references to any such liability which has been or could be established in an action brought against him in England and Wales by or on behalf of the person who suffered the damage; but it is immaterial whether any issue arising in any such action was or would be determined (in accordance with the rules of private international law) by reference to the law of a country outside England and Wales. 2 Assessment of contribution. (1) Subject to subsection (3) below, in any proceedings for contribution under section 1 above the amount of the contribution recoverable from any person shall be such as may be found by the court to be just and equitable having regard to the extent of that person’s responsibility for the damage in question. (2) Subject to subsection (3) below, the court shall have power in any such proceedings to exempt any person from liability to make contribution, or to direct that the contribution to be recovered from any person shall amount to a complete indemnity. … 6 Interpretation. (1) A person is liable in respect of any damage for the purposes of this Act if the person who suffered it (or anyone representing his estate or dependants) is entitled to recover compensation from him in respect of that damage (whatever the legal basis of his liability, whether tort, breach of contract, breach of trust or otherwise).”
“140A Unfair relationships between creditors and debtors (1) The court may make an order under section 140B in connection with a credit agreement if it determines that the relationship between the creditor and the debtor arising out of the agreement (or the agreement taken with any related agreement) is unfair to the debtor because of one or more of the following– (a) any of the terms of the agreement or of any related agreement; (b) the way in which the creditor has exercised or enforced any of his rights under the agreement or any related agreement; (c) any other thing done (or not done) by, or on behalf of, the creditor (either before or after the making of the agreement or any related agreement). (2) In deciding whether to make a determination under this section the court shall have regard to all matters it thinks relevant (including matters relating to the creditor and matters relating to the debtor). … (4) A determination may be made under this section in relation to a relationship notwithstanding that the relationship may have ended. … 140B Powers of court in relation to unfair relationships (1) An order under this section in connection with a credit agreement may do one or more of the following– (a) require the creditor, or any associate or former associate of his, to repay (in hole or in part) any sum paid by the debtor or by a surety by virtue of the agreement or any related agreement …; (2) An order under this section may be made in connection with a credit agreement only– (a) on an application made by the debtor or by a surety; (b) at the instance of the debtor or a surety in any proceedings in any court to which the debtor and the creditor are parties, being proceedings to enforce the agreement or any related agreement; or (c) at the instance of the debtor or a surety in any other proceedings in any court where the amount paid or payable under the agreement or any related agreement is relevant. … 140C Interpretation of ss. 140A and 140B (1) In this section and in sections 140A and 140B ‘credit agreement’ means any agreement between an individual (the ‘debtor’) and any other person (the ‘creditor’) by which the creditor provides the debtor with credit of any amount. … (4) References in sections 140A and 140B to an agreement related to a credit agreement (the ‘main agreement’) are references to– … (b) a linked transaction in relation to the main agreement or to a credit agreement within paragraph (a); …” (a) any of the terms of the agreement or of any related agreement; (b) the way in which the creditor has exercised or enforced any of his rights under the agreement or any related agreement; (c) any other thing done (or not done) by, or on behalf of, the creditor (either before or after the making of the agreement or any related agreement). (a) require the creditor, or any associate or former associate of his, to repay (in hole or in part) any sum paid by the debtor or by a surety by virtue of the agreement or any related agreement …; (a) on an application made by the debtor or by a surety; (b) at the instance of the debtor or a surety in any proceedings in any court to which the debtor and the creditor are parties, being proceedings to enforce the agreement or any related agreement; or (c) at the instance of the debtor or a surety in any other proceedings in any court where the amount paid or payable under the agreement or any related agreement is relevant.