"Whether under the Accident Group Scheme the Regulation 4 information is given by a "legal representative" within the meaning of Regulations 1 and 4 of theConditional Fee Agreement Regulations 2002 . If the answer is in the negative what are consequences of that for the Claimants claims for costs?"
"Yes, where the Regulation 4 information is given by a TAG representative on behalf of the "legal representative" within the meaning of Regulations 1 and 4 of theConditional Fee Agreements Regulations 2000 . If the first question had been answered in the negative then the consequence for the Claimants’ claims for costs would have been that they would have been irrecoverable, save for the claim for the premium which is not affected by the fact that the Regulation 4 briefing was not given by the legal representative."
"GENERAL ISSUES A. Premium Issues 1. If the CFA is unenforceable, is the ATE premium recoverable; if so, in what circumstances, and on what basis? 2. Is the whole sum payable for insurance by a claimant under the TAG scheme properly to be regarded as a premium withins 29 Access to Justice Act 1999 ? If not, how much of the sum payable by the claimant is such a premium? 3. Does the sum payable for insurance under the TAG scheme finance services or provide benefits which are collateral or extraneous to such insurance? (For the avoidance of doubt, this is intended to include the "block rating" issue.) To what extent should the cost of collateral or extraneous services or benefits be recoverable? 4. Was it reasonable of claimants under the TAG scheme to purchase insurance costed on a block rated basis? 5. Is the premium-element of the sum claimed a reasonable and proportionate sum (a) for the benefits actually purchased and (b) for cases of this character? 6. Of the "premium" paid by the claimant, how much is retained by the underwriter, and how much is paid on to TAG or any other person by way of commission or other payment? 7. Is it reasonable for the TAG scheme to be structured so that the whole of the premium is incurred immediately before any letter of claim? 8. What premium would be reasonable in circumstances where liability is admitted before a policy is taken out? B. Standardised TAB Disbursements 9. What are the financial arrangements between all parties involved in the TAG scheme? Who pays what to whom? 10. Are all or part of the following referral fees: (a) the payment of£310 + VAT to AIL; (b) the payment of£385 to Mobile Doctors Limited; (c) the payment of Rowe & Cohen of a vetting fee? 11. If so does the solicitor’s agreement to pay them breach the Introduction and Referral Code? 12. If so, what are the consequences? 13. Are the payments identified at [10] irrecoverable (in whole or part) for any other reason? C. Consumer Credit 14. Does MDL provide panel solicitors with credit under theConsumer Credit Act 1974 ? 15. If so, what are the consequences? D. Indemnity Principle Issues 16. Does the TAG panel solicitor’s obligation to reimburse any disbursements which are not recovered from the defendant breach the indemnity principle? If so, what are the consequences? 17. In some versions of the CFA, it is explicitly provided that the panel solicitor will, in successful cases, limit his fees to those recovered from the paying party. Does this breach the indemnity principle? If so, what are the consequences?"
"A … which will provide an indemnity … for AAB clients … in relation to legal work undertaken by solicitors previously approved by AAB … prior to and/or following the issue of legal proceedings … commenced by AAB clients in connection with claims arising out of personal injuries and other ancillary losses sustained by AAB clients …"
"E LPL has agreed to engage AAB to undertake certain services … which will enable LPL as underwriters representatives both to introduce and to manage the necessary insurance arrangements in respect of each and every claim which is the subject matter of legal proceedings ("insurance services"). F Investec Bank (UK) Ltd ("
"First National Bank Plc ("
"(a) From1 February 2001 certificates of insurance have been issued on behalf of the underwriters providing insurance under the terms of binding authorities …, TAG have been providing insurance services (as hereinafter defined) as coverholder to underwriters and from the date hereof BESSO shall provide intermediary services (as hereinafter defined) to underwriters and TAG. Underwriters, TAG and BESSO have now agreed to enter into this agreement to set out the terms on which such services are and have been provided. … (f) This agreement is supplementary to and should be read in conjunction with binding authority agreements between underwriters and TAG. However, in the event of a conflict between the agreements the terms of this document shall prevail. (g) Parties to this agreement have agreed that it shall enter into effect on1 February 2001 notwithstanding that it is executed at a later date. … 1. TAG’s obligations 1.1 TAG will provide the initial insurance services specified in the second schedule and the continuing insurance services specified in the third schedule. … 2. Underwriters obligations 2.1 In consideration of the provision by TAG of these insurance services underwriters will pay to TAG the premium allocation specified in the fourth schedule which premium allocation shall be paid and refunded as set out in the fourth schedule and profit commission specified in the fifth schedule which profit commission shall be payable as set out in the fifth schedule."
"The net premium will be adjusted to ensure that the cumulative paid loss ratio does not exceed 80% per annual period subject too a maximum net premium of£500 (less brokerage) per certificate issued for the relevant annual period. This will be achieved by rebating the underwriters contribution to costs. Any such adjustment shall be calculated and closed on a monthly basis. Retention Fund: out of the amount paid as the underwriter’s contribution to costs, the coverholder shall pay£55 per certificate. The above amounts shall be paid into a trust account for the benefit of the underwriters as security for any amount refundable as set out under the adjustment of premium provision above. This retention fund shall form part of the annual review."
"Appendix 1 Profit Commission The Underwriters agree to pay annually an 25% Profit Commission based on the net ascertained profit from the operations of this Agreement calculated as follows: … The first calculation of Profit Commission will be made provisionally 24 months after expiry of the Agreement year and re-calculated every subsequent 12 months until all outstanding losses have been settled."
"Background (a) TAG markets post event legal expenses schemes to its customers and administers such schemes. The insurer provides post event legal expenses insurance. (b) The insurer wishes to appoint TAG as its agent for the purposes of marketing post event legal expenses insurance underwritten by the insurer and binding the insurer to and administering such insurances on behalf of the insurer. … 3. Marketing TAG will market the insurance(s) as agreed between the parties in writing from time to time. TAG may appoint sub-agents for this purpose but TAG will be liable to the insurer as principal for any acts or omissions of such sub-agents. 4. Binding Authority 4.1 TAG will on behalf of the insurer accept for insurance all customers who are eligible for and request insurance. TAG is authorised by the insurer to – 4.1.1 accept up to 36,000 customers for insurance in any one year; 4.1.2 administer the insurances; and 4.1.3 handle and settle claims up to a limit of£5,000 on the insurers behalf. … 5. Premium Rates 5.1 The rates of premium applicable to the insurance(s) are as specified in Appendix 1 Part 5 as varied from time to time [premium rates are set at£997.50 including insurance premium tax]. 5.2 The insurer may vary any net rates of premium as specified in Appendix 1 Part 5 by such amount as it reasonably considers appropriate taking into account (amongst other things) deteriorating claims experience always provided that the insurer shall give at least 90 days notice to TAG of any such variation. 6. Payment of the Premium Allocation 6.1 In consideration for TAG providing the services the insurer will pay the premium allocation to TAG. 6.2 Each working day the insurer will pay to TAG the premium allocations in respect of all insurance policies for which the insurer has received payment of the premium up to close of business on the previous working day less the insurer retention and if appropriate the funder retention. … 12. Service Levels TAG and the insurer will in the performance of their respective obligations comply with the agreed service level specified in the service level agreement [see below]. … Appendix 1 … Part 2 premium allocation£650 Part 3 funder retention£100 Part 4 insurer retention£50 [Parts 3 and 4 relate to paragraph 6.2 above] … Appendix 2 Service Level Agreement 1. General Terms 1.1 This service level agreement relates to the administration and claims handling services to be provided by TAG in respect of the insurances. 1.2 The services described relate to insurance administration and claims work. 1.3 Times shown as ideal objectives are the normal operating times … … 2. Services TAG shall provide the following services in respect of insurance: 2.1 insurance administration, comprising: 2.1.1 policy issue; 2.1.2 policy processing; 2.1.3 claims administration (where relevant); 2.14 creation of claims management reports. 3. New Insurance Fulfilment 3.1 Details of the claim will be taken down by the TAG representative who will make an initial assessment of the claim. If the representative believes that there may be a claim then they will explain the service offered by TAG, including details of the premium for TAG Protect and the funding arrangement. If the claimant is happy to proceed the claim will be sent to TAG Head Office from where it will be passed to AIL for investigation. 3.2 TAG will request AIL to assess the claim by speaking further with the claimant and any witnesses in order to obtain full details of the claim. Once AIL has investigated the claim and believes that there is sufficient information for the vetting solicitor to assess it, TAG will collate the initial assessment, with such other documents as may be required to substantiate the claim and all relevant documentation will be forwarded to the vetting solicitors for the claim to be approved. 3.3 If a claim is approved by the vetting solicitor, it will be referred to such panel solicitor as is agreed between TAG and the vetting solicitor based on the panel solicitor’s respective capacities. 3.4 If the claim is accepted by the panel solicitor TAG will contact the claimant and arrange to visit the claimant. The TAG representative visiting the claimant will complete the AIL questionnaire incorporating a statement of truth for signature by the claimant. The TAG representative will also arrange for the claimant to complete any related loan agreement at such meeting. 3.5 TAG will issue evidence of insurance to the claimant, forward the loan agreement, if any, to the funder and advise the insurer that the policy has become active and is "on risk". 3.6 TAG will write to the insured customer setting out the key terms of the arrangement including the key terms of the indemnity offered by TAG Protect and what the insured customer will be liable for on a successful claim and explain that they will have no liability on an unsuccessful claim. 4. Claims Handling TAG shall: 4.1 Obtain such further information, including a detailed statement of truth and statements from witnesses and experts, as may be required by the panel solicitor. 4.2 Monitor the conduct of the panel solicitor during the course of the legal proceedings and reporting on same to the insurer whenever it its felt that the insurer ought to be made aware of such conduct in circumstances where due compliance with the Operating Manual agreed between all members of the TAG panel, TAG and the insurer and with the terms and conditions of the insurance so far as conducting the legal proceedings with due care and diligence is concerned. 4.3 In cases where there is a claim under the insurance and where in its opinion it is appropriate to do so, attend to a review by a suitably qualified costs draftsman of the appointed representatives disbursements and of the bill of costs of the opponents representatives. 5. Administrative Services 5.1 Staff Matters 5.1.1 TAG will provide a supervised team of trained staff to administer the insurances (including claims) to the standard set out below. 5.1.2 … 5.1.3 … 5.2 Telephones 5.2.1 TAG will provide adequate telephone lines for in-coming customer account enquiries and customer claims enquiries … 5.2.2 … 5.3 Customer Complaints 5.3.1 If a complaint is received by TAG by telephone an attempt to resolve the problem will immediately be made by a member of TAG’s staff. 5.3.2 Any unresolved telephone complaint or written complaint received by TAG will be referred to the appropriate Department manager … [the procedure is set out] …"
"Whereas (a) the Bank has agreed to provide funding for clients of the firm to finance premia due in respect of their Accident Protect legal expenses insurance policy; (b) the firm [TAG] acts as a provider of claims management services in assisting its clients to obtain compensation for personal injuries claims; (c) the parties have agreed to enter into this agreement for the purpose of regulating their relationship and establishing the terms on which the Bank will provide its services to the firm’s clients."
"2. General Obligations of the Bank 2.1 The Bank shall ensure that at all times when it is providing funding to clients it holds all appropriate licenses … relative to granting credit and administering credit transactions and banking facilities to clients. 2.2 The Bank will use its best endeavours to provide the firm with credit and ancillary documentation for the purpose of credit transactions which conform with all requisite statutory and regulatory requirements so as to be enforceable against the relevant client if duly completed and validly executed. … 2.6 The Bank will open and maintain an account designated "litigation protection IBA No.2 account" into which it will pay the premium and insurance premium tax advanced to a client under a credit transaction. 2.7 On receipt of valid instructions … from [LPL] acting on behalf of the underwriters of the policy the Bank will, within 48 hours of receipt of such instructions pay to the firm the premium allocation [£480 ] less the premium retention [£100 ]. … 3. Warranties and Undertakings by the Firm 3.1 The firm warrants that: 3.1.1 the appointed representative has entered into an agreement with the firm … 3.1.2 the vetting solicitor have entered into an agreement with the firm … 3.1.3 the firm has entered into an agreement with [LPL] … 3.2 The firm hereby undertakes and agrees that it will use its best endeavours to ensure that the parties to the agreements … above meet their duties and obligations under such agreements … 3.3 The firm undertakes and agrees to observe and perform all its duties and obligations in respect of its agreement with [LPL] … … 4. Credit Transactions 4.1 When introducing a client to the Bank, the firm shall be deemed to warrant to the Bank that: 4.1.1 the client has the benefit of a policy of legal expenses insurance; and 4.1.2 the client has signed an application form … and 4.1.3 the client has signed an AAB service agreement and declaration … and 4.1.4 the claim is a bona fide claim; 4.1.5 the claim has been accepted in writing by an appointed representative and the appointed representative is in receipt of a signed conditional fee agreement pursuant toSection 58(1) of the Courts and Legal Services Act 1990 and a client care letter … 4.2 The firm warrants that it will at all times and for all purposes (including the methods used to make known or available to clients funding under credit transactions) act in a lawful, proper and professional manner … …"
"(a) The Bank has agreed to provide funding for clients of the firm to finance premia due in respect of their Accident Protect legal expenses policy." (2574) (emphasis added) Whereas under the new Agreement it states: "(b) The Bank has agreed to provide funding to clients of the company to finance premia due in respect of their Accident Protect legal expenses policy … and disbursements payable by the client to their appointed representative in furtherance of their claim."
"2. General obligations of the Bank 2.1 … the Bank shall offer to provide credit transactions to clients of the company … Finance provided by the Bank under such credit transactions may only be used by the client to pay for: 2.1.1 premia due and payable by the client in respect of the policy; or 2.1.2 disbursements due and payable by the client to their appointed representative. … 3. Warranties and Undertakings by the Company 3.1 The company warrants that: 3.1.1 the appointed representative has entered into an agreement with the company … 3.1.2 the vetting solicitor has entered into an agreement with the company … 3.1.3 the company has entered into an agreement with [LPL] ... … 4. Credit Transactions 4.1 When introducing a client to the Bank, the company shall be deemed to warrant to the Bank that: 4.1.1 the client has the benefit of a policy of legal expenses insurance; and 4.1.2 the client has signed an application form or a questionnaire (as the case may be) … 4.1.3 the client has signed a TAG service agreement and declaration … 4.1.4 the claim is a bona fide claim; 4.1.5 the claim has been accepted in writing by an appointed representative and the appointed representative is in receipt of a signed [CFA] … and a client care letter … …"
"(b) The Bank is prepared to enter into a loan agreement with certain claimants for the purpose of financing the cost of claims under TAG’s legal expenses insurance cover scheme. … 2. Provision of Services and Loans 2.1 TAG and the Bank agree with effect from the commencement date to provide the services in accordance with the operational service levels and the Operating Manual on the terms of this agreement. 2.2 The Bank agrees with effect from the commencement date to make the loan available to claimants for the term in accordance with the provisions of Clauses 3.1 and Clause 5. [Clause 3.1 deals with the duration of the agreement.] 4. Obligations of TAG 4.1 TAG will promote the scheme and provide the services using all due care, skill and diligence in accordance with Best Industry Practice and in accordance with all applicable laws and Codes of Practice. 4.2 TAG will ensure that the services are performed substantially by properly trained, experienced and supervised employees of TAG possessing suitable skills. 4.3 … 4.4 TAG will comply at all times with its obligations under the Operations Manual. … 5. Obligations of the Bank … 5.2 The Bank shall pay to TAG for each loan agreement upon which a draw down of funds on behalf of the claimant is made the sum of£13.10 (inclusive of any applicable value added tax) by way of commission monthly in arrears … … 5.5 The interest rate under the loan is to be set at a margin over the Bank’s base lending rate and the bank shall be entitled to vary the amount of such margin upon notice to TAG in writing. … 5.7 The Bank shall be under no obligation to enter into a loan agreement with any claimant if and to the extent that the aggregate number of loans with outstanding balances at that time exceeds£33,000 . 6. Panel Solicitor 6.1 TAG will ensure that each firm of solicitors appointed to TAG’s panel of solicitors will enter into the Panel Solicitors Agreement and the solicitors indemnity and undertaking. TAG will provide the Bank from time to time with the name and address of each firm of solicitors approved for the purpose of the scheme."
"Whereas: (a) TAG provides legal expenses insurance to persons ("claimants") who have suffered personal injury where TAG is satisfied that such persons have in their reasonable opinion a better than 50% prospect of success in a claim against a culpable third parties ("opponents") in respect of injuries sustained in an accident where damages for such injuries have a reasonable prospect of exceeding£1,500 ("a bona fide claim"). (b) The appointed representative is a firm of solicitors which specialises in personal injury litigation and who have agreed subject to obtaining claimants instructions to act on claimants behalf in bringing a claim for damages for personal injury against opponents. It is agreed as follows: 1. Duties of the Appointed Representatives 1.1 In consideration of TAG’s undertaking and agreement pursuant to Clause 2 the appointed representative undertakes and agrees with TAG that it will: (a) observe and perform its obligations set out in the Operating Manual … (b) observe and perform its obligations set out in the Accident Protect Legal Expenses Insurance Policy .. (c) observe and perform as obligations hereunder the obligations which are contained in or referred to in Section 5 (step by step procedure), Section 6 (panel solicitors obligations and service standards) and Section 7 (review of files – random selection) … (d) use the form of client care letter and conditional fee agreement, copies of which are contained or referred to in the Operating Manual … (e) enter into an agreement with Legal Report Services Limited (the "
"1. Compliance … (b) The assured and the appointed representative shall conduct the proceedings with due care and diligence and shall take all reasonable steps to minimise or avoid the costs and expenses payable under the policy … In conducting the proceedings, compliance by the appointed representative with the terms of the TAG Operating Manual shall be a condition precedent to any liability of the underwriters to make payment under the policy so that, whilst underwriters will be prepared to provide an indemnity to the assured notwithstanding non compliance by the appointed representative with the terms of the TAG Operating Manual, underwriters will be entitled to make a recovery of any payment made in these circumstances from the appointed representative. 2. Arrangements with Funders … (b) In addition to making available loan facilities to the insured in respect of the payment of the premium, funders have made arrangements to provide loan facilities to the appointed representatives in respect of own disbursements including counsel’s fees to the extent of the investigation costs. (c) If at the conclusion of the proceedings, an amount of damages and costs is either awarded to the assured by order of the court as a result of the outcome of the proceedings or becomes payable to the assured by the opponent pursuant to a settlement entered into as part of the terms of a compromise, discontinuance or withdrawal of the proceedings, such amount of damages and costs shall first be used to discharge the loan together with related interest made by the funders in respect of the premium and own disbursements including counsel’s fees and thereafter the loan together with the related loan interest made by the funders to the appointed representative in order to fund own disbursements including counsel’s fees to the extent of the investigation costs. 3. Conditional Fee Agreement The assured and the appointed representative shall ensure that the [CFA] entered into meets with the requirements [of Section 58 of the CLSA 1990] …"
"EXCLUSIONS No indemnity under this insurance shall be provided by the underwriters in respect of: (1) Own disbursements including counsel’s fees where these are payable by the opponent … (2) Proceedings where the assured is … entitled to indemnity under any other insurance … (3) Proceedings which have been conducted in such a manner that, in the reasonable opinion of the underwriters, their position as insurers has been prejudiced as a result of the delay or other default by the assured or the appointed representative … (4) Proceedings which are compromised … or discontinued or withdrawn by the assured unless the prior written consent of the underwriters has been obtained … (5) Proceedings where it is discovered during the course of the proceedings that the opponent is not insured in respect of the outcome of the proceedings except in respect of own disbursements including counsel’s fees incurred before discovery and of the premium and loan interest."
"The Role of the AAB Claims Manager The claims manager provides initial insurance services to the client and continuing insurance services once a claim has been accepted by the panel solicitors. The Initial Insurance Services The initial insurance services to be provided by AAB and its representatives will include: 1. Arranging for the completion of the AAB application form which will be signed by the AAB client. The AAB representative will emphasise to the AAB client the requirement for full disclosure of all material facts which will enable a proper assessment. 2. Arranging for the completion of the consumer credit agreement application form in respect of the premium to be paid for the insurance and arranging for this to be forwarded to Investec Bank (UK) Ltd for processing. 3. Instructing Accident Investigations Ltd (AIL) to investigate the claim further and provide initial vetting services. 4. Collating the AAB application form, with such other documents as may be required to substantiate the claim, in order that the documentation can be forwarded to the vetting solicitor for assessment who will then refer the case to the panel solicitor who is appointed to conduct the legal proceedings (as defined in the policy). 5. Obtaining such further information as may be requested by the panel solicitor prior to his agreement to commence the legal proceedings. 6. Keeping the client informed of the progress of the case prior to acceptance and the outcome of the investigations. The Continuing Insurance Services The continuing insurance services to be provided by AAB and its representatives will include: 1. Advising the client of acceptance of the case and issuing the necessary insurance documentation. Assisting in obtaining such further information, including a detailed statement of truth, statements from witnesses and experts, as may be required by the panel solicitor ("appointed representative"). 2. Monitoring the conduct of the appointed representative during the course of the legal proceedings. Reporting on same to LPL. Reporting to LPL whenever it is felt that the underwriters ought to be made aware of such conduct in circumstances where due compliance with the procedures agreed between the panel solicitors, AAB and LPL and their terms and conditions of the insurance so far as conducting the legal proceedings with due care and diligence is concerned. 3. Providing ongoing assistance to the client when requested by them during the course of the legal proceedings. 4. In cases where there is a claim under the policy, attending to a review by a suitably qualified costs consultant of the panel solicitors disbursements and, where appropriate, of the opponents representatives. 5. Providing and maintaining relevant financial information as may be required by LPL for the purposes of monitoring the overall insurance result."
"Step by Step Procedure 1. AAB currently have 25 teams of three who will run a stand in various shopping malls, etc. 2. A member of the public attends at the stand and completes an [AAB] application form which includes a statement of truth. 3. At this point the Consumer Credit Agreement ("
"6(ii) Obtaining Reports and Authorisation Levels (a) Single Disbursements (1) If a single disbursement exceeding£500 is to be incurred authorisation must be sought from the relevant claims manager. If the single disbursement is less than£500 no authorisation is required. (2) … (3) AAB’s written authority is required prior to incurring the disbursement. (b) Profit Costs … 6(iii) Incurring Disbursements See above Section 6(ii)(a) for single disbursement authorisation levels. AAB require panel solicitors to use specific medical agencies. Referrals must be notified to AAB immediately …"
"To give your claim the best opportunity we will require more in-depth information regarding your accident so we will refer your claim to [AIL] to investigate. They will be contacting you in the near future to complete a questionnaire. They will need information about the circumstances of your accident, who you feel was at fault and the reasons why. They will endeavour to collate as much evidence as possible giving your claim the best opportunity of success. It will be of great assistance if you could have any details regarding you accident no matter how unimportant you feel the information is, ready in anticipation of the investigations team call."
"Please undertake all investigation work necessary relating to this claim on behalf of the panel solicitor who will be instructed, if appropriate to handle this claim."
"We understand from [AAB] that you would like us to act on your behalf in accordance with your claim for damages for an injury sustained on the above date. To enable us to deal with your claim efficiently we would be obliged if you would (1) sign the enclosed copy of this letter and return it to us. Please note that we have enclosed with this letter our Form of Conditional Fee Agreement (Terms and Conditions) ("the Terms and Conditions"). This letter, together with the enclosed terms and conditions, forms the basis of the agreement between us. Please make sure that you understand this letter and the enclosed terms and conditions before signing and returning the letter to us; (2) sign the enclosed Accident Investigation Questionnaire which contains a Statement of Truth … and return it to us."
"If you win the case, you are liable to pay own disbursements, basic costs and a success fee. You may be able to recover our disbursements, basic costs and our success fee from your opponent. If you are not able to recover these fees from your opponent you may be able to recover your disbursements under the policy. For full details, see Conditions 4 and 6 and details of insurance. Please note that if you are unable to recover the basic costs and any success fee from your opponent we will not seek to recover these from you."
"We have taken into account the factors referred to Clause 3(11) above and the fact that you have agreed to purchase the policy and accordingly we have determined to apply a success fee of: ◦ o 0% of the basic costs The total of the success fee will not be more than 25% of the damages or settlement you win."
"We will not ask you to pay own disbursements until the conclusion of your case. However, it is anticipated that these will be met by your opponents under the policy as explained above."
"Payments we make on your behalf to others involved in the case. These may be: court fees; expert fees; accident report fees; investigation fees; official search fees; travelling expenses; fees for barristers may also be counted as own disbursements … You have to pay all own disbursements, whether you win or lose. However, there are three exceptions to this: • § if you win, we may be able to recover on your behalf the money for own disbursements from your opponent or, if these are not recoverable from your opponent and they have been reasonably incurred, then, we will make a claim under the policy; • § if you lose, then we will make a claim under the policy."
"Whereas … 2. AIL undertake investigatory works as instructed by claimants at a fixed cost (the "investigation fee") of£315 plus VAT … 3. The appointed representative is a firm of solicitors which specialised in personal injury litigation and which is a member of TAGs panel of solicitors and has agreed with TAG to comply with the procedures set out in its Operating Manual [OM5]. 4. It is envisaged that the said sum of£315 plus VAT … will be funded by a credit transaction. "
"Whereas … (c) the Bank has entered into credit agreements with clients (as defined below) to fund personal injury litigation, insurance policy premia and disbursements; now it is agreed as follows: 1. Definitions … 1.3 "
"1. That the information in this form is true to the best of my knowledge, information and belief and I request that [AAB] deal with this matter on my behalf. 2. I understand that the information in this form may be used as a basis for court proceedings and for an application for a legal expenses insurance policy. 3. I have carefully read and understood the AAB service agreement and declaration enclosed with this form."
"This information form is designed to ensure that you understand the proposals [AAB] are providing under this arrangement and is also intended as a guide for future reference. Your signature below confirms that you have carefully read and understand the form and that you have retained a copy. Please keep the form safe for future reference. I understand that: (1) If my application is accepted by AAB and evidence of insurance is issued, that AAB will assist me with my claim; (2) … (3) AAB will undertake whatever action is necessary to ascertain whether or not I have a claim that in their opinion has a reasonable prospect of success; (4) … (5) if AAB do not accept my application and do not issue evidence of insurance, the loan agreement with Investec Bank (UK) Ltd which I have signed will be cancelled automatically; (6) if my claim is successful my appointed solicitor will attempt to recover the amount of premium, loan interest and any charges I have paid to purchase the insurance policy from my opponent in addition to my compensation; (7) if my claim is successful but my appointed solicitor fails to recover all or any part of the balance outstanding on my loan, then the money I receive for my compensation will first be used to discharge my obligations under the loan. If the compensation I receive is less than the balance outstanding on my loan, then my liability to repay such outstanding balance will be indemnified, in so far as provided by, and subject to, the terms of the Accident Protect legal expenses policy ("the policy"); (8) if my claim is successful, the policy, subject to compliance with its terms and conditions, provides for deficiency of damages cover which will guarantee a minimum sum of£500 damages being retained by myself after the deduction of any obligation under the loan and/or the policy provided my damages exceed this amount; (9) if my claim is not successful I will be indemnified, … against my liability to pay my own disbursements and counsel’s fees …, my opponent’s legal costs and the outstanding balance on the loan made available to me to purchase the policy. Declaration I agree that if AAB accepts this claim: (1) I will pay the premium of£840 [including IPT] for the policy; (2) as I will borrow the money to pay the premium from Investec Bank UK Ltd I hereby irrecoverably and unconditionally authorise any solicitor appointed to act on my behalf to [deal with the money as provided by the funding agreement]."
"Cover/Debit Note This is being specially produced and will be with you shortly. What we have will not provide the information that you require. Policy Document The final version has now been agreed by underwriters and has therefore been "scratched off" and is ready for use. Premium Allocation You expressed an unwillingness to accept that the additional£10 imposed by underwriters to extend the cover to include "positive deficiency of damages up to£500 " [ring fencing] should be shared between us. I have been back to underwriters who are adamant that this should stand, a view point with which I cannot disagree. You also expressed a view on what you called "our commission" and described it as "more than enough"
"as specified in Appendix 1", but no Appendix 1 has been produced. Mr Ross was asked if he could confirm that it was£78 per head at that stage. He replied that there was confusion as to what the commission was during 2000. He knew that the premium was inclusive of brokerage but "we were never very comfortable hence why we were chasing documents, as to what the exact breakdown was. We knew that it was around£112 "
"The only issue which I am undecided on is with regard to the level of commission we are receiving and which has to be detailed to the other side if proceedings are issued. I realise most of our costs is for providing post and pre insurance services on behalf of the underwriters but I recall there being a small element of commission. What are your views here? A commission could be challenged."
"Interest: conditional fee insurance scheme Limit:£50,000 each case Policy wording: to be drafted by Berrymans including deficiency in costs limit£500 each case [ring fencing] – wording as previously provided. Claims: Coverholder to have settlement authority of up to£5,000 each claim. Premium income limit:£20 million based on 60,000 policies Premium:£345 (including PDP brokerage of£18 ) with swing adjustment on 125% paid loss load up to a maximum£550 . In lieu of LOC underwriters to have charge on£100 per case upon release from retention fund. (Terms to be agreed.) Profit commission: 25% to TAG …"
"We were trying to develop a system whereby different areas of business – there was time recording put against the different aspects of the scheme so with regard to AIL you can see upwards of 10 or so different activities and Accident Advice Bureau activities."
"That is more a deficiency of this time recording system which has had a lot of failings with regard to being inputted correctly and being correctly written in the first place, programming errors, wrong usage, under usage and so on."
"I think to be honest about this description there was no claims manager as such and this step by step procedure is quickly amended when Operating Manual 2 comes out. The reality was that the claim would come into the office and would receive a very high level vetting of what I would describe as an inputting stage, inputting that claim onto the system and then would be passed to AIL to carry out the investigation."
"The investigator contacts the claimant, usually by telephone and completes a detailed questionnaire which contains a statement of truth specifically designed to the category of claim (road traffic, employers liability or public liability). The investigator will determine whether or not or one of his colleagues should meet with the claimant to obtain further information or take photographs."
"… by virtue of the type of individual who are clients, they tended to quite often be more comfortable contacting us for an update on the progress of their claim or if they had received a communication from the solicitor that they did not understand or whether they felt the case was not progressing quickly enough. There were many occasions when we would deal with customer enquiries after acceptance."
"We are not saying that under the insurance services the actual investigation is being done. That is completely separate. That is Accident Investigations Ltd. It is important for the underwriters and the insurers that the process, if you like, of an investigation in terms of gathering information, is done. It is that service that we are being paid for, ensuring that a full investigation is being carried out and information is being collated and then vetted, rather than the actual investigation, the actual information gathering, which is done by Accident Investigations."
"It does not accurately reflect what is meant by the statement "obtaining such further information including a detailed statement of truth, and statements from witnesses and experts as may be required by the appointed representative. That is not in my view reference to the actual investigation work by AIL."
"… the investigation services were a necessary function of the scheme and … the scheme did not simply refer the panel solicitor to a name and address of a client but to enable the client’s claim to be considered properly and the investigation fee was charged but paid by the client, an intention really on behalf of the claimant as opposed to a claimant going directly to a solicitor and spending some time giving detailed information regarding the circumstances of an accident which I am not sure would happen before [or] after a retainer but that was always the intention as opposed to it being a claim by the solicitor for the referral of the case."
"2. AIL undertake investigatory work as instructed by claimants at a fixed cost … of£315 plus VAT … … 5. The appointed representative agrees (and undertakes hereunder) for the benefit of claimants for whom the appointed representative has agreed to act to recover the investigation fee (save where the claimant’s claim for personal injuries is unsuccessful)."
"1.1 AIL will on behalf of claimants investigate claims referred to AIL by TAG and as far as they are able to do so ascertain: [relevant information]"
"The intention of the scheme had always been that this was a disbursement incurred on behalf of the claimant, paid by the solicitor on behalf of the claimant and in November 2000 it was decided that the payment of that would move from the panel solicitor to the claimant. It is correct to say that the paperwork with regard to that probably took another 12 months to catch up."
"Prior to the February 2001 renewal I had formed the opinion that the risk premium retained by underwriters was significantly unrealistic and insufficient to either pay for claims or generate any profit. I was also interested in formalising the underwriter’s partnership with TAG by creating a "swing premium" mechanism whereby the underwriters would receive by way of refund from TAG an additional premium allocation to the extent justified by underwriting performance. For the 2001 underwriting it was agreed that there would be an initial premium allocation to underwriters of£328.50 per policy including£16.50 brokerage to the Lloyds broker. Up to an additional£238 per policy making a total of£566.50 would be payable to the underwriters to the extent necessary to cap the underwriters loss ratio at 80% …"
"No cases will be assigned to the bottom 20% of coverholders solicitors panel "league table" as at31 October 2002 , without underwriters prior written consent."
"That meant that as the scheme was maturing we were getting more data and were able to apply – if you look at the first slip there is a lot more underwriting discipline that is reflected. What that particular paragraph is about is that TAG maintains statistics … what sort of success rates they have and by looking at that league table you can see there is a number of solicitors whose performance is not very good and we said as underwriters we are not happy to have those solicitors continuing to handle cases because they are giving us bad results."
"We received£2.7 million during the 2000 year which reflected our percentage of all business written, plus the additional£3 million or thereabouts, as reflected in this contract. So our total premium for TAG for the 2000 year, all of which is called risk premium, whatever, our premium, our accounted premium, is£5.7 million , and that is the amount that we use in all of our accounting, recording and reserving."
"• expenses of claims allocation teams • expenses of post acceptance disbursement funding team • expenses relating to collection and dispatch of files to external vetting solicitors including IT costs, support and staff costs, etc • 25% of the cost of panel liaison consultants, this element being referable to "process chasing" in relation to solicitors • other miscellaneous expenses not connected to the provision of insurance services."
"The cost of initial and continuing insurance services per case handled by TAG has been calculated at£310.33 . This calculated is based upon an equal distribution of the AE cost across the number of accepted cases handled by TAG in the relevant period. This does not include allowance for void cases which are cases abandoned by the client. These cases involve a substantial proportion of initial and insurance services but are subsequently abandoned beyond acceptance. The percentage of cases which fail in this way amount to 13%. If the cost of initial and continuing insurance services is spread across the remainder of the accepted cases handled during the period, the total AE cost per case for insurance services amounts to£356 per case."
"I gave instructions to the finance team to undertake an exercise, but the actual split of that exercise was in conjunction with the executives in the TAG business who understood what the contractual position was."
"To provision of enquiry agents services, quantity 1, value£310 . To our charges in connection with liaising with claimant, obtaining information as to the date of the incident, obtaining full details, including name, address, date of birth, national insurance number and occupation of the claimant including address, department, telephone and facsimile numbers. Obtaining full details of the relevant third party, including name, address and telephone number together with appropriate insurance details. Providing you with information to progress the case including obtaining details of the accident, the nature and extent of the injury, details as to the hospital and general practitioner who attended, details as to the extent and nature of treatment received. Further obtaining preliminary details as to financial losses of the claimant including loss of salary, prescription charges, travelling expenses and other losses, together with other relevant information to assist you in pursuing the claim."
"VAT rates 17½%, goods total£310 deliver to T Ashbourne. [The last word is misprint for Ashmore.]"
"on the face of it, yes, but the reality of it is that the disbursement here was discharged by the client directly out of his or her loan account … I am not an expert in banking law, but I believe it was the client’s obligation to authorise payment of the invoice and it was paid out on account which was nominated to the client’s name, yes. It might physically have been paid by First National."
"We shall attempt to recover the premium from your opponent if you win your case but the court may disallow it in whole or in part. In such circumstances the loan you have taken out to pay for the policy premium, disbursements (if applicable) and any interest and charges due and payable by you in respect of your loan will be deducted from your damages (compensation)."
"Payment of that invoice was made by the client directly out of his or her loan account to AIL. My firm played no part in arranging for that payment to be made and indeed it can be seen from the [CFA] signed in each case that the client was aware that the investigation fee would be incurred. My firm has not made any payment to AIL in these cases."
"… It was paid by FNB to the order of my client."
"… It was my view that working on the basis of a 0% success fee or no success fee … would maximise the client’s chances of recovering the premium in full. That has been borne out by what I have been able to achieve in my own practice over the last 2 or 3 years and because of that that meant to me that it was more likely that clients interests were not going to [be] prejudiced under this type of [CFA]; and so that fits, that is a very close fit with my outlook in terms of delivering client’s service and what happens to the client, whether I am responsible for him or not. That is the reason why primarily I was prepared to accept the situation of a 0% success rate."
"The [BWD] report assumes that the average cost of a claim depends upon the length of the time the claim takes to settle; it sets out the assumed average cost of each component of the claim for different delays to settlement [M/3363] and the assumed proportions of claims which are settled within those periods … these enable me to derive an overall average cost for each component of the claim. Multiplying the average claims cost by the claim frequency gives the estimated "burning cost", or expected claim cost per policy."
"(a) insurance premium against the risk of meeting the premium on losing cases is recoverable; (b) premium against the risk of meeting own sides disbursements is recoverable, except in respect of the fees paid to AIL; (c) premium against the risk of meeting the defendant’s costs is recoverable; (d) premium against the risk of meeting the loan interest, whether relating to the loan for premium or the loan if different for disbursements, is not recoverable; (e) premium against the risk of the [ringfencing] clause operating is not recoverable."
"I have used period 4 as an example. The only difference between the terms of insurance in period 3 (activation months February 2001 to February 2002) and in period 4 is the level of the AIL fee as I have assumed that this element of the premium is not recoverable, this would make no difference to my figure in table RHSC3. The burning costs for periods 3 and 4, associated with the net premium of£327 and the legal assumptions at paragraph 13, are set out in table RHSC4."
"Where explicit assumptions were made around levels of brokerage and commission and expenses that might be implicit within the premium calculation."
"… because the insurance policy pays for the premium when a claim is made, as the premium goes up by£150 it goes up by the amount of the insurance services, so does the claim costs in the policy by an amount and therefore the increase in the premium is … it is a circular sort of thing."
"The particular feature of this policy is that in the event of a claim the policy pays its own premium, so the return of the premium comprises a substantial component of the claims costs. So. as the premium is increased, so the claim costs under the policy increases and so the premium must again increase to maintain a given level of profitability so there is a circular element. That means that the effect on the ultimate premium of a given increase in insurance service charge, for instance – there is a gearing up effect in terms of the impact and the overall premium charged."
"44.4(1) Where the court is to assess the amount of costs (whether by summary or detailed assessment) it will assess those costs – (a) on the standard basis … but the court will not … allow costs which have been unreasonably incurred or are unreasonable in amount. (2) Whether the amount of costs is to be assessed on the standard basis the court will – (a) only allow costs which are proportionate to the matters in issue; and (b) resolve any doubt which it may have as to whether costs were reasonably incurred or reasonable and proportionate in amount in favour of the paying party."
"Premium defined. The premium is the consideration required of the assured in return for which the insurer undertakes his obligation under the contract of insurance (Lewis Ltd v Norwich Union Fire Insurance Co[1916] AC 509 , 519)."
"87. In my judgment, in this quite exceptional case, it was inevitable that the Master should adopt this [deconstruction] approach in order to identify what should truly be treated as the premium. As this court explained in Callery v Gray (No.2) at paras 11-12: "
"44. … I would observe that for the purposes of Section 29, it is the premium as between the claimant and the provider of the policy which is in issue. In my judgment the premium is not necessarily limited to payments paid on inception of cover, but could include any further amounts paid by or on behalf of the insured, pursuant to terms agreed with the insurer. The premium could also include sums paid to the benefit of the insurer. We are told that the insurer has, in effect, out sourced claims administration. The cost of this is borne by Claims Direct on behalf of underwriters. Any part of the sum paid by the insured which is devoted to this purpose may be capable of forming part of the premium."
"[Presenting] such figures requiring non expert analysis, ie by persons who are not accountants, is misconceived as a means of assisting the court in a particular case. Assessing costs is not an exact science; neither is accountancy. Treating the latter as if it were so that the results of an accountancy exercise can be used as a basis for the former, seems to me to achieve the worst of both worlds. The [Costs Judges] general knowledge and experience of local conditions and circumstances remains the only firm basis for reliable and consistent [assessment]."
"In my judgment it is clear that the Master attached too much weight to the figures quoted in the prospectus about which Mr Doona was quite rigorously cross examined. The difference between the minimum fee of£395 which a panel solicitor had to pay a claims manager and the sum of£425 quoted in the prospectus as a direct cost suggests a net outlay of£30 by MLSS on each claim, but I do not consider this figure casts any particularly useful light on anything the Master had to decide. It is clear that MLSS incurred significant expense in performing the "insurance services" required of them under the 26 August agreement. The central issue under question 2 is whether the Master was entitled to lift the veil and to be influenced by what was actually being provided in return for the premium allocation paid to MLSS …"
"In deciding whether the costs of insurance cover is reasonable, relevant factors to be taken into account include: (1) where the insurance cover is not purchased in support of a conditional fee agreement with a success fee, how its cost compares with the likely costs of funding the case with a conditional fee agreement with a success fee and supporting insurance cover;"
"(3) Solicitors must not reward introducers by the payment of commission or otherwise …"
"I understand and agree that … (9) [AIL] will investigate and obtain further information surrounding the circumstances of my accident. I understand that the costs of the investigation will form part of my claim."
"[AIL] will investigate and obtain further information surrounding the circumstances of my accident. I understand the cost of the investigation will form part of my claim."
"If TAG accepts this claim I further understand and agree that … the loan includes the premium investigation fee of£364.25 (inclusive of VAT) interest and any other expenses incurred by my solicitor on my behalf."
"investigate the case on behalf of the client/appointed representative" and later that: "the client’s indebtedness to AIL will automatically be paid by the funders (and debited to the client’s loan) following acceptance of the case by the appointed representative."
"5. The appointed representative agrees (and undertakes hereunder), for the benefit of the claimants for whom the appointed representative has agreed to act, to recover the investigation fee …"
"… for the client to fund disbursements … properly incurred by the panel solicitor on behalf of the client …"
"81 Other questions arise when one considers the nature of the MLSS invoice. In my judgment the invoice, which is sent as soon as the panel solicitor has accepted the case, can refer only to future work, ie to work done after the solicitor has been retained. In order for a disbursement to be recoverable it must have been made by the solicitor on the client’s behalf or be an out of pocket expense of the client personally (see Re: Remnant [1849] 11 Beav 603 at 611; Re: Buckwell & Berkeley[1902] 2 Ch 596 CA and Brown v Barber[1913] 2 KB 533 ). In the Claims Direct Test Cases no client has ever been called upon to pay the MLSS fee. Indeed the client does not even know of the existence of MLSS. 82. Solicitors can only pay disbursements as agent for a client if they are authorised to do so by the client. Prior to the acceptance of the case by the solicitor there is no client and therefore no authority. It is quite clear therefore that any recoverable element of the£395 plus VAT could only be in respect of work undertaken by the claims manager after the case has been accepted. It may well be that, once the case has been accepted, the claims manager carries out work, on the instructions of the solicitor, for which it is appropriate to make a charge, the cost of which may be recoverable as a disbursement. On the evidence before me, applying the above principles, none of the cases contain details of work which would bring the amount properly chargeable near to the figure of£395 plus VAT."
"2.1 … the bank shall offer to provide credit transactions to clients of the company … finance provided by the bank … may only be used by the client to pay for: … 2.1.2 disbursements due and payable by the client to their appointed representative."
"I confirm that the client understands this disbursement will be added to their loan for the premium (and any other disbursements already incurred if applicable). I understand that in the event of a successful case if this disbursement is not recovered it will be repaid to the client by ourselves."
"What happens if you win. If you win: • § You are then liable to pay all our basic charges, our disbursements and success fee … • § Normally you will be entitled to recover part or all of our basic charges, our disbursements and success fee from your opponent. • § If you and your opponent cannot agree the amount, the court will decide how much you can recover. If the amount agreed or allowed by the court does not cover all our basis charges and our disbursements then you pay the difference …"
"(2) For the purpose of this Section and Section 58A- (a) a conditional fee agreement is an agreement with a person providing advocacy or litigation services which provides for his fees and expenses, or any part of them, to be payable only in specified circumstances …"
"(3) In Parts 44 to 48 costs are recoverable where – (a) advocacy or litigation services are provided to a party under a conditional fee agreement (within the meaning ofSection 58 of the Courts and Legal Services Act 1990 ); and (b) the client is only liable to pay his legal representatives fees and expenses to the extent that those costs are – (i) received from another person; or (ii) ordered or agreed to be paid to the client."
"(d) Paying us If you win the case, you are liable to pay own disbursements, basic costs and a success fee. You may be able to recover our disbursements, basic costs and our success fee from your opponent. If you are not able to recover these from your opponent you may be able to recover your disbursement under the policy … please note that if you are unable to recover the basic costs and any success fee from your opponent we will not seek to recover these from you."