“I am really starting to stress.”
“Re: insurance cover arranged for you by Ernst & Young (“E&Y”) Following our telephone discussion earlier this week, I confirm that Fox Williams LLP will be very pleased to act for you in connection with the above matter. The purpose of this letter is to set out the scope of our role … Scope You have explained that, following your accident in June 2006, it has become apparent that the insurance cover arranged on your behalf by E&Y does not provide the type or level of ‘accidental death and dismemberment’ (“ADD”) cover which E&Y had previously represented to you was in place. I understand that the shortcomings in the cover in fact in place at the time of your accident can be demonstrated by comparing it with the cover which was arranged by E&Y when the insurance provider was changed with effect from1 July 2006 . I have suggested that the areas to be considered further are as follows: (1) to check the extent of the cover in fact provided by the insurance in place at the time of your accident to ensure there are no arguments available which E&Y have failed to take up with insurers on your behalf; (2) to compare that cover with the insurance put in place with effect from1 July 2006 ; and (3) to obtain further details of the representations made to you by E&Y as to the ‘ADD’ cover supposedly in place at the time of your accident. In order to advise on these points, I will need to see the following: (a) copies of the relevant insurance policies; (b) all correspondence or emails between you and E&Y or insurers/brokers relating to the extent of the cover available for your accident, including in particular any emails/correspondence dealing with the meaning/interpretation of that cover; and (c) anything from E&Y which refers to the insurance benefits available to you in the event of death or serious accident. In relation to (c) you have explained that you were not provided with a copy of the presentation given to you by E&Y. However, you may have received at some stage at least a summary of the health / insurance benefits available to you. Depending on the outcome of my review of this material, the intention would then be to draft a letter to be sent to you to E&Y, in order to put some pressure on them either to extract the fullest cover to which you are entitled under the insurance in place at the time of your accident, and/or to compensate you for the disparity between that cover and the insurance which they represented to you as being in place. …”
“(i) A solicitor's contractual duty is to carry out the tasks which the client has instructed and the solicitor has agreed to undertake. (ii) It is implicit in the solicitor's retainer that he/she will proffer advice which is reasonably incidental to the work that he/she is carrying out. (iii) In determining what advice is reasonably incidental, it is necessary to have regard to all the circumstances of the case, including the character and experience of the client. (iv) In relation to (iii), it is not possible to give definitive guidance, but one can give fairly bland illustrations. An experienced businessman will not wish to pay for being told that which he/she already knows. An impoverished client will not wish to pay for advice which he/she cannot afford. An inexperienced client will expect to be warned of risks which are (or should be) apparent to the solicitor but not to the client. (v) The solicitor and client may, by agreement, limit the duties which would otherwise form part of the solicitor's retainer. As a matter of good practice the solicitor should confirm such agreement in writing. If the solicitor does not do so, the court may not accept that any such restriction was agreed”
“In order to advise on these points…”
“earning [?] ca. 700k USD a year.”
“I agree that I had not seen anything that said that they would deny his LTD claim…”
“I was just about to ask Jim for an update, when I received the message below. 4 in total. Is there anything else I should do?”
“…our understanding of the AD&D and LTD was so mixed together that we were looking for an insurance legal professional to guide us through it.”
“What is completely unclear to me – and I have no documents which shed any light on this – is why EY continued to tell you that your claim would be covered by Generali”
“I would say that’s the best we can do. Unfortunately, it may not be the most accurate.”
“Q. But you say, you see, in paragraph 35 of your witness statement: "If the letter was not sent, I can be reasonably confident that I would have discussed its contents with Mr Custance the next time I spoke to him." You are trying, through your witness statement, to imply that you would have had a discussion about LTD with Mr Custance. Is that really your reconstruction of all this, Mr Mandel? A. As I say, I don't recollect the details of the conversation. It's possible I could have mentioned it in passing or I may not have mentioned it. I just don't know. Q. So what you say in your witness statement is simply wrong, isn't it? A. That I believed that Fox Williams was advising – Q. No. "I can be reasonably confident that I would have discussed its contents ..." What you have done in the previous paragraph, you see -- or someone has done it for you -- is to highlight in bold the bits that relate to LTD. A. Right. Q. You can see what this is trying to imply, isn't it? It's plucking a passage out of the letter which wasn't even sent, putting it in bold, and saying, "Well, although it wasn't sent, I'm reasonably confident I would have discussed it". That's just simply not your reconstruction of events, is it, Mr Mandel? It doesn't fit with the documents. A. As I say, I don't recall the conversation. Since my discussions with AON or my correspondence with AON covered both LTD and AD&D and since we were concerned about generally lowering the temperature and making people aware that we were aware of all the policies and the situation -- I may have mentioned it, but I do not remember the conversation specifically. Q. So what you said in your witness statement is wrong, isn't it? You are not reasonably confident that you would have mentioned LTD, are you? A. I guess I'm not reasonably confident, that's correct”
“So you are not going to believe it but Jim did get a response but did not have to balls to let us know”
“I can start with Jim (I met him today but no details) we briefly spoke about consulting idea etc”
“Ernst & Young had been actively leading the claim on the LTD insurance, albeit too slowly for me.”
“There is no jurisdiction stated and if they file in Russia I am doomed thanks to their relationship with the courts.”
“I need you to be able to confirm that you and Jim spoke about UK jurisdiction, we know you both did so it’s important that you say so. As Jim has confirmed he vaguely remembers that you did discuss it and is will to say so. Also he will say that philipp turowski would have agreed to this as he assumed that 1 the deal was done and 2 would have given me practically anything. It’s hugely important you confirm, will you?”
“There is generally a duty to point out any hazards of the kind which should be obvious to the solicitor but which the client, as a layman, may not appreciate. In Boyce v Rendells the Court of Appeal accepted the following as a general proposition: “if, in the course of taking instructions, a professional man like a land agent or a solicitor learns of facts which reveal to him as a professional man the existence of obvious risks, then he should do more than merely advise within the strict limits of his retainer. He should call attention to and advise upon the risks”
“In order to assess the validity of any claim the Covered Person shall, upon request and at the expense of the Insurer, undergo a medical examination with a medical expert nominated by the Insurer. As soon as the validity of claim is assessed, the benefits under this policy will be paid to the Covered Person in the currency of the policy. Payment of any disability benefit will be subject to and depend upon the assessment of the medical expert so nominated… The Insurer will ask any Covered Person receiving a pension under this policy to undergo medical examinations at intervals of not less than six months”
“If a Covered Person is unable to perform his Own Occupation due to an accident or an illness prior to his 65th birthday, the Insurer will pay the Covered Person a temporary annuity after the Waiting Period. This annuity is paid monthly in arrears while the Covered Person is unable to perform his Own Occupation. This annuity is equal to 70% of a Covered Person’s prior Annual Salary, after deduction of an offset equal to US$180,000 , at the onset of the date of the Accident or Illness. It is decreased by any remuneration received by the Covered Person. The first and the last instalments are apportioned. It is subject to a maximum of US$120,000 per annum. The payment of the Short Term Disability annuity stops: - after the payment of the 25th monthly instalment - on the attainment of the Covered Person’s 65th birthday - on the disappearance of the Covered Person - when the Covered Person resumes full time employment in his Own Occupation Whichever shall first occur”
“The monthly benefit will cease on… 4. The date the insured’s current earnings exceed 80% of his pre-disability earnings”
“My work has dropped since 2006 and in 2009 dropped so I could not do job. I did part time 2009-10 but not anymore.”
“RECURRENT DISABILITY means a disability which is related or due to the same cause(s) as a prior disability for which a monthly benefit was payable. A recurrent disability will be treated as part of the prior disability if, after receiving disability benefits under this policy, an insured: 1. Returns to his regular occupation on a full-time basis for less than [six] months; and 2. Performs all the material duties of his occupation. To qualify for a recurrent disability benefit, the insured must experience more than 20% loss of pre-disability earnings. Benefit payments will be subject to the terms of this policy for the prior disability. If an insured returns to his regular occupation on a full time basis for [six] months or more, a recurrent disability will be treated as a new period of disability. The insured must complete another elimination period”
“The monthly benefit will cease on… 4. The date the insured’s current earnings exceed 80% of his pre-disability earnings”
“…first this lawyer said he was reviewing contracts for cost effectiveness.”