PART 5Late payment of insurance claims

28Insurance contracts: implied term about payment of claims

1

After section 13 of the Insurance Act 2015 (remedies for fraudulent claims: group insurance) insert—

PART 4ALate payment of claims

13AImplied term about payment of claims

1

It is an implied term of every contract of insurance that if the insured makes a claim under the contract, the insurer must pay any sums due in respect of the claim within a reasonable time.

2

A reasonable time includes a reasonable time to investigate and assess the claim.

3

What is reasonable will depend on all the relevant circumstances, but the following are examples of things which may need to be taken into account—

a

the type of insurance,

b

the size and complexity of the claim,

c

compliance with any relevant statutory or regulatory rules or guidance,

d

factors outside the insurer's control.

4

If the insurer shows that there were reasonable grounds for disputing the claim (whether as to the amount of any sum payable, or as to whether anything at all is payable)—

a

the insurer does not breach the term implied by subsection (1) merely by failing to pay the claim (or the affected part of it) while the dispute is continuing, but

b

the conduct of the insurer in handling the claim may be a relevant factor in deciding whether that term was breached and, if so, when.

5

Remedies (for example, damages) available for breach of the term implied by subsection (1) are in addition to and distinct from—

a

any right to enforce payment of the sums due, and

b

any right to interest on those sums (whether under the contract, under another enactment, at the court's discretion or otherwise).

2

In section 22 of that Act (application etc of Parts 2 to 5), after subsection (3) insert—

3A

Part 4A applies only in relation to contracts of insurance entered into after that Part has come into force, and variations to such contracts.