ICOB 7.2 Group policies and third party claimants

Any person who, under the terms of a policy, has a right to claim directly on the insurer, is a policyholder (see ICOB 1.2.15 R to ICOB 1.2.16 G). When dealing with claims under group policies, insurers should consider whether the person claiming is a commercial customer or a retail customer and should apply the rules in this chapter accordingly when dealing with a customer's claim.

When an insurer deals directly with a third party who claims against his customer because the third party has a legal right to bypass the customer and claim directly against the insurer (for example, certain motor claims or because of the insolvency of the customer), these rules do not require the insurer to treat the third party as a customer. However, the insurer should have regard to Principle 1 (Integrity), Principle 2 (Skill, care and diligence) and Principle 5 (Market conduct) in its dealings with the third party and should not deal with the claim in any way less favourably than it would have done had the claim been proceeded against its customer.