1An insurer must:

1. (1)

   handle claims promptly and fairly;

2. (2)

   provide reasonable guidance to help a policyholder make a claim and appropriate information on its progress;

3. (3)

   not unreasonably reject a claim (including by terminating or avoiding a policy); and

4. (4)

   settle claims promptly once settlement terms are agreed.

A rejection of a consumerpolicyholder's claim is unreasonable, except where there is evidence of fraud, if it is for:

1. (1)

   non-disclosure of a fact material to the risk which the policyholder could not reasonably be expected to have disclosed; or

2. (2)

   non-negligent misrepresentation of a fact material to the risk; or

3. (3)

   breach of warranty or condition unless the circumstances of the claim are connected to the breach and unless (for a pure protection contract):

   1. (a)

      under a ‘life of another’ contract, the warranty relates to a statement of fact concerning the life to be assured and, if the statement had been made by the life to be assured under an ‘own life’ contract, the insurer could have rejected the claim under this rule; or

   2. (b)

      the warranty is material to the risk and was drawn to the customer's attention before the conclusion of the contract.

1. (1)

   This section applies to a motor vehicle liability insurer.

2. (2)

   The rules in this section relating to the appointment of claims representatives apply in relation to claims by injured parties resulting from accidents occurring in an EEA State other than the injured party'sEEA State of residence which are caused by the use of vehicles insured through an establishment in, and normally based in, an EEA State other than the injured party'sEEA State of residence.

3. (3)

   The rules in this section relating to claims handling apply in respect of claims arising from any accident caused by a vehiclenormally based in the United Kingdom.

A firm must ensure that each claims representative:

1. (1)

   is responsible for handling and settling a claim by an injured party;

2. (2)

   is resident or established in the EEA State where it is appointed;

3. (3)

   collects all information necessary in connection with the settlement of a claim and takes the measures necessary to negotiate its settlement;

4. (4)

   possesses sufficient powers to represent the firm in relation to an injured party and to meet an injured party's claim in full; and

5. (5)

   is capable of examining cases in the official language(s) of the EEA State of residence of the injured party.

1. (1)

   A firm must notify to the information centres of all EEA States:

   1. (a)

      the name and address of the claims representative which they have appointed in each of the EEA States;

      [Note: article 5(2) of the Fourth Motor Insurance Directive]

   2. (b)

      the telephone number and effective date of appointment; and

   3. (c)

      any material change to information previously notified.

2. (2)

   Notification must be made within ten business days of an appointment or of a material change.

Within three months of the injured party presenting his claim for compensation:

1. (1)

   the firm of the person who caused the accident or its claims representative must make a reasoned offer of compensation in cases where liability is not contested and the damages have been quantified; or

2. (2)

   the firm to whom the claim for compensation has been addressed or its claims representative must provide a reasoned reply to the points made in the claim in cases where liability is denied or has not been clearly determined or the damages have not been fully quantified.

1. (1)

   If liability is initially denied, or not admitted, within three months of any subsequent admission of liability, the firm must (directly, or through a claims representative) make a reasoned offer of settlement, if, by that time, the relevant claim for damages has been fully quantified.

2. (2)

   If an injured party's claim for damages is not fully quantified when it is first made, within three months of the subsequent receipt of a fully quantified claim for damages, the firm must (directly, or through a claims representative) make a reasoned offer of damages, if liability is admitted at that time.

A claim for damages will be fully quantified for the purpose of this section when the injured party provides written evidence which substantiates or supports the amounts claimed.

1. (1)

   If the firm, or its claims representative, does not make an offer as required by this section, the firm must pay simple interest on the amount of compensation offered by it or awarded by the court to the injured party, unless interest is awarded by any tribunal.

2. (2)

   The interest calculation period begins when the offer should have been made and ends when the compensation is paid to the injured party, or his authorised representative.

3. (3)

   The interest rate is the Bank of England's base rate (from time to time), plus 4%.

A firm will be taken to have received a claim, or a fully quantified claim, for damages when the claim is delivered to it, or a claims representative, by any person by any method of delivery which is lawful in the firm's, or its claims representative's, respective State of residence or establishment.