Insurance Coverage Disputes

Strategic Legal Support for Businesses and Professionals Facing Denied or Delayed Insurance Claims

Whether you’re an SME, startup, director, or established commercial entity, having your insurance claim denied can be a deeply frustrating and financially damaging experience. Despite fulfilling your obligations and paying premiums, insurers may seek to reject, reduce, or delay payment on claims—often without clear justification.

At The Jonathan Lea Network, we represent corporate policyholders, business owners, and senior professionals in navigating complex insurance coverage disputes. From directors’ and officers’ liability to business interruption and cyber cover, we help you assert your entitlements and recover what’s rightfully owed.

What Is an Insurance Coverage Dispute?

An insurance coverage dispute occurs when your insurer:

• Denies liability on the grounds that your loss is not covered by the policy;
  
• Offers a significantly undervalued settlement, failing to reflect the real impact of the loss;
  
• Delays payment or decision-making, undermining your cash flow or legal position;
  
• Relies on technicalities such as alleged non-disclosure or late notification to refuse payment.
  

For businesses, this can lead to major operational disruption, reputational damage, and legal exposure. For individuals, especially those with professional or executive responsibilities, it can result in personal liability, regulatory action, or career risk.

Types of Insurance Disputes We Handle

We advise across a wide range of corporate and personal coverage disputes, including:

Commercial and Corporate Policies

• Directors’ & Officers’ (D&O) Liability Insurance: Disputes often arise over coverage for shareholder claims, regulatory investigations, or allegations of breach of fiduciary duty. Insurers may invoke exclusions for dishonest acts or prior knowledge.
  
• Professional Indemnity (PI) / Errors & Omissions (E&O): Common among solicitors, consultants, accountants, and architects. We challenge denials based on scope of services, exclusion clauses, or alleged failure to mitigate.
  
• Business Interruption (BI) Insurance: Particularly post-COVID, many claims are disputed over policy wording, causation, and limits of indemnity. We help ensure cover is properly interpreted in line with FCA and UK Supreme Court guidance.
  
• Cyber Liability Insurance: Disputes can emerge over what constitutes a “security failure,” whether third-party liabilities are covered, or delays in reporting ransomware events.
  
• Employment Practices Liability (EPL): Claims for unfair dismissal, discrimination, or harassment can be excluded by insurers if not precisely notified or if alleged to fall outside the retroactive period.
  
• Legal Expenses and Regulatory Defence: Insurers may seek to deny early-stage regulatory cover for SRA, FCA, or HMRC inquiries. We ensure clients get the legal support their policy provides.
  

Individual and High-Net-Worth Policies

• Property and Contents: Disputes over underinsurance, high-value item valuations, or wear-and-tear exclusions.
  
• Travel, Life, and Medical Insurance: Insurers may rely on pre-existing conditions or alleged non-compliance to avoid payment.
  
• Motor Insurance: Allegations of fronting or misrepresentation, including telematics-based disputes.

Why Disputes Arise – Common Insurer Tactics

Understanding how and why insurers dispute claims helps us build stronger, pre-emptive strategies for our clients. Common insurer tactics include:

• Ambiguous policy language: Especially in bespoke commercial policies where terms have not been clearly defined or cross-referenced.
  
• Strict interpretation of exclusions: Particularly around fraud, dishonesty, or prior acts—even where no final adjudication has occurred.
  
• Late or incomplete notification: Often cited in claims-made policies such as D&O or PI cover.
  
• Aggregation issues: Disputes over whether multiple claims fall under a single limit of indemnity, as in AIG Europe v Woodman.
  
• Allocation disputes: Insurers may seek to limit cover by asserting only part of a matter is covered (e.g., defence costs versus uncovered damages).
  
• Excessive reliance on digital surveillance data: For example, using smartphone GPS or app usage data to question claimants’ accounts.

Our Approach: Commercially Minded, Legally Precise

We act decisively to protect your interests. Our support includes:

• Comprehensive policy review: Including analysis of wording, endorsements, exclusions, and historic amendments.
  
• Strategic dispute resolution: Early-stage negotiation, complaint escalation, and preparation for adjudication or court proceedings.
  
• Evidence development: Working with forensic accountants, loss adjusters, and industry experts to substantiate your claim.
  
• Protecting your reputation and continuity: For directors and professionals, our goal is not only to win the dispute but preserve your credibility and standing.

Financial Lines (FinPro) Coverage Disputes – A Deeper Look

These are among the most technical and contentious insurance claims. Insurers may refuse cover where:

• The alleged misconduct triggers fraud or dishonesty exclusions, despite a lack of final adjudication.
  
• You notified a potential issue late, or notification was deemed insufficiently specific.
  
• They allege a ‘prior circumstances’ exclusion applies, often relying on vague policy definitions.
  
• They contest regulatory defence coverage, especially during informal inquiries.

We are well-versed in the wording and intent behind FinPro policies. Whether you’re a director under scrutiny or a firm defending its service delivery, we can work swiftly to preserve your cover and minimise legal and financial fallout.

Emerging Trends: How Insurers Are Changing the Game

Insurers are using technology and policy changes to limit liability. We stay ahead of these trends:

• Data-driven denials: Use of telematics, wearable data, and geolocation to challenge travel, health, and motor claims.
  
• Re-drafting policies post-pandemic: Tighter BI wordings and exclusions inserted quietly on renewal.
  
• Increased regulatory scrutiny: Growing tension over insurers’ obligation to treat customers fairly under FCA rules.

We help policyholders respond to these shifts, ensuring they’re not caught off guard.

Dispute Resolution Options

Depending on your circumstances and policy terms, we will guide you through the most appropriate route:

• Negotiation and mediation: Often the fastest and most cost-effective way to resolve a dispute.
  
• Arbitration: May be required under some commercial policies, providing a private forum with specialist arbitrators.
  
• Litigation: Where necessary, we can bring High Court proceedings—especially for high-value or reputationally significant disputes.
  
• Financial Ombudsman complaints: For individuals and small businesses with claims under £375,000, we help you present a strong, well-evidenced complaint.

Why Choose The Jonathan Lea Network?

• Commercially focused: We understand the pressures facing business owners, executives, and founders—and the importance of protecting reputation and continuity.
  
• Proven experience: We’ve resolved disputes involving complex policy structures, multi-party liability, and high-stakes commercial exposure.
  
• Tailored pricing: Transparent billing, fixed-fee stages where possible, and litigation funding advice.
  
• Team approach: We work collaboratively with your in-house counsel, accountants, and brokers to align legal and commercial objectives.

Next Steps: What To Do Now

Time is crucial—especially in FinPro or claims-made policies. If you suspect a coverage issue:

1. Preserve all documents: Policy wording, schedules, endorsement emails, notification letters, and loss adjuster reports.
   
2. Avoid casual communication with insurers until you’ve taken legal advice.
   
3. Book a free 20-minute consultation with us to assess your position and options.

We’ll provide a roadmap and, where appropriate, a fixed-fee review to get started.

Contact Us

Whether you’re a business facing a complex insurance claim dispute or a professional concerned about your personal liability cover, we’re here to support you.

📞 Call now for a free 20-minute consultation on +44 (0)1444 708 640, or
Email us and we’ll provide an initial assessment.

Get the strategic legal support you need—protect your business, reputation, and future.