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A complaint made by mr. C against das legal expenses insurance company limited regarding their refusal to cover his preferred solicitor in an employment dispute. The background details the assessment of mr. C's claim, the involvement of a barrister, and das's subsequent offer of alternative solicitors. Mr. C's dissatisfaction with the offered solicitors and the hourly rate limit led to an investigation and a final decision by the financial ombudsman.
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complaint
Mr C complains that DAS Legal Expenses Insurance Company Limited won’t pay for him to use his preferred solicitor in action he’s taking in an employment dispute.
background
Mr C has legal expenses cover under his home insurance policy. DAS underwrites that part of the policy. In early 2017, Mr C got in touch with DAS about an employment dispute.
Mr C’s claim was initially assessed by a solicitor on DAS’s panel. They said the claim had less than a 51% chance of success. DAS would only cover claims with a better chance of winning.
Mr C appointed a barrister to give a second opinion. They thought his claim had a better prospect of success. Mr C went back to DAS, and it paid his legal costs for the second opinion. It also agreed to cover his claim, subject to the policy limits.
DAS gave Mr C details of three firms of solicitors on its panel which it said he could use. One had a conflict of interest so couldn’t act for Mr C, and another was the firm which had said the claim had less than a 51% chance of winning.
Mr C felt he wasn’t being offered a real choice of solicitors. He wanted to use his own solicitors, but DAS would only pay £100 an hour towards their costs, and Mr C couldn’t afford to pay the difference.
After Mr C got in touch with us, one of our investigators looked into the matter. The investigator initially agreed with Mr C. She thought DAS hadn’t given him a meaningful choice of solicitor because:
DAS then said Mr C could use another firm of solicitors not on its main panel, at no cost to him – up to the limit under the policy.
Our investigator said that was fair, because it meant Mr C had a reasonable choice of solicitors. She also said the £100 hourly limit on the legal costs DAS was prepared to pay if Mr C went ahead with a solicitor who wouldn’t accept its standard terms was clear in the policy – and it wouldn’t be fair to require it to pay more than that. But she thought DAS could have given Mr C the option of another firm of solicitors sooner, and Mr C had been caused stress and worry as a result of the delay. She recommended DAS pay him £ compensation to reflect that.
DAS accepted it hadn’t offered another firm of solicitors as early as it could have done, so it said it would settle this complaint. Mr C didn’t accept the investigator’s conclusions. He still felt he hadn’t been offered a real choice, and he was unhappy that DAS had only offered him another firm of solicitors shortly before he was due in court.
Ref: DRN
my findings
I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. Having done so, while I realise Mr C will be disappointed, I find I’ve reached the same overall conclusions as the investigator.
I think it’s entirely understandable that Mr C didn’t want to appoint the solicitor who thought he didn’t have much chance of winning his case. He was unhappy with their service and had raised a complaint about them. But DAS has since offered an alternative with relevant expertise in employment law. Mr C hasn’t said anything which leads me to conclude that the two solicitors DAS has now made available to him are unsuitable or not appropriately qualified. I don’t accept that one of them is unsuitable simply because they’re associated with DAS; they are separate businesses.
I’ve noted Mr C’s point that the £100 limit on the amount DAS is prepared to pay per hour is unreasonable. Where there’s a significant limit on the cover provided, such as a fixed hourly rate lower than the policyholder would pay if they instructed a non-panel solicitor, the insurer needs to make this clear; policyholders should know at the outset what cover they’re getting. DAS does set this out clearly in the policy terms. And I don’t think it would be fair to require DAS to pay unlimited costs – unless, of course, that were provided for in the policy.
DAS had to give Mr C a reasonable choice of representation, and I think it has now done so. It has given him a choice of two panel solicitors, or if Mr C chooses his own solicitor, it has said it will pay the first £100 of their hourly rate – up to the policy limits. I’m satisfied that, in doing so, DAS has met its obligations under the terms of Mr C’s policy with it.
I agree with the investigator’s view that DAS didn’t give Mr C a reasonable choice of solicitors earlier – in the light of one solicitor’s conflict of interest and the other solicitor’s initial view of the claim’s prospects of success. I also agree that it should reasonably have offered Mr C an alternative sooner. It only did so two weeks before Mr C was due in court.
I think Mr C was caused a good deal of unnecessary worry and inconvenience because of the time this took, and he should fairly receive some compensation in recognition of that. In all the circumstances, I think £500 is fair.
my final decision
My final decision is that DAS Legal Expenses Insurance Company Limited should pay Mr C £500.
Under the rules of the Financial Ombudsman Service, I’m required to ask Mr C to accept or reject my decision before 6 November 2017.
Janet Millington ombudsman
Ref: DRN