Home Insurance

About your policy

Understanding and using your policy

This section ‘About your policy’ does not form part of the legal contract between you and us. It includes information which will help you to understand and use your policy.

Insurance policies can be difficult to understand so we have tried to make this policy easy to read. Some words have a special meaning in your policy and these are listed and explained under the heading ‘Words with special meanings’. From now on whenever a word with a special meaning is used it will be printed in bold type.

Your policy is in two parts – the policy wording and the schedule. The policy wording explains what is and what is not covered, how we settle claims and other important information.

The schedule shows which sections of the policy wording apply, the limits to the cover and the premium. Please keep your schedule with the policy wording.

We will send you a new schedule whenever you or we make a change to the insurance and each year before renewal so you can check that the cover still meets your needs.

Once you have received your policy you will have 14 days to make sure the cover is exactly what you need. If it isn’t, you can send back your documents and ask us to make any necessary changes. Alternatively, you can request cancellation of the policy and you will receive a full refund of premium, as long as no claim has been made.

Remember to keep your sums insured (which are shown on your schedule) up to date.

If you have selected buildings insurance, you should increase your sum insured if you extend or make improvements to your home, such as installing doubleglazing, adding a fitted kitchen or conservatory.

If you have selected contents and personal belongings insurance, your cover is for replacement as new. Remember to keep your sums insured up to date when you buy new items. Items such as jewellery, articles of precious metal, clocks, watches, paintings, works of art, antiques and stamp, medal and coin collections often change in value. These changes are not reflected in the indices used for inflation protection and you should make certain that these items are insured for the correct
amount at all times.

If you have any questions please contact us. The telephone numbers are shown on your schedule.

If you need to make a complaint

At Royal & SunAlliance, providing excellent customer service is something we always strive to achieve. When that doesn't happen, we want you to tell us about it. Full details of our complaint procedure are shown on your schedule.

How to make a claim

If you need to make a claim, what you need most of all is speedy, professional, practical help. That is exactly what we provide. Whatever the problem, big or small, we are here to help you.

When an accident happens, you should take any immediate action you think is necessary to protect your property and belongings from further damage, such as switching off the gas, electricity or water.

Call our claims helpline on the number shown on your schedule. Please have your policy number handy when you call. While most claims can be agreed over the phone, there may be times when we will ask you to complete a claim form and provide us with further information.

• To help us deal with your claim quickly, please read this policy booklet carefully, particularly the Claims conditions and Policy exclusions.

The insurance contract

This policy is a legal contract between you and us. The policy wording and schedule make one document and must be read together. Please keep them together.

The contract is based on the information you gave us when you applied for the insurance.

Our part of the contract is that we will provide the cover set out in this policy wording:

• for those sections which are shown on your policy schedule;
• for the insurance period set out on the same schedule.

Your part of the contract is:

• you must pay the premium as shown on your schedule for each insurance period;
• you must comply with all the conditions set out in this policy.

If you do not meet your part of the contract, we may turn down a claim, increase the premium or you may find that you do not have any cover.

We can both choose the law which will apply to this contract. However, unless it says differently anywhere else in this policy, or unless you and we agree otherwise, the law which applies to this contract is:

• the law which applies to the part of the United Kingdom, the Channel Islands or the Isle of Man in which you live; or
• the law of England and Wales if you do not live in the United Kingdom, the Channel Islands or the Isle of Man.

This policy has been issued by Royal & Sun Alliance Insurance plc in the United Kingdom.

Words with special meanings

This part of the policy sets out the words which have a special meaning. Each word is listed with the meaning explained below it and is printed in bold type whenever it appears in the policy.

There are other words with special meanings listed under the Legal expenses section. You should also look at these. Your schedule will show you if you have this section insured under your policy.

Accidental damage

Sudden, unexpected and visible damage which has not been caused on purpose.

Buildings

The home, fixtures and fittings, patios, paved terraces, footpaths, tennis courts, swimming pools, garden ponds, statues and fountains permanently fixed into the ground, drives, walls, fences, hedges and gates.

Buildings does not include aerials and satellite receiving equipment.

Clerical business equipment

Computer, telecommunication and office equipment, office furniture and stationery, owned by your family or your family’s responsibility under contract.

Clerical business equipment does not include business stock or business money or credit cards and no cover is provided for:

• the cost of replacing paper records, except for their value as stationery;
• any loss or erasure of, or any damage, distortion or corruption to records, data, programs and software.

Company/our/us/we

Royal & Sun Alliance Insurance plc.

Contents

Household goods, high risk items, personal documents, personal belongings, clerical business equipment, pedal cycles and money, owned by your family or your family’s responsibility under contract.

Visitors personal belongings in your home.

Contents does not include:

• motor vehicles and children’s motor vehicles whether licensed for road use or not (other than motorised or electric wheelchairs), mechanically propelled or assisted vehicles (other than garden machinery and pedestrian controlled vehicles), aircraft, trains and boats (other than models), gliders, hang-gliders, wetbikes, hovercraft and other mechanically propelled or assisted watercraft,
  caravans, trailers or parts or accessories for any of them whether attached or detached, other than removable entertainment equipment while removed;
• animals;
• anything used for trade, professional or business purposes except clerical business equipment;
• fixtures and fittings;
• credit cards.

Excess

The first part of any claim which you must pay.

Heave

Upward and/or lateral movement of the site on which your buildings stand caused by swelling of the ground.

High risk items

Televisions, computers, audio and video entertainment equipment, CDs, DVDs and computer games, photographic equipment, jewellery, watches, articles of precious metal, clocks, paintings, works of art, stamp, medal and coin collections.

Home

The house or flat at the address shown on your schedule, its garages, greenhouses and outbuildings, all used for domestic and clerical business purposes only.

Insurance period

The period shown on your schedule and any further period for which you have paid or have agreed to pay and we have accepted or have agreed to accept your premium.

Money

Current bank notes and coins, stamps, cheques, electronic cash pre-payment cards, savings certificates, gift tokens, postal and money orders, phone cards or vouchers, traveller’s cheques, premium bonds, parking, luncheon, retail vouchers and season or travel tickets, owned by your family or your family’s responsibility under contract.

Money does not include:

• promotional vouchers, air miles vouchers, credit notes, store or loyalty points, lottery tickets, scratchcards, raffle tickets and stamps which are part of a stamp collection;
• money used or held for any trade, professional or business purposes.

Pedal cycles

Any pedal cycle and its accessories, owned by your family or your family’s responsibility under contract.

Pedal cycles does not include any motorised pedal cycle.

Personal belongings

Jewellery, watches and personal items which your family normally wear or carry and which are owned by your family or your family’s responsibility under contract.

Personal belongings does not include:

• household goods and domestic appliances;
• external television and satellite receiving equipment;
• motor vehicles and children’s motor vehicles whether licensed for road use or not (other than motorised or electric wheelchairs), mechanically propelled or assisted vehicles, aircraft, trains and boats (other than models), pedal cycles, gliders, hang-gliders, wetbikes, hovercraft and other mechanically propelled or assisted watercraft, caravans, trailers or parts or accessories for any of them
  whether attached or detached, other than removable entertainment equipment while removed;
• animals;
• money, credit cards, securities and documents of any kind;
• anything used for any trade, professional or business purposes (other than portable computer equipment and mobile phones);
• china, glass, pottery and any other items of a similar nature which are fragile.

Policyholder/you/your

The person(s) named as policyholder on your schedule.

Subsidence

Downward movement of the site on which your buildings stand by a cause other than the weight of the buildings themselves.

Unoccupied

When your home has not been lived in by your family or by anyone who has your permission, for more than 60 days in a row. Lived in means slept in frequently.

Us/we/Company/our

Royal & Sun Alliance Insurance plc.

We/Company/our/us

Royal & Sun Alliance Insurance plc.

You/your/policyholder

The person(s) named as policyholder on your schedule.

Your family

You or any of the following people providing they normally live with you:

• your husband, wife or partner;
• children (including foster children);
• your relatives;
• your domestic employees.

Wheelchairs

Any wheelchair or similar electric scooter specifically designed for the disabled or infirm and which does not legally require to be licensed for road use.

Conditions and exclusions

Policy conditions

These are the conditions of the insurance you will need to meet as your part of this contract.

Taking care

Your family must take all reasonable steps to avoid incurring liability and prevent loss or damage to everything which is covered by this insurance and to keep all the property insured in good condition and in good repair.

Changes in your circumstances

Using the address on the front of your schedule, you must tell us within 30 days as soon as you know about any of the following changes:

• you are going to move home permanently;
• someone other than your family is going to live in your home;
• your home is going to be used for short periods each week or as a holiday home;
• your home is going to be unoccupied;
• work is to be done on your home which is not routine repair, maintenance or decoration;
• the number of bedrooms in your home has changed;
• you or any member of your family has any conviction for any offence;
  There is no need to tell us about parking or speeding offences or any offences which are spent under the Rehabilitation of Offenders Act 1974.
• you or any member of your family has received any formal police caution in the last 5 years;
  There is no need to tell us about police cautions for parking or speeding offences.
•  any part of your home is going to be used for any trade, professional or business purposes;
  There is no need to tell us about trade, professional or business use if:
  • the trade, professional or business use is only clerical; and
  • you do not have staff employed to work from your home; and
  • you do not have any visitors to your home in connection with your trade, profession or business; and
  • you do not keep any business money or stock in your home.
• any increase in the value of your contents or the rebuilding cost of your buildings.

We may re-assess your cover and premiums when we are told about changes in your circumstances. If you do not tell us about changes or give us incorrect information, the wrong terms may be quoted, a claim might be rejected or payment could be reduced. In some circumstances your policy might be invalid,
and you may not be entitled to a refund of premium.

Fraud

If dishonesty or exaggeration is used by your family or anyone acting on behalf of your family to obtain:

• a claims payment under your policy; or
• cover for which you do not qualify; or
• cover at a reduced premium;

all benefits under this policy will be lost, the policy may be invalid, you may not be entitled to a refund of premium and legal action may be taken against you.

Transferring your interest in the policy

You cannot transfer your interest in this policy to anyone else without our written permission.

Cancelling the policy

You may cancel this policy by giving us 14 days notice in writing to the address shown on the front of your schedule. If you cancel the policy you may be entitled to a refund of premium provided that no claim has been made during the current insurance period. We may cancel this policy by giving you at least 14 days notice at your last known address. If we cancel the policy we may refund premium paid for the remainder of the current insurance period.

Cancelling the monthly premium instalment agreement

Your policy has a normal insurance period of 12 months and your legal contract with us is for this period. You may have asked and we may have agreed for your annual premium to be paid on a monthly basis by instalments under the terms of
the Consumer Credit Act 1974.

We will send you a Default Notice as required under the Consumer Credit Act 1974 asking for payment of any unpaid monthly instalments of your annual premium. If you do not pay all the unpaid instalments by the date given in the Default Notice, all the cover under your policy will be cancelled from this date.

If you want to cancel your credit agreement but not your policy, you must contact us at the address given on the front of your schedule. We can then tell you how much you will have to pay for the rest of the insurance period. If this amount is not paid by the date given in our reply to you, then all cover under your policy will be cancelled from this date.

Other conditions

There are other conditions which relate to any claim you may make and these are shown under the heading ‘Claims conditions’. You should also refer to any conditions shown under individual sections of your policy.

Claims conditions

These are the claims conditions you will need to keep to as your part of the contract.

If anything happens which might lead to a claim, what you must do depends on what has happened. The sooner you tell us the better. In some cases, there are other people you must contact first.

When an incident occurs which may result in a claim, you must also read the information on ‘How to make a claim’.

You should also check the information on ‘How we settle claims’ under the section of your policy which covers the loss or damage, e.g. contents, buildings.

What you must do

If you are the victim of theft, riot, a malicious act or vandalism, or if you lose something away from your home, tell the police immediately and ask for a crime reference number and tell us as soon as you can, or in the case of riot tell us immediately.

If someone is holding any of your family responsible for an injury or any damage, no one in your family must admit responsibility. Give us full details in writing as soon as you can and any claim form, application notice, legal document or other correspondence sent to your family must be sent to us straightaway without being answered.

For all other claims, tell us as soon as you can.

You should do all we reasonably ask you to do to get back any lost or stolen property.

Do not throw away any damaged items before we have had a chance to see them.

To help us deal with your claim quickly, we may require additional information which may include the following:

• original purchase receipts, invoices, instruction booklets or photographs;
• purchase dates of lost or damaged items;
• for damaged items, confirmation by a suitably qualified expert that the item you are claiming for is beyond repair.

Rights and responsibilities

We may need to get into a building that has been damaged to salvage anything we can and to make sure no more damage happens. You must help us to do this but you must not abandon your property to us.

You must not settle, reject, negotiate or offer to pay any claim you have made or intend to make under this policy without our written permission. We have the right, if we choose, in your name but at our expense to:

• take over the defence or settlement of any claim;
• start legal action to get compensation from anyone else;
• start legal action to get back from anyone else been made.

You must give us, at your reasonable expense, all
about any claim. You must help us to take legal action
defend any legal action if we ask you to.

When you call us, at our option we will:

• ask you to get estimates for building repairs or
• arrange for the damage to be inspected by one
  independent loss adjuster – their aim is to help
  you; or
• arrange for the repair or a replacement as quickly as possible

Other insurance

If you claim under this policy for something which insurance policy, you must provide us with full details policy. We will only pay our share of any claim.

Policy exclusions

These exclusions apply to all the sections of your policy with the exception of Pollution or contamination and Rot which do not apply to the Legal expenses section.

This insurance does not cover:

Radioactive contamination

Any loss, damage, liability, cost or expense of any kind caused directly or indirectly by:

• ionising radiation or radioactive contamination from any nuclear fuel or waste which results from the burning of nuclear fuel;
• the radioactive, toxic, explosive or other dangerous properties of nuclear machinery or any part of it.

War risks

Any loss, damage, liability, cost or expense of any kind caused directly or indirectly by war, invasion or revolution.

Sonic bangs

Any loss, damage, liability, cost or expense of any kind caused directly or indirectly by pressure waves from aircraft.

Pollution or contamination

Any loss, damage, liability, cost or expense of any kind caused directly or indirectly from pollution or contamination which:

• was the result of an intentional act; or
• was expected or should have been expected; or
• was not caused by a sudden incident; or
• was not during any insurance period.

Rot

Any loss, damage, liability, cost or expense of any kind caused by rot whether or not this is caused directly or indirectly by any other cover included in this insurance.

Date change and computer viruses

Any direct or indirect loss or damage caused:

• to equipment by its failing correctly to recognise data representing a date in such a way that it does not work properly or at all;
• by computer viruses.

Legal expenses, legal benefits and /or liability arising directly or indirectly from:

• equipment failing correctly to recognise data representing a date in such a way that it does not work properly or at all;
•  computer viruses;

but any claim for legal expenses / benefits to pursue compensation for personal injury is not excluded.

For the purposes of this exclusion:
Equipment includes computers and anything else insured by this policy which has a microchip in it.
Computers include hardware, software, data, electronic data processing equipment and other computing and electronic equipment linked to a computer.
Microchips include integrated circuits and microcontrollers.
Computer viruses include any program or software which prevents any operating system, computer program or software working properly or at all.

Existing & deliberate damage

Any loss, damage, liability, cost or expense of any kind occurring, or arising from an event occurring, before the insurance period starts or caused deliberately by your family.

Terrorism

Any loss, damage, liability, cost or expense of any kind directly or indirectly caused by, resulting from or in connection with any act of terrorism.

For the purposes of this exclusion, ‘terrorism’ means the use, or threat of use, of biological, chemical and/or nuclear force or contamination by any person(s), whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government(s) or put any section of the public in fear.

Wear & tear

Any loss, damage, liability, cost or expense of any kind caused by or resulting from wear and tear, depreciation, corrosion, rusting, damp, insects, vermin, fungus, condensation, fading, frost or anything which happens gradually, the process of cleaning, dyeing, repair, alteration, renovation or restoration or any consequential loss.

Defective construction or design

Any loss, damage, liability, cost or expense of any kind caused by or resulting from poor or faulty design, workmanship or materials.

Home emergency assistance

This part of the policy provides access to advice and help with the cost of home emergency assistance.

Emergency advice and repairs

Call our 24 hour emergency helpline on the number shown on your schedule after taking any immediate action you think is necessary to protect your property and belongings from further damage, such as switching off the gas, electricity or water.
We have a team of contractors on hand to carry out urgent repairs 24 hours a day, 7 days a week.

If the emergency means that your family need to move out of your home overnight, we can arrange accommodation for you and may be able to help with the cost of the bill.

The most we will pay for any one claim, which includes any overnight accommodation, the cost of the emergency repair, parts and call out charges, is the limit shown on your schedule.

If the emergency is a result of an incident which is also covered under a specific section of your policy, you may be able to claim for any further repair costs under that section. Please call our claims helpline on the number shown on your schedule and we will be happy to check this for you.

Our staff take pride in their service and will do all they can to help you.

How we settle claims for home emergency assistance

Telephone the 24 hour Home Emergency Assistance Helpline which has been arranged for our policyholders convenience. The telephone number is shown on your schedule.

The most we will pay for any one claim is the limit shown on your schedule.

Payment for repairs will be made directly to our contractor.

Homecare services

This part of the policy provides access to Legal advice, and explains the cover we provide for Locks and keys and trees, shrubs, plants and lawns.

Legal advice

Whatever legal matter you need help and guidance with, simply call this free service and speak to an expert. This service is available 24 hours a day, 365 days a year. The telephone number is shown on your schedule.

You will need to quote the scheme reference number shown on your schedule when using this helpline. You can use this service as many times as you wish, whenever you need to.

How we settle claims for locks and keys and trees and shrubs

We will pay the cost of repairing or replacing the damaged parts of the locks and keys or trees, shrubs, plants or lawns.

Where an excess applies, this will be taken off the amount of your claim.

The most we will pay for any one claim is the limit shown on your schedule.

Buildings

This part of the policy sets out the cover we provide for your buildings, unless your schedule states ‘Not insured under this policy’.

How we settle claims

If you wish to claim under this section of your policy please follow the steps detailed in the ‘How to make a claim’ section.

How we settle claims for buildings

1. We will pay for the reasonable cost of work carried out in repairing or replacing the damaged parts of your buildings and agreed fees and related costs.

   At our option we will arrange for specialist investigations to be carried out.

   We may take over and conduct in your name with complete and exclusive control, the defence or settlement of any claim.

   If the repair or replacement is not carried out, we will pay the decrease in market value of your buildings due to the damage but not more than it would have cost us to repair the damage to your buildings if the repair work had been carried out without delay.

   At our option we will make a cash settlement but we will not pay more than it would have cost us to repair the damage to your buildings if the repair work had been carried out without delay.

   No allowance will be made for VAT when a cash settlement is made.

2. Where an excess applies, this will be taken off the amount of your claim.
3. If your buildings have not been kept in a good state of repair or if the sum insured at the time of the loss or damage is less than the cost of rebuilding all your buildings in the same way, size, style and appearance as when they were new, including fees and related costs, we will pay the cost of repairing or replacing the damaged parts of your buildings and we will, where appropriate, take off an amount for wear and tear.
4. The most we will pay for any one claim, including fees and related costs, is the amount it will cost us to repair the damage to your buildings in the same way, size, style and appearance as when they were new, but not more than the sum insured or any limits shown on your schedule.

We will not pay for:

• Loss of value resulting from repairs to or replacement of damage to your buildings;
• Replacing or changing undamaged parts of your buildings which belong to a set or suite or which have a common design or use, such as a bathroom suite or fitted kitchen units, when the damage is restricted to a specific part or clearly defined area.

Inflation protection

The sum insured shown on your schedule will be adjusted in line with a recognised index. Please note that if we selected your sum insured for you the sum insured shown on your schedule will not be adjusted.

No extra charge will be made for any increase until the renewal of the policy, when the renewal premium will be based on the adjusted sum insured and limits.

Index linking of the sum insured will continue during repair or replacement following loss or damage provided the sum insured at the time of the loss or damage represents the full rebuilding cost and you ensure that the work is carried out without undue delay.

For your protection, we will not reduce your sum insured if the index moves down unless you ask us to.

As well as insuring your buildings, we also provide the following cover.

This part of the policy explains the cover we provide for the contents in your home unless your schedule states ‘Not insured under this policy’.

Contents

How we settle claims

If you wish to claim under this section of your policy please follow the steps detailed in the ‘How to make a claim’ section. You should also read the Claims conditions and Policy exclusions.

How we settle claims for contents

1. If an item has been damaged and it can be economically repaired we will either arrange or authorise repair and we will pay the cost of repair.
   Otherwise, we will replace the item with a new one of similar quality through our preferred suppliers, or at our option, we will pay the replacement cost of a new item of similar quality.

   If we agree, at your request, not to repair or replace an item, at our option we will make a cash or voucher settlement equal to the cost we would have paid for replacement or repair through our preferred suppliers.

2. We will not pay the cost of replacing or changing undamaged items or parts of items which belong to a set or suite, or which have a common design or use such as suites of furniture and carpets which are only damaged in one area, when the loss or damage relates to a specific part or part of an item or to a clearly defined area.
3. We will not pay for any loss of value to any item which we have repaired or replaced.
4. Where an excess applies, this will be taken off the amount of your claim.
5. If loss or damage happens and the sum insured on your schedule is less than the cost of replacing all your contents as new, we will, where appropriate, take off an amount for wear and tear from the cost of the new item unless the item can be economically repaired when only the cost of the repair will be paid.
6. The most we will pay for any one claim is the amount it will cost us to replace all your contents as new but not more than the sum insured or any limits shown on your schedule.

Inflation protection

The sum insured, the total high risk items limit and the high risk items single article item limit shown on your schedule will be adjusted in line with a recognised index. Please note that if we selected your sum insured for you, the sum insured shown on your schedule will not be adjusted.

No extra charge will be made for any increase until the renewal of the policy, when the renewal premium will be based on the adjusted sum insured and limits.

For your protection, we will not reduce your sum insured or limits if the index moves down unless you ask us to.

Legal liability

As well as insuring your contents, we also provide the following cover.

This part of the policy sets out the cover we provide for your personal belongings and money in or away from your home, unless your schedule states ‘Not insured under this policy’.

Personal belongings and money

How we settle claims

If you wish to claim under this section of your policy please follow the steps detailed in the ‘How to make a claim’ section.

How we settle claims for personal belongings

1. If an item has been damaged and it can be economically repaired we will either arrange or authorise repair and we will pay the cost of repair. Otherwise, we will replace the item with a new one of similar quality through our preferred suppliers or at our option, we will pay the replacement cost of a new item of similar quality.

   If we agree, at your request, not to replace or repair an item, at our option we will make a cash or voucher settlement equal to the cost we would have paid for replacement or repair through our preferred suppliers.

2. We will not pay for any loss of value to any item which we have repaired or replaced.
3. Where an excess applies, this will be taken off the amount of your claim.
4. The most we will pay for any one claim is the amount it will cost us to replace all your personal belongings and personal documents as new but not more than the sum insured or any limits shown on your schedule.

How we settle claims for money

1. Where an excess applies, this will be taken off the amount of your claim.
2. The most we will pay for any one claim for money is the sum insured shown on your schedule.

Inflation protection

The sums insured and the limits shown on your schedule for personal belongings will be adjusted in line with a recognised index.

No extra charge will be made for any increase until the renewal of the policy, when the renewal premium will be based on the new sums insured and the limits shown on your schedule.

For your protection, we will not reduce your sums insured or limits if the index moves down unless you ask us to.

This part of the policy covers pedal cycles belonging to your family while in or away from your home, unless your schedule states ‘Not insured under this policy’.

Pedal cycles

How we settle claims

If you wish to claim under this section of your policy please follow the steps detailed in the ‘How to make a claim’ section.

How we settle claims for pedal cycles

1. If a pedal cycle has been damaged and can be economically repaired we will either arrange or authorise repair and we will pay the cost of repair.
   Otherwise we will replace it with a new pedal cycle of similar quality through our preferred suppliers, or at our option, we will pay the replacement cost of a new pedal cycle of similar quality.

   If we agree, at your request, not to replace or repair a pedal cycle, at our option we will make a cash or voucher settlement equal to the cost we would have paid for replacement or repair through our preferred suppliers.

2. We will not pay for any loss of value to any pedal cycle which we have repaired or replaced.
3. Where an excess applies, this will be taken off the amount of your claim.
4. The most we will pay for any one claim for each pedal cycle is either the limit per cycle or the sum insured shown on your schedule subject to any policy limits.

Inflation protection

The limit per cycle shown on your schedule will be adjusted in line with a recognised index.

No extra charge will be made for any increase until the renewal of the policy, when the renewal premium will be based on the new limit per cycle shown on your schedule.

For your protection, we will not reduce the limit per cycle if the index moves down unless you ask us to.

Legal expenses

The words with special meaning which apply to this section are listed under 'Words with special meanings'. You should look at these.

This part of the policy explains the cover we provide for legal expenses up to the amount shown in your schedule for any one claim unless your schedule states ‘Not insured under this policy’.

This section of your policy provides you with access to a wide range of effective solutions, including professional mediation, that are designed to address your individual circumstances.

The cover at a glance

• Personal injury
• Consumer protection
• Residential
• Employment
• Tax

If you need legal advice

If you or your family need legal advice on any personal or domestic matter or are unsure of the best way forward, just call our free legal helpline on the number shown on your schedule for expert advice and guidance at any time of the day or night.

If you think you might have a claim

If anything happens which might lead to a legal expenses claim, you must tell us immediately in writing by filling in a claim form that can be obtained from
FirstAssist Group Limited, Marshall’s Court, Marshall’s Road, Sutton, Surrey, SM1 4DU.

Words with special meanings

Words used in this section of the policy that have special meanings are shown below, each word is listed and its meaning explained. These words have the meanings shown wherever they appear in this section.

There are other words with special meanings listed at the beginning of this document and you should also look at these.

Any one claim

All legal proceedings, including appeals, arising from or relating to the same original cause or event.

Arbitration

A meeting held in private to settle a dispute about the policy. This is less formal than a court hearing.

Court

A court, tribunal or other appropriate authority.

Disbursements

Money that your solicitor has spent on your behalf in dealing with your case.
These amounts are different from your solicitor’s own fees and will be shown as a separate item on your solicitor’s bill.

Expert Witness

A person who has a special skill or technical or professional knowledge (for example, a doctor or a surveyor) and whose opinion can be given as evidence in court.

Full enquiry

Action taken by the Inland Revenue following a Notice issued under Section 9A of the Taxes Management Act 1970 saying they plan to carry out a ‘Special Compliance Office Investigation’ or a ‘Local Tax Office Enquiry’ which involves examining and considering all areas of your tax affairs in detail.

Goods

Items you own or for which you are legally responsible, except motorised vehicles or parts of them, land, buildings, or items used for business purposes.

Household

You, your husband, wife, partner, children, parents and relatives who all normally live with you at your home.

Insurer

Royal & Sun Alliance Insurance plc.

Legal expenses

Your representative’s fees, costs and disbursements which we have agreed or the costs of any other people involved in the legal proceedings if you have to pay those costs. This includes costs following an ‘out-of-court’ settlement to which we have agreed. This does not include any damages, fines or penalties you have to pay.
Anything more than is allowed on the standard basis must be paid by you.

Legal proceedings

Legal action in a civil court to protect your rights in a dispute.

Partner

A person you have a continuous relationship with who lives with you at your home.

Representative

The solicitor or other suitably-qualified person appointed to act for you.

Standard Basis

The basis for charging costs:

• in England and Wales under Civil Procedure Rules rule 44.4; or
• in Scotland under Chapter II (in Ordinary Proceedings) or Chapter IV (in Summary Cause Proceedings) of the Act of Sederunt (Fees of Solicitors in the Sheriff Court) (Amendment and Further Provisions) 1993.

Territorial limits

Great Britain and Northern Ireland, all other countries in the European Union, the Isle of Man, the Channel Islands, Andorra, the Czech Republic, Egypt, Gibraltar, Hungary, Iceland, Israel, Liechtenstein, Monaco, Morocco, Norway, San Marino, Slovakia, Switzerland, Tunisia, Turkey, Vatican City and islands in the Mediterranean.

We, us, our

FirstAssist Group Limited, which handles claims on behalf of the insurer.

You can contact us at: FirstAssist Group Limited, Marshall’s Court, Marshall’s Road, Sutton, Surrey SM1 4DU.

You, your

The person named as policyholder on your schedule and members of your household.

The cause of the action must happen within the territorial limits and during the insurance period. The legal proceedings must be taken or defended in the territorial limits.

You must have told us about the claim within six months of the cause of action arising. We must have given our agreement to support your claim.

A. Personal injury

B. Consumer Protection

C. Residential

D. Employment

E. Tax

Exclusions

Exclusions applying to the Legal expenses section.

The exclusions below apply to all the cover which the insurer provides under this Legal expenses section. You should also refer to the specific exclusions shown under each part of the Legal expenses section and to the general policy exclusions.

What is not covered.

1. Any claim where there is not a reasonable chance of you winning the case and achieving a reasonable outcome.
2. Any event, dispute or cause of action that first happened or started before you took out this insurance.
3. An event which you report to us more than six months after it happened.
4. Legal expenses which apply to the period before we have agreed in writing to support your claim.
5. Legal proceedings where a reasonable estimate of your total legal expenses is greater than the amount in dispute.
6. Any legal expenses you could claim under any other insurance.
7. Any legal proceedings over loss or damage covered under a specific insurance policy.
8. A dispute about either the amount an insurance company should pay to settle an insurance claim or the way a claim should be settled.
9. Defending legal proceedings that are connected with:
   1. death, disease or illness of or bodily injury to anyone;
   2. your duties as a member of a profession or your duties as a director or officer of any company;
   3. the loss or destruction of or damage to any property. (This includes property which cannot be used because of the loss, destruction or damage.)
10. Any application for judicial review.
11. Any legal proceedings between any members of your family. (This does not apply to accidents involving motor vehicles.)
12. Any legal proceedings between you and your husband, wife or partner or former husband, wife or partner. This includes legal proceedings relating to custody, access or maintenance.
13. Defending any criminal proceedings or legal proceedings arising from anything you did deliberately or recklessly.
14. Any dispute with us or the insurer that is not dealt with under the arbitration condition below.

Policy conditions

You will need to meet the policy conditions set out in the ‘Conditions and exclusions’ as these conditions apply to the whole policy. In addition, for this section you must also meet the following conditions.

1. Preventing legal proceedings

You must take all reasonable measures to prevent or avoid being involved in legal proceedings and keep the cost as low as possible. The legal helpline is available 24 hours a day 7 days a week, to provide you with advice concerning your problem.

2. Arbitration

If there is a dispute between you and us or the insurer about this section of the policy, it can be taken to an independent arbitrator. The arbitrator will be a solicitor or barrister you and we agree to. If we cannot agree with you on an arbitrator, the President of the Law Society (or similar organisation within the appropriate territorial limits) will choose an arbitrator.

The side that loses the arbitration will pay all the costs of the arbitration. If the decision is not totally in favour of one side, the arbitrator will decide who pays the costs. If you lose, the policy will not cover these costs.

Claims conditions

You will need to meet the claims conditions set out in the ‘Conditions and exclusions’ as these conditions apply to the whole policy. In addition, for this section you must also meet the following conditions.

1. Telling us about the claim

If anything happens which might lead to a legal expenses claim, you must tell us as soon as possible by filling in a claim form. You must tell us fully and truthfully in writing all the details about your claim and give us all the information that we may need. Until you have told us about the claim and we have given our written agreement, the insurer will not be responsible for any legal expenses. The insurer will not cover legal expenses involved in your representatives handling the claim before the date when we gave our written agreement. You must have told us about the claim within six months of the cause of action arising.

2. Giving our agreement

We will agree if all of the following apply:

• we think you have a reasonable chance of winning your case and achieving a reasonable outcome.
• the legal proceedings arise from a cause of action which is covered by this insurance. This cause of action must happen within the territorial limits and during the insurance period.
• the legal proceedings will be dealt with by a court within the territorial limits.
• you have kept to the terms and conditions of the policy and none of the exclusions listed above apply.

If we do not accept your claim, we will tell you why.
If, during the claim, we think that there is no longer a reasonable chance of your winning the case and achieving a reasonable outcome, we may not continue to support your legal proceedings. If we do not carry on with your claim, we will tell you why.

3. Choosing a representative

In the period before we can agree that legal proceedings are necessary, or in the circumstances set out in claims condition 8 we may take on and carry out in your name, any negotiations for you. You must agree to a settlement which is reasonable.
If we agree that legal proceedings are necessary, but we are not able or you do not want us to act for you, we will agree with you on a representative to act for you.
We will suggest a shortlist of representatives who will be willing and able to act for you. You can choose a representative from this shortlist. If you prefer not to use a representative from this list, we will consider your choice. You will need to satisfy us that your chosen representative has the necessary expertise to deal with your legal proceedings. You must also confirm that he or she will not charge more than a representative on the list.
However, you can pay the difference between your chosen representative’s fees and those of a representative on the shortlist. In some circumstances, we may not accept the representative you have suggested, but we will explain why. If we cannot agree on your representative, you can take the matter to an independent arbitrator. This process is set out above. Any representative you choose is appointed to act for you.
If we and you cannot agree whether legal proceedings are necessary, you can take the matter to an independent arbitrator. This process is set out above.

4. Rights and responsibilities

You must tell us if an offer is made to settle the dispute. You must not negotiate or agree to settle the dispute without getting our agreement beforehand. If you do not accept a reasonable offer to settle the dispute, we may not continue to support your claim.
We will not pay any bills until the case is completed and the representative has submitted its final bill to you. You must confirm to us that any charges you have to pay for the representative handling this dispute are acceptable and that we may pay the bill for you.
You and your representative must take every step to recover legal expenses. You must pay any recovered legal expenses to your representative who must then refund any legal expenses which the insurer has paid or has been asked to pay.
If the insurer pays legal expenses up to the policy limit and you pay more legal expenses to end your case, the insurer and you will share any legal expenses that are recovered.
The insurer and you will each receive the same percentage as originally paid.

5. Information your representative will need from you

You must give your representative all the information and help he or she may need.
This will include a truthful account of the facts of your case and any paperwork to do with your case.

6. What you and your representative must do for us

We must be able to contact your representative. You and your representative must co-operate and tell us about developments to do with your case. If we ask for this, we must be able to have access to your representative’s files. This includes the truthful account of the facts of your case and any paperwork you have supplied to your representative.
If your representative wants to consult a barrister or expert witness, we will agree if we think it is reasonable. You must give us the name of the barrister or expert witness, and the reasons why you need one.

7. Appealing against a court’s decision

If you want to appeal against a court’s decision, you must give us your reasons for bringing the appeal. We will give you our agreement if all of the following apply.

• You tell us that you want to appeal as soon as your right of appeal arises.
  This is because strict time limits may apply.
• The appeal arises from legal proceedings to which we have already given our agreement under the terms of claims condition 2.
• Your appeal meets the requirements of claims condition 2 in the same way as your initial claim for legal expenses.

8. What action we may take

We may take over, in your name, all legal action in any of the following circumstances:

• If the dispute is for an amount which is under £5,000 or if the dispute could be dealt with by the small claims court.
• If you take legal action against someone or defend a case without our agreement, or in a different way from that advised by your representative.
• If you do not give proper instructions to your representative or barrister in time.
• If you cause a delay and your representative thinks it will harm your case.

In these circumstances, we may carry out our own investigation and try to settle your dispute. You must agree to a settlement which is reasonable.

If we ask, you must tell your representative to get the court to tax your legal expenses, or get the Law Society to certify them according to the Solicitors Act 1974 or the Solicitors Remuneration Order 1972.

If you withdraw from defending a full enquiry by the Inland Revenue without our agreement, we will be entitled to recover from you any amounts the insurer paid during the defence.

No claim discount

This part of the policy explains how No claim discount works and only applies if ‘No claim discount’ is shown on your schedule.

If no incident occurs during the insurance period which results in a claim under the Buildings, Contents, Personal belongings and Money or Pedal cycles sections, your No claim discount will increase in line with our scale at the renewal of the policy.

For each incident that occurs during the insurance period which results in a claim under the Buildings, Contents, Personal belongings and Money or Pedal cycles sections, your No claim discount may reduce in line with our scale at the renewal of the policy.

You cannot transfer your No claim discount to anyone else.