When legal cover is the judge

IN 1991 Keith Brazier suffered injuries in a fall and decided to pursue a claim against the shop whose sign caused the accident. Mr Brazier has a stand-alone legal fees insurance policy with CareAssist, the legal expenses insurer that is part of Royal Insurance.

But CareAssist has refused to fund his case to pursue a personal injury claim, even though a barrister has given him an 'evens chance of success'.

Mr Brazier, who lives in Rotherham, has paid a premium of pounds 150 this year, a rise of more than 60 per cent since last year.

CareAssist paid Mr Brazier's solicitor's fee, and also for barrister's advice. Mr Brazier says: 'Counsel considered that I had an evens chance of winning. The solicitor told CareAssist that he believes that if the case is proceeded with, the shop owner's insurers will probably make an offer rather than go to trial on the case.'

However, a spokesman for CareAssist says: 'Counsel in his opinion states that at best he sees chances of succeeding in this claim as being even.

'The policy requires that there must be reasonable prospects of success before we will grant indemnity. In other words, the case must on balance be more likely to succeed than lose.'

Mr Brazier does not agree. He says that in the dictionary 'reasonable' is defined as 'having modest or moderate expectations' and that an evens chance is just that.

He has asked CareAssist to reconsider the decision, but has received no reply. A CareAssist spokesman apologised for the failure to reply to Mr Brazier's two letters. However, the company's decision not to fund the case remains unchanged.

Mr Brazier's predicament highlights the inherent problem with legal fees insurance - the insurance company is judge and jury rolled into one. Before an issue can get to court the insurer makes a decision on the merits of the case.

Meanwhile, CareAssist admits that the existence of its stand- alone legal fees policies is 'under review'.