Sometimes a claim is intimated which does not sit easily with the policy cover and a decision must be made as to whether or not the claim is actually an insured risk.
Generally these matters involve advising an insurer as to whether the claim that has been intimated under professional indemnity policy is in fact one to which the insurers have to respond and, if not, why not.
Questions may arise as to whether the claim falls within one of the exceptions under the policy or whether the insurer has a basis for avoiding the claim. For instance, the insurer may consider that full information was not provided to it at the time of agreeing to underwrite the risk. Alternatively, the insurer may take the view that the information that was provided was materially inaccurate.