Brokers may show
Without prejudice to any other provision of the Claims Lead Arrangements, where a Lloyd’s broker has been directed by the insured to show its CLA claim to the managing agents of the Lloyd’s syndicates which underwrote the insurance, the Lloyd’s broker may show the CLA claim to each Lloyd’s syndicate.
Lloyd’s Claims Lead Arrangements, paragraph 16
Matters requiring referral to all managing agents of following Lloyd’s syndicates
The managing agents of the leading Lloyd’s syndicate and the second Lloyd’s syndicate shall not agree on behalf of any following Lloyd’s syndicates any ex gratia settlement, commutation or rescission of an insurance, other than in accordance with the terms of that insurance, without referring the matter to the managing agents of the following Lloyd’s syndicates for agreement.
Lloyd’s Claims Lead Arrangements, paragraph 17
Provision of information to following Lloyd’s syndicates
1. In respect of standard claims the managing agent of the leading Lloyd’s syndicate shall notify the following Lloyd’s syndicates of the following matters or events as soon as practicable –
(a) any recommended reserve or reserves for a CLA claim;
(b) any revision to the recommended reserve or reserves;
(c) the receipt of notice of any commencement of dispute resolution proceedings relating to a CLA claim;
(d) where the managing agent of the leading Lloyd’s syndicate has delegated the determination of a CLA claim to another person under paragraph 3. in Claims determination – general, the identity of that person;
(e) the commencement of any court, arbitration or equivalent proceedings against a person pursuant to rights of subrogation; and
(f) such other matters or events as may be required in any guidance Lloyd’s may from time to time prescribe.
A managing agent of a following Lloyd’s syndicate may request the managing agent of the leading Lloyd’s syndicate to provide such further information as the managing agent of the following Lloyd's syndicate may reasonably require.
Lloyd’s Claims Lead Arrangements, paragraph 18
2. In respect of complex claims the managing agent of the leading Lloyd’s syndicate and the managing agent of the second Lloyd’s syndicate shall notify the managing agents of the following Lloyd’s syndicates of the following matters or events as soon as practicable –
(a) any recommended reserve or reserves for a CLA claim;
(b) any revision to the recommended reserve or reserves;
(c) the intention to commence, or the receipt of notice of any commencement of dispute resolution proceedings relating to a CLA claim and the managing agents of the leading Lloyd’s syndicate and the second Lloyd’s syndicate shall make available to the managing agents of the following Lloyd’s syndicates all pleadings and other documents relating to the dispute resolution proceedings;
(d) where either of the managing agents of the leading Lloyd’s syndicate or the second Lloyd’s syndicate has delegated the determination of a CLA claim to another person under paragraph 3. in Lloyd’s Claims Lead Arrangements: Claims determination – general, the identity of that person;
(e) the commencement of any court, arbitration or equivalent proceedings against a person pursuant to rights of subrogation; and
(f) such other matters or events as may be required in any guidance Lloyd’s may from time to time prescribe.
A managing agent of a following Lloyd’s syndicate may request either of the managing agents of the leading Lloyd’s syndicate and second Lloyd’s syndicate to provide such further information as the managing agent of the following Lloyd's syndicate may reasonably require.
Lloyd’s Claims Lead Arrangements, paragraph 19
Resolution of disagreements between the managing agents of the leading Lloyd’s syndicate and the second Lloyd’s syndicate
1. In respect of complex claims if the managing agents of the leading Lloyd’s syndicate and the second Lloyd’s syndicate disagree on the determination of a CLA claim they will confer and use best endeavours to resolve that difference and proceed with agreed next steps. If any disagreement remains unresolved, the managing agents shall follow the procedures set out in paragraphs [2. and 3 below].
Lloyd’s Claims Lead Arrangements, paragraph 20
2. The managing agent of the leading Lloyd’s syndicate shall convene a meeting (a "market meeting") to which all following Lloyd's syndicates shall be invited if:
(a) the leading Lloyd's syndicate and the second Lloyd's syndicate are unable to resolve a difference under paragraph [1. above][ or;]
(b) the managing agent(s) of one or more following Lloyd’s syndicates so requests at any time, provided that those following Lloyd’s syndicates have underwritten in the aggregate at least 50% of the insurance (excluding any share of the insurance underwritten by a non-Lloyd’s insurer).
Lloyd’s Claims Lead Arrangements, paragraph 21
3. The following procedures will apply to a market meeting –
(a) the managing agent of the leading Lloyd’s syndicate sets a reasonable time and location for the market meeting (which may include arranging for the meeting to be conducted electronically or online) and invites the managing agents of all following Lloyd’s syndicates;
(b) the managing agents of the leading Lloyd’s syndicate and the second Lloyd’s syndicate shall confirm that the relevant information required for the meeting is available to those invited in good time in advance of the meeting;
(c) the meeting is chaired by a senior representative of the managing agent of the leading Lloyd’s syndicate or someone nominated by him or her and that person facilitates a fair and open discussion of the matter; and
(d) the attendees use their best endeavours to reach a consensus and agree the next steps in the determination of the CLA claim.
Lloyd’s Claims Lead Arrangements, paragraph 22
Processing of claims payments
1. Those involved in the determination of a CLA claim shall ensure that all supporting information has been properly documented prior to payment of the CLA claim being authorised.
Lloyd’s Claims Lead Arrangements, paragraph 23
2. Where a CLA claim is to be paid directly to the insured, the managing agent of the leading Lloyd’s syndicate shall make reasonable efforts to advise the relevant Lloyd’s broker prior to the CLA claim being paid.
Lloyd’s Claims Lead Arrangements, paragraph 24