LegalAI[Space]

Insurance · Insurer in-house counsel, claims manager, compliance lead

Check a declinature letter before it goes out

A claims team has drafted a letter declining a property claim on the basis of a breach of a warranty about alarm maintenance. The review tests whether that ground works on the wording and whether the letter says what it needs to say.

First draft
A reasoned check of the ground and the drafting comes back from one run, before the letter is issued.

The problem

Declinature is the point where an insurer's file becomes evidence. A ground that turns out to be a term rather than a warranty, reasoning that does not address the causal connection required, or a letter that omits the complaint route will each be raised later. Fixing that after issue is much harder than fixing it before.
  1. Step 01 of 05

    Open the claim matter

    The policy, the proposal, the claim file, the loss adjuster's report and the draft letter go on one matter with the claim reference recorded.

    Matters · Project Halcyon · SPA warranties and disclosureOpen

    Project Halcyon: SPA warranties and disclosure

    Buy-side warranty review, disclosure analysis and cited due-diligence grid.

    Client
    Halcyon Bidco Ltd
    Reference
    WC-2026-0412
    Practice area
    Corporate / M&A
    Jurisdiction
    England and Wales
    Responsible partner
    E. Vance
    No conflict check on file.

    Chat, on this matter

    Compare warranties with the disclosure letter.

    Three high-priority exceptions require action: the unregistered charge, the change-of-control right and the tribunal claim.

    Send a message… (@ to mention tools)BalancedPrepare for
    1. 25 Aug

      Disclosure exceptions matrix

      Chat

    2. 21 Aug

      Disclosure exceptions matrix

      Run · completed · 560 credits

    3. 18 Aug

      Project Halcyon: Disclosure Letter

      Document · indexed

    4. 16 Aug

      Project Halcyon: Share Purchase Agreement

      Document · indexed

    5. 4 Aug

      Matter opened

      Opened

  2. Step 02 of 05

    Test the ground

    Prepare for: Work-Stream Memo. The clause relied on is read for whether it is a warranty, a condition precedent or a bare term, and the consequence of each is set out.

    Agents · Contract Agent · New runMatter: Northgate · senior associate hire

    Agent

    Jurisdiction

    Prepare for

    Deliver as

    Instruction

    What should the agent look for?

    Documents

    Drop a contract, or pick one from the matter

    Also on the matter

    • Offer_letter_v3.pdf2 pages
    • Staff_handbook_2025.docx61 pages
    • Board_minute_14_Aug.pdf3 pages
    Platform model · zero data retention · audit register on
  3. Step 03 of 05

    Apply the causal requirement

    The memo works through whether the breach could have increased the risk of the loss that actually occurred, on the adjuster's own findings.

    Agents · Contract Agent · Employment Contract Compliance ReviewCompleted
    6 items need your confirmation14 authorities · Where we looked

    Senior Associate Employment Contract: English Law Review

    Summary

    1. 1.

      Clause 9(c), non-competeHigh

      The 12-month prohibition on working for any law firm anywhere in the UK, Ireland or EU, in any capacity, is almost certainly wider than reasonably necessary and therefore unlikely to be enforceable.

      Tillman v Egon Zehnder Ltd [2019] UKSC 32
    2. 2.

      Clause 11, data and monitoringHigh

      Blanket contractual consent is not an adequate basis for general employment processing, special-category data or unrestricted monitoring.

      UK GDPR, Arts 6 and 9
    3. 3.

      Clause 4, holiday carry-overHigh

      The unconditional five-day cap conflicts with mandatory carry-over rights where sickness, statutory leave or employer failure prevents leave being taken.

      Working Time Regulations 1998, regs 13 to 13A
  4. Step 04 of 05

    Check the letter itself

    The draft is checked for whether it states the ground clearly, explains the reasoning, refers to the evidence relied on and sets out the complaint route.

    Agents · Contract Agent · Employment Contract Compliance ReviewCompleted
    6 items need your confirmation14 authorities · Where we looked

    Senior Associate Employment Contract: English Law Review

    Summary

    1. 1.

      Clause 9(c), non-competeHigh

      The 12-month prohibition on working for any law firm anywhere in the UK, Ireland or EU, in any capacity, is almost certainly wider than reasonably necessary and therefore unlikely to be enforceable.

      Tillman v Egon Zehnder Ltd [2019] UKSC 32
    2. 2.

      Clause 11, data and monitoringHigh

      Blanket contractual consent is not an adequate basis for general employment processing, special-category data or unrestricted monitoring.

      UK GDPR, Arts 6 and 9
    3. 3.

      Clause 4, holiday carry-overHigh

      The unconditional five-day cap conflicts with mandatory carry-over rights where sickness, statutory leave or employer failure prevents leave being taken.

      Working Time Regulations 1998, regs 13 to 13A
  5. Step 05 of 05

    Take the redraft

    Action items cover the two additions to the letter, the further evidence to obtain from the adjuster, and the decision to escalate before issue.

    Agents · Contract Agent · Employment Contract Compliance ReviewCompleted
    • Replace the UK/Ireland/EU non-compete with a 3 to 6 month restriction tied to competing corporate-law work.

    • Replace blanket data consent with a lawful-basis clause and a separate monitoring notice.

    • Remove the five-day carry-over cap and reference the statutory carry-over rules.

    • Narrow the client non-solicit to clients dealt with in the final 12 months.

    • Add an explicit working-time opt-out withdrawal mechanism.

    • Confirm the bonus clause states the discretion is exercised in good faith.

What comes back

A document, not a transcript.

  • A classification of the clause relied on, with what follows from each possible classification.
  • The causal analysis applied to the adjuster's findings rather than asserted in general terms.
  • A drafting review of the letter itself, including the complaint route it currently omits.
  • An escalation recommendation with the evidence still needed before any letter is issued.

Authorities it checks

  • Insurance Act 2015, s 8
  • Insurance Act 2015, s 11
  • FCA Handbook, ICOBS 8
Every source it may cite

What it does not do

  • It does not make the declinature decision, which stays with the claims team and its escalation policy.
  • It does not send the letter or communicate with the policyholder.
  • It does not obtain further evidence from the loss adjuster; that is an action item with an owner.

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