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Underwriting

Information Request Form

Vetting/assessment

Do you require cover for
Explain how new cases are vetted/triaged to determine whether to accept a new case:
Does this change from case to case? *
At what point do you seek ATE insurance? *
Do you outsource work to a pagination firm? *
Do you currently have other ATE arrangements? *

Case details – volumes and types

Complete the following table by indicating the volume of cases run under a Conditional Fee Agreement in each value category
Personal Injury in Last Year:
Personal Injury in Last Year +1:
Personal Injury in Last Year +2:
Personal Injury in Last Year +3:
Clinical Negligence in Last Year:
Clinical Negligence in Last Year +1:
Clinical Negligence in Last Year +2:
Clinical Negligence in Last Year +3:
If applicable, will you continue to act on cases where quantum is below £25,000 after the introduction of FRC?
If so, do you envisage making changes to the way in which:
(a) Cases are vetted for prospects?
(b) Disbursements and costs are incurred?
Does your firm have any specialisms? For example (Dental Negligence/Animals Act/Industrial Disease)

Performance – last three years

Please complete the following tables confirming how many cases have successfully concluded (won with the recovery of damages) and failed (either abandoned or discontinued) – regardless of whether any costs or disbursements have been incurred.

Personal Injury

Quantum Under £10k
Pre issue
Post issue
Total issue
Under £100k
Pre issue
Post issue
Total issue
Quantum Under £500k
Pre issue
Post issue
Total issue
Quantum Over £500k
Pre issue
Post issue
Total issue

Performance – last three years

Please complete the following tables confirming how many cases have successfully concluded (won with the recovery of damages) and failed (either abandoned or discontinued) – regardless of whether any costs or disbursements have been incurred.

Clinical Negligence

Quantum Under £10k
Pre issue
Post issue
Total issue
Under £100k
Pre issue
Post issue
Total issue
Quantum Under £500k
Pre issue
Post issue
Total issue
Quantum Over £500k
Pre issue
Post issue
Total issue

Under £10k
damages

Please complete the following tables confirming cost exposure on failed cases. Clinical Negligence ONLY.
Last Year
Pre issue
Post issue
Trial
Last year + 1
Pre issue
Post issue
Trial
Last year + 2
Pre issue
Post issue
Trial
Last year + 3
Pre issue
Post issue
Total issue

Under £100k
damages

Please complete the following tables confirming cost exposure on failed cases. Clinical Negligence ONLY.
Last Year
Pre issue
Post issue
Trial
Last year + 1
Pre issue
Post issue
Trial
Last year + 2
Pre issue
Post issue
Trial
Last year + 3
Pre issue
Post issue
Total issue

Under £500k
damages

Please complete the following tables confirming cost exposure on failed cases. Clinical Negligence ONLY.
Last Year
Pre issue
Post issue
Trial
Last year + 1
Pre issue
Post issue
Trial
Last year + 2
Pre issue
Post issue
Trial
Last year + 3
Pre issue
Post issue
Total issue

Over £500k
damages

Please complete the following tables confirming cost exposure on failed cases. Clinical Negligence ONLY.
Last Year
Pre issue
Post issue
Trial
Last year + 1
Pre issue
Post issue
Trial
Last year + 2
Pre issue
Post issue
Trial
Last year + 3
Pre issue
Post issue
Total issue
Maxima

DAS Legal Expenses Insurance Company Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority (FRN202106) and the Prudential Regulation Authority | DAS Legal Expenses Insurance Company Limited, DAS House, Quay Side, Temple Back, Bristol BS1 6NH | Registered in England and Wales |Company Number 103274 | Website: www.das.co.uk | Underwriting | Information Request Form | 09.2020 | DAS 20523.01

 

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We have offices located in London and the Midlands.
For all enquires please contact us by either telephone or email.

Tel: 0333 772 0454
Email: admin@maximallp.com

Maxima Litigation Solutions Ltd
4a The Hayloft, Blakenhall Business Park,
Barton under Needwood, Staffordshire
DE13 8AJ
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Maxima Litigation Funding LLP
4a The Hayloft, Blakenhall Business Park,
Barton under Needwood, Staffordshire
DE13 8AJ
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Maxima Litigation Solutions Ltd - Registered in England & Wales No. 07789604. Authorised & Regulated by the Financial Conduct Authority Authority No. 580890.

Maxima Litigation Funding LLP - Partnership No. OC340300. Registered in England as Maxima Litigation Funding LLP.

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