Master Policy Wording

This Policy wording, the Certificate and any Endorsements should be read as if they were one document and, together, they represent the contract between You and Us.  They set out what is and what is not covered, are legal documents and should be kept in a safe place.

5CONTENTS AND INDEX

 

Clause no. Title Description
Contents and Index    
Introduction Information about the documents that make up Your Policy  
Information You have given Us Information about Your duty of ‘fair presentation’ when purchasing or varying this Policy  
1 Insured Event A – Professional Indemnity Sets out the scope of Your professional indemnity cover  
2 Insured Event B – Third Party (Public Liability) Sets out the scope of Your Public Liability cover  
3 Insured Event C – Criminal Prosecution and Civil Proceedings Sets out the scope of Your cover in respect of certain criminal or civil proceedings against You  
4 Insured Event D – Employment Disputes Sets out the scope of Your cover in respect of employment disputes You have cause to bring against Your employer.  
5 Insured Event E – Professional Disciplinary Episodes Sets out the scope of Your cover in respect of regulatory or disciplinary proceedings brought against You  
6 Exclusions Sets out exclusions from the scope of Your cover applying to the whole Policy  
7 Conditions Sets out the conditions that You must comply with, including the conditions precedent to the right to be indemnified under this Policy.  
8 Complaints Sets out how You can make a complaint about Us.  
9 Dispute Resolution Sets out how disputes between You and Us relating to this Policy will be resolved.  
10 Definitions Sets out the definitions that apply to the whole Policy.  

 

INTRODUCTION

Thank You for choosing Us for Your insurance.

This Policy wording, the Certificate and any Endorsements should be read as if they were one document and, together, they represent the contract between You and Us.  They set out what is and what is not covered, are legal documents and should be kept in a safe place.

The Certificate sets out each of the Insured Events that apply to Your Policy and only those Insured Events that appear on Your Certificate form part of this Policy.

Please check that this Policy (including the Certificate and any Endorsements added at any time) meets Your needs and that You understand them.  If You have any questions about this Policy, or if you consider that they do not meet Your needs, please contact Your broker or agent who will be pleased to help You.

In return for payment of the Premium shown in the Certificate, We agree to insure You, in the manner and to the extent provided in this Policy during the Period of Insurance, subject to its terms and conditions.

Some of the clauses in the Policy are described as conditions precedent to the right to be indemnified.  If you fail to follow these requirements then We may have the right to reject your request for indemnity.

INFORMATION YOU HAVE GIVEN US

 

In deciding to accept You as an Insured for this insurance and in setting (or at any time varying) the terms and Premium, We have relied on the information You have given Us

You have a duty to inform Us of all material information that You know or ought to know.  Anyone else responsible for Your insurance arrangements also has a duty to inform Us of every material information that they know or ought to know.  All such material information should be provided in a way that is reasonably clear and accessible to Us.  You also have a duty to answer any questions We have asked You accurately and to ensure that any information You do provide is correct.  Information or a representation is ‘material’ if it would influence Our judgement in determining whether to take the risk insured by this Policy and if so on what terms and for what Premium.

If We establish that You deliberately or recklessly provided Us with incorrect information We have the right to treat this insurance as if it never existed, decline indemnity in respect of all Claims, and retain the Premium.  A breach will be deliberate if You know that You are in breach of this duty.  It will be reckless if You do not care whether You are in breach of this duty.

If You have been in breach of Your duty to provide us with complete and accurate information, but Your breach was not deliberate or reckless, We are entitled to do any of the following, in our discretion:

  • treat this insurance as if it had never existed and refuse to indemnify you in relation to any Claims and return the Premium We will only do this if We provided You with insurance cover which We would not otherwise have offered; or
  • amend the terms of Your We will then apply these amended terms as if they were already in place at the time the Policy started; and/or
  • reduce the amount We pay on a Claim in the proportion the Premium You have paid bears to the Premium We would have charged You; and/or
  • cancel the Policy in accordance with the cancellation condition detailed in this document.

We or Your insurance broker or agent will write to You if We intend to exercise Our rights to these remedies.

 

  1. Insured Event A: PROFESSIONAL INDEMNITY.

This part of Your Policy provides liability cover on a “claims made” basis.  This means that We cover You for Claims which are first made against You and that You tell Us about during the Period of Insurance.

For the purposes of Insured Event A, “Claim” means any demand from someone else against You, or an assertion of a right against You, alleging a Wrongful Act, which is communicated to You.  This includes (but is not limited to) a demand for or an assertion of a right to compensation.

What will We cover You for?

  • We will provide cover for all sums which You become legally liable to pay as compensatory damages (including interest, claimant’s costs and payments to the CRU) as the result of any Claim first made against You during the Period of Insurance resulting from any Wrongful Act committed by You whilst You are performing any of the usual duties of a registered pharmacy professional, either as an employee or as a self-employed individual. Such duties include services or contractual obligations undertaken by You to a patient or customer in the course of Your Activities or in the provision of Good Samaritan Acts. In addition:

1.1(a)      We will indemnify You for Claims for defamation, libel or slander when this is caused by words written or spoken by You in the course of Your Activities, provided that the defamation, libel or slander was not Malicious.

1.1(b)      We will indemnify You for Claims made against You that have arisen from any breach or alleged breach, during the course of Your Activities, of Your duty of confidentiality, including an infringement or violation of any right to privacy including a breach of any privacy policy that You were required to comply with.

1.1(c)      For Business consultant policies and Business consultant extensions only, We will indemnify You for Claims made against You that have arisen from financial loss to third parties who commissioned your services caused by a Wrongful Act committed by You in the course of Your Activities.

1.2     Professional Indemnity Defence Costs and Expenses

We will also, inclusive within the Aggregate Limit of Indemnity for Insured Events 1.1, 1.1a and 1.1b above, as specified in the Certificate, indemnify You against Defence Costs and Expenses incurred with Our prior written consent in the defence, handling or settlement of any Claim covered under Insured Events 1.1, 1.1a or 1.1b above.

For the purposes of clarification, if You seek indemnity in respect of Claims and/or for Defence Costs and Expenses in respect of a matter which falls to be dealt with, or which triggers any coverage or payment, under Insured Events B, C, D and E below, then those Defence Costs and Expenses are not covered under Insured Event A.

What are the limits of this Insured Event?

For any one Claim covered under this Insured Event, the maximum amount We will pay to indemnify You for liabilities and Your Defence Costs and Expenses together is the Limit of Indemnity for this Insured Event specified in the Certificate, subject always to the Annual Aggregate Limit of Indemnity for Insured Events A-E.

  • You will only be indemnified under this Insured Event if:

 

  • The Claim was made during the Period of Insurance and You have complied with Your obligations to inform Us of the Claim or Circumstance under condition 7.2; and

 

  • The Circumstance arose on or after the Retroactive Date and was reported to Us during the Period of Insurance in accordance with condition 7.2; and

 

  • The Claim was commenced within the Territorial Limit; and

 

  • None of the exclusions in Section 6 of this Policy apply; and

 

  • You comply strictly with the conditions in Section 7 of this Policy.

 

 

  1. Insured Event B: THIRD PARTY (PUBLIC LIABILITY)

This section provides liability coverage on a “claims made” basis. This means that We cover You for Claims which are first made against You and that You tell Us about during the Period of Insurance.

In respect of Insured Event B, “Claim” means the following:

  • Your receipt of any oral or written assertion, allegation, suggestion or intimation that You have or may have failed to comply with Your legal duties or responsibilities, whether by act or omission, and/or
  • Your receipt of any oral or written assertion, allegation, suggestion or intimation that You have or may become liable to pay compensation, damages, interest, legal costs, expenses or refund Your fees, and /or
  • Your receipt of any oral or written assertion, allegation, suggestion or intimation that You have or may become liable to provide any form of non-financial redress, and/or
  • Your receipt of any letter or communication expressed to be in accordance with the pre-action protocol, or receipt of any claim form, particulars of claim or other court proceedings or applications

in relation to actual or alleged physical or mental injury, disease or death of a visitor to Your Premises, or in relation to alleged loss of or damage to the property of a visitor to Your Premises.

What will We cover You for?

2.1 We will indemnify You against Your legal liability to pay compensatory damages (including interest, claimant’s costs and payments to the CRU) as a result of any Claim first made against You during the Period of Insurance resulting from accidental Injury and/or Damage arising in connection with Your Activities and within the Territorial Limit.  We will also agree to provide indemnity at Your request, within the scope of this Insured Event B, to:

2.1.1 the representatives of Your estate in the event of Your death.

2.1.2 Indemnity to Principal – Where any contract or agreement entered into by You for the performance of work so requires, We will indemnify the principal in like manner to You in respect of the principal’s liability arising from the performance of the work by You.

Third Party (Public Liability) Defence Costs and Expenses

2.2     We will also, inclusive within the Aggregate Limit of Indemnity for Insured Events 2.1- 2.1.2 above, as specified in the Certificate, indemnify You against Defence Costs and Expenses incurred with Our prior written consent in the defence, handling or settlement of any Claim covered under Insured Event B above.

For the purposes of clarification, if You seek indemnity in respect of Claims and/or for Defence Costs and Expenses in respect of a matter which falls to be dealt with, or which triggers any coverage or payment, under Insured Events A, C, D and E below, then those Defence Costs and Expenses are not covered under Insured Event B.

Third Party (Public Liability) Extensions to cover

  • Motor contingent Liability Extension

We will indemnify You in respect of Injury or Damage arising out of the use of any motor vehicle owned by You and being used in the course of Your Activities. Provided always that no indemnity is provided by this Extension:

(i) in respect of Injury to any person being carried by motor cycle

(ii) for loss or Damage to any vehicle and/or contents within such vehicle

(iii) For Injury or Damage arising while such vehicle is being driven

(iv) If such vehicle is more specifically insured

(v) If such vehicle is being used outside of the Territorial Limit

What are the limits of this Insured Event?

2.4 For any one Claim covered under this Insured Event, the maximum amount We will pay to indemnify You for liabilities and Your Defence Costs and Expenses together is the Limit of Indemnity for this Insured Event specified in the Certificate, subject always to the Annual Aggregate Limit of Indemnity for Insured Events A-E.

  • This Insured Event does not provide cover under 2.1 to 2.2 above in respect of:

 

  • any Claim made in respect of damage to property owned, leased to, hired by, under hire purchase, on loan to or held in trust by You or otherwise in Your care custody or control other than clothing and personal effects of visitors; and

 

  • any Claim relating to breaches or alleged breaches of any laws relating to motor vehicles or motoring, except where indemnity is provided by the extension under this Insured Event at clause 2.3 above; and

 

  • any liability arising from or in any way relating to asbestos or asbestos fibres including but not limited to Injury or Damage caused by or in any way connected with asbestos or asbestos fibres or any commodity, article or thing containing asbestos or asbestos fibres or the costs of removing, nullifying or cleaning up asbestos fibres or any commodity article or thing containing asbestos or asbestos fibres; and

 

  • any Claim made in respect of Injury or Damage arising out of or in connection with any Product; and

 

  • any Claim arising out of any alleged Wrongful Act, error or omission in the course of the practice of Your Activities; and

 

  • any Claim relating to the Defective Premises Act 1972

 

  • You will only be covered under this Insured Event if:

 

  • The Claim was made during the Period of Insurance and You have complied with Your obligations to inform Us of the Claim or Circumstance under condition 7.2; and

 

  • The Circumstance arose on or after the Retroactive Date and was reported to Us during the Period of Insurance in accordance with condition 7.2; and

 

  • The Claim was commenced within the Territorial Limit; and

 

  • None of the exclusions in Section 6 of this Policy apply; and

 

  • You comply strictly with the conditions in Section 7 of this Policy.

 

 

  1. LEGAL DEFENCE COSTS INSURANCE

Insured Event C: CRIMINAL PROSECUTION AND CIVIL PROCEEDINGS

This section provides cover for Legal Defence Costs on a “claims made” basis. This means that We cover You for Legal Defence Costs which are first made against You and that You tell Us about during the Period of Insurance.

For the purposes of this Insured Event C, “Claim” means:

  1. Your receipt of any oral or written assertion, allegation, suggestion or intimation that You have or may have committed a criminal act or omission in relation to Your Activities, and/or
  2. Your receipt of any oral or written assertion, allegation, suggestion or intimation that You have or may breached any anti-discrimination legislation in relation to Your Activities, and/or
  3. Your receipt of any oral or written assertion, allegation, suggestion or intimation that You have or may have breached the Health and Safety at Work Act 1974 or any related legislation in relation to Your Activities, and/or
  4. Your receipt of any oral or written assertion, allegation, suggestion or intimation that You have or may have breached Section 13 of the Data Protection Act 2018, and or any related legislation, in relation to Your Activities.

What will We cover You for?

3.1 We will arrange for Your Legal Representatives to be appointed in accordance with Our Standard Terms of Appointment defend You if an event arising from or related to Your Activities leads to:

3.1.1 Criminal proceedings brought against You in a court of criminal jurisdiction, including criminal proceedings alleging a breach of the Medicines Act 1968 and/or the Human Medicines Regulations 2012;

3.1.2 Civil proceedings being taken against You under any anti-discrimination legislation;

 

3.1.3 Civil proceedings being taken against You under the Health and Safety at Work Act 1974 and or any related legislation;

 

3.1.4 Civil proceedings being taken against You under Section 13 of the Data Protection Act 1998, and or any related legislation.

What are the limits of this Insured Event?

3.2 This Insured Event does not provide any cover or indemnity for any fines, penalties, damages or other compensation that You may be liable to pay in respect of any proceedings referred to in clause 3.1.1 – 3.1.4, nor in respect of any legal costs that You are ordered to pay to the authority that brought the proceedings referred to in clause 3.1.1 – 3.1.4.

3.3This Insured Event does not provide cover for any Claim arising from:

3.3.1 any alleged offence of violence, abuse of position or authority, or any other form of coercion or controlling behaviour;

3.3.2 death, sickness, disease, emotional distress, mental anguish, mental stress, personal injury or any other Injury;

3.3.3 damage to or destruction of any property or loss of use thereof, or any other Damage;

3.3.4 Any Claim relating to breaches or alleged breaches of any laws relating to motor vehicles or motoring;

3.3.5 Any Claim relating to any act or alleged act of sexual harassment and/or sexual molestation and/or coercion and/or inappropriate sexual behaviour or suggestion/request, including acts relating to obscene material;

3.3.6 Any demand from someone else against You, or an assertion of a right against You, alleging a Wrongful Act, in the course of the practice of Your Activities, including (but not limited to) a demand for or an assertion of a right to compensation.

3.4 For all proceedings covered under this Insured Event, the maximum amount We will pay to indemnify You for Your Legal Costs and Expenses together is the Aggregate Limit of Indemnity for Insured Events C-E specified in the Certificate, subject always to the Annual Aggregate Limit of Indemnity for Insured Events A-E.

3.5 You will only be covered under this Insured Event if:

3.5.1 You have complied with Your obligation to give Us notice of the Claim during the Period of Insurance under condition 7.2; and

 

3.5.2 The Claim was commenced within the Territorial Limit; and

 

3.5.3 In respect of any Claim under 3.1.1 above only, You have been formally charged with the commission of a criminal offence; and

 

3.5.4 In respect of clause 3.1.4 only, You are registered with the Information Commissioner in accordance with Sections 18 and 19 of the Data Protection Act 2018 and or any amended regulations for the data processing that You carry out and were so registered at the time that the circumstances giving rise to the civil action occurred; and

 

3.5.5 For criminal and civil proceedings the date You first became aware of any cause, act, incident, event or Circumstance that may give rise to a Claim under this Insured Event began on or after the Start Date; and

 

3.5.6 For criminal and civil proceedings, the prospects that You will successfully defend the proceedings or achieve an outcome that we have agreed to, are 51% or greater throughout the proceedings, in the opinion of Your Legal Representative or a suitably qualified independent expert leading counsel appointed by Us; and

 

3.5.7 You have complied strictly with the Conditions under Section 7 below; and

3.5.8 None of the Exclusions under Section 6 apply.

3.6 We will indemnify You for Your Legal Costs and Expenses as long as:

3.6.1 Your Legal Representatives were retained by Us on Your behalf, or were retained by You with Our express permission; and

 

3.6.2 Your Legal Costs and Expenses were paid direct from Us to Your Legal Representatives; and

 

3.6.3 Your Legal Costs and Expenses, or any other costs related to legal advice or assistance, were not incurred prior to Our agreement that they could be incurred; and

 

3.6.4 For civil cases only, Your Legal Costs and Expenses do not exceed the value of the compensation and related remedies You are likely to be ordered to pay in the proceedings referred to clauses 3.1.2. – 3.1.4. above, in Our reasonable opinion based on the assessment at the outset of such proceedings by Your Legal Representative, and

 

3.6.5 Your Legal Representatives comply with Our Standard Terms of Appointment.

 

 

 

  1. Insured Event D: EMPLOYMENT DISPUTES

This Insured Event is on a “claims made” basis. This means that We cover Your Legal Costs and Expenses for Disputes in respect of which You first become aware that You may wish to commence a Dispute, and You tell Us about Your wish to commence a Dispute, during the Period of Insurance.

What will We cover You for?

4.1 We will cover Your Legal Costs and Expenses incurred in preparation for or in the course of representing You in a Dispute arising from or related to a contract of employment or contract for services entered into by You in connection with Your Activities.

What are the limits of this Insuring Clause?

  • This Insured Event does not provide any cover or indemnity for any fines, penalties, damages or other compensation that You may be liable to pay to any other party in respect of any proceedings referred to in clause 4.1, or in respect of any counter-claim arising out of those proceedings, nor in respect of any legal costs that You are ordered to pay to the other party in those proceedings.

 

  • You will only be indemnified by this Policy under this Insured Event if:

 

4.3.1 You have complied with Your obligation to give Us notice of the Dispute during the Period of Insurance under condition 7.2; and

 

4.3.2 The Legal Costs and Expenses in clause 4.1 arise from a Dispute that arises from or is related to the practice of Your Activities or research connected with that practice; and

 

4.3.3The Claim or Dispute was commenced within the Territorial Limit; and

 

4.3.4 None of the Exclusions in Section 6 of this Policy apply, and

 

  • You comply strictly with the conditions in Section 7 of this Policy, and

 

  • The prospects that You will succeed in the Dispute or achieve an outcome that we have agreed to, are 51% or greater throughout the proceedings, in the opinion of Your Legal Representative or a suitably qualified independent expert leading counsel appointed by Us

 

  • For all proceedings covered under this Insured Event, the maximum amount We will pay to indemnify You for Your Legal Costs and Expenses together is the Aggregate Limit of Indemnity for Insured Events C-E specified in the Certificate, subject always to the Annual Aggregate Limit of Indemnity for Insured Events A-E.

 

  • We will indemnify You for Your Legal Costs and Expenses as long as:

 

  • Your Legal Representatives were retained by Us on Your behalf, or were retained by You with Our express permission; and
  • Your Legal Costs and Expenses were paid direct from Us to Your Legal Representatives; and
  • Your Legal Costs and Expenses, or any other costs related to legal advice or assistance, were not incurred prior to Our agreement that they could be incurred; and
  • Your Legal Representatives comply with Our Standard Terms of Appointment.

 

  • Insured Event E: PROFESSIONAL DISCIPLINARY EPISODES

This Insured Event is on a “claims made” basis and only covers Claims notified to Us during the Period of Insurance. This means that We cover Your costs for legal representation in respect of Claims which are first made against You and that You tell Us about during the Period of Insurance.

For the purposes of this Insured Event, “Claim” means Your receipt of any oral or written assertion, allegation, suggestion or intimation:

  1. That disciplinary proceedings will be commenced against You,
  2. that You will be required to attend a coroner’s inquest or Fatal Accident Act Enquiry, and that the tribunal will be required to consider whether You caused the death that is the subject of those proceedings,
  • that You will be the subject of a National Health Service Tribunal or RPS Council member code of conduct panel hearing.

What will We cover You for?

  • We will arrange for Your Legal Representatives to be appointed under Our Standard Terms of Appointment to advise and represent You in relation to:

5.1.1 a principal disciplinary or health Fitness to Practice committee hearing relating to You, or a review hearing relating to You held by a Fitness to Practice committee, where the Fitness to Practice committee has been constituted by any government, regulatory, statutory professional or supervisory authority with jurisdiction to do so, including the General Pharmaceutical Council Statutory Committee hearing or its Northern Ireland equivalent.

5.1.2 an appeal against the outcome of any proceedings listed in 5.1.1, where Your prospects of success in the proposed appeal are, in the opinion of Your Legal Representatives or a suitably qualified independent expert or leading counsel appointed by Us, 51% or greater.

5.1.3 a coroner’s inquest or Fatal Accident Act Enquiry where You may be implicated in the death that is the subject of those proceedings.

5.1.4 a National Health Service Tribunal or RPS Board member code of conduct panel hearing.

For clarity, in relation to 5.1.1, please note that We will not indemnify You for the cost of any advice or representation that You may desire in relation to matters that have not yet reached a Fitness to Practice committee, including matters that have only reached the “Initial consideration by the Registrar” or “Consideration by the Investigating Committee” stages under the GPhC (Fitness to Practise and Disqualification etc.) Rules 2010, or their Northern Ireland equivalent.

What are the limits of this Insured Event?

  • This Insured Event does not provide any cover or indemnity for any fines, penalties, damages or other compensation that You may be liable to pay in respect of any proceedings referred to in clause 5.1.1 – 5.1.4, nor in respect of any legal costs that You are ordered to pay to the authority that brought the proceedings referred to in clause 5.1.1 – 5.1.4.

 

  • You will only be indemnified by this Policy under this Insured Event if:

5.3.1 You first became aware of any cause, incident, act, event or Circumstance that may give rise to a Claim under this Insured Event after the Start Date and You have complied with Your obligation to give Us notice of the Claim during the Period of Insurance under condition 7.2; and

5.3.2 The proceedings, inquest or Fatal Accident Act inquiry arises from or is related to acts or omissions by You in the course of Your Activities; and

5.3.3 The prospects that You will successfully defend the proceedings or achieve an outcome that we have agreed to, are 51% or greater throughout the proceedings, in the opinion of Your Legal Representative or a suitably qualified independent expert leading counsel appointed by Us; and

5.3.4The acts or alleged acts giving rise to the proceedings were carried out on or after the Retroactive Date and commenced within the Territorial Limit; and

  • None of the Exclusions in Section 6 of this Policy apply; and

 

  • You comply strictly with the conditions in Section 7 of this Policy.

We will indemnify You for Your Legal Costs and Expenses as long as:

  • Your Legal Representatives were retained by Us on Your behalf, or were retained by You with Our express permission; and

 

5.5.1 Your Legal Costs and Expenses were paid direct from Us to Your Legal Representatives; and

 

5.5.2 Your Legal Costs and Expenses are agreed by Us and incurred in accordance with Our Standard Terms of Appointment.

 

5.5.3 Your Legal Costs and Expenses, or any other costs related to legal advice or assistance, were not incurred prior to Our agreement that they could be incurred; and

 

5.5.4 For any Proceedings We have not paid more than the Annual Aggregate Limit of Indemnity for Your Legal Costs and Expenses for such Proceedings specified in the Certificate since the Inception Date in relation to any matters covered under Insured Events C – E; and

5.5.5 For all Proceedings covered under this Insured Event, the maximum amount We will pay to indemnify You for Your Legal Costs and Expenses together is the Aggregate Limit of Indemnity for this Insured Event specified in the Certificate, subject always to the Annual Aggregate Limit of Indemnity for Insured Events A – E.

 

 

  • EXCLUSIONS (applicable to the whole of this Policy)

 

Known Claims and Circumstances

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim or Dispute arising out of any cause, incident, event or Circumstance notified under any insurance attaching prior to the Start Date or which should have been so notified, or any other cause, event or Circumstance that a reasonable person would believe could give rise to a Claim or Dispute as defined within this Policy which was or ought to have been known to You prior to the Start Date.

 

Deliberate Acts, Fraud, Dishonesty and Collusion

 

  • We shall not indemnify You in respect of any Claim, Dispute or Circumstance (nor for any Defence Costs and Expenses, nor for Legal Costs and Expenses), loss, costs or expenses arising from any of the following:
  1. any deliberate or wilful misconduct by You.
  2. any sexual harassment and/or sexual molestation and/or coercion and/or inappropriate sexual behaviour, suggestion or request, and/or any sexual discrimination committed or carried out by You.
  3. any racial harassment and/or inappropriate racially-motivated comments or statements, and/or any racial discrimination committed or carried out by You.
  4. any offences against the person including but not limited to violence, abuse of position or authority and/or any form of coercion or controlling behaviour committed or carried out by You.
  5. The performance of Your Activities while You are under the influence of intoxicants or narcotics.
  6. any actual or alleged dishonest or fraudulent act or omission by You.
  7. any other criminal act committed or carried out by You.
  8. Any Claim or Dispute solicited by You or that results from collusion with someone else in the making of the Claim or Dispute.

If We have indemnified You in respect of any Claim, Dispute or Circumstance (or for any Defence Costs and Expenses, or for Legal Costs and Expenses) and We subsequently discover (whether because of an admission by You, or a finding by a Court or other tribunal, or if evidence comes to Our attention) that any of these exclusions applied, We are entitled to decline to provide any further indemnity and to recover from You any sums paid in respect of that in respect of any Claim, Dispute or Circumstance (including any Defence Costs and Expenses, or Legal Costs and Expenses).

 

Other Insurance

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance in respect of which You are, or but for the existence of this Policy would be, entitled to indemnity under any other insurance or indemnity arrangements, including any public funding of defence costs.

Fines and Penalties

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any taxes, fines, penalties, or other award that is not primarily intended to compensate the claimant or complainant, but is intended to have a punitive effect on You or to act as example or warning to others.

 

Sexual harassment

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance relating to any act or alleged act of sexual harassment and/or sexual molestation and/or coercion and/or inappropriate sexual behaviour or suggestion/request, including acts relating to obscene material.

 

Vehicles

 

  • Save for where indemnity is provided by the extension under Insured Event B at clause 2.4.1 above, We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance directly or indirectly arising from the use, ownership or possession of any aircraft (or any other aerial devices), watercraft, hovercraft, vessel, motor vehicle or any other vehicle or mechanically propelled mobile machinery.

 

Judicial Review

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Legal Costs and Expenses incurred in relation to any application for Judicial Review.

Ownership

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance arising from Your work in a community Pharmacy, GP Practice or residential home business which You own or of which You are a director, or that You partly own, or where the owner is Your spouse or a member of Your immediate family.

 

Directors’ and Officers’ liability, and disagreements with partners

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance arising from any liability incurred by any person in their capacity as a director or officer of any company or other entity, or as a designated member of a limited liability partnership, or as a trustee of any trust that is not associated with the practice of Your Activities.

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance by or against You, made against or by any person who is an existing or former partner of Yours (which includes persons with whom You practice in a Limited Liability Partnership or other corporate structure).

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance by or against You, made against or by any person who is Your spouse or is or has recently been in a sexual or romantic relationship with You.

HMRC investigations

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance arising from any dispute with or any investigation by Her Majesty’s Revenue and Customs (HMRC).

 

Social security investigations

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance arising from any investigation by the Government Department for Work and Pensions or other governmental body in relation to national insurance contributions.

 

Defamation

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance involving alleged defamation, libel, slander and/or malicious falsehood by You.  This exclusion does not apply to Insured Event A clause 1.1(a).

 

Intellectual Property

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance arising out of the ownership or existence of any intellectual property rights.

 

Other disputes

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance arising out of any disagreement between You, Us, and/or any Legal Representative.

 

Information Technology

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute or Circumstance, including those alleging a common law breach of confidentiality, arising directly or indirectly from:

 

6.17.1 Any alleged transmission or receipt of any virus, program or code that causes loss or damage to any computer system and or prevents or impairs its proper function or performance;

 

6.17.2 Any hacking of, or other unauthorised access to, any computer system by a third party;

 

6.17.3 The functioning, non-functioning, improperly functioning, availability or unavailability of:

6.17.3.1 any programme, instruction or data for use in any computer or other electronic processing device, equipment or system;

6.17.3.2 any plant and/or machinery, including without prejudice to the generality of the foregoing any computer, data processing equipment or medi, microchip, integrated system, circuit, or similar device, or any software;

6.17.3.3 the internet or similar facility;

6.17.3.4 any intranet or private network or similar facility; or any website, bulletin board, chat room, search engine, portal or similar application service.

This exclusion does not apply to Insured Event C and will not exclude indemnity under clause 3.1.4 in respect of a Claim for breach of confidentiality where this is brought together with a Claim under Section 13 of the Data Protection Act.

Pollution

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute, Circumstance or loss directly or indirectly caused by or contributed to by or arising from any pollution, seepage, discharge, dispersal, release or escape of any solid, liquid, gaseous, or thermal irritant or contaminant including, but not limited to, smoke, vapours, soot, dust, fibres, fungi, mould, fumes, acids, alkalis, chemicals and waste (including but not limited to material to be recycled, reconditioned or reclaimed) or contamination of any kind.

 

Radioactivity

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute, Circumstance or loss directly or indirectly caused by or contributed to by or arising from ionising radiations or contamination by radioactivity (except for any Claim by a patient relating to the therapeutic use of radioactivity) from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or the radioactive, toxic, explosive, or other hazardous properties of any explosive nuclear assembly or nuclear component.

 

 

War

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute, Circumstance or loss directly or indirectly caused by or contributed to by or arising from war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition or destruction of or damage to property by or under the order of any government or public authority.

 

Terrorist Action

 

  • We shall not be liable to indemnify You under any of the Insured Events A-E in respect of any Claim, Dispute, Circumstance or loss directly or indirectly caused by or contributed to by or arising from any Terrorist Action.

 

This exclusion also excludes any Claim, Dispute, Circumstance or loss arising from any action taken in controlling, preventing or suppressing any Terrorist Action.

Sanctions

  • We shall not be liable to indemnify You under any of the Insured Events A-E, nor provide any benefit under this insurance, where doing so would breach any sanction, prohibition or restriction imposed by law or regulation.

 

 

  • CONDITIONS

 

  • The following conditions apply to Insured Events A-E of the Policy. You are obliged to comply with the terms and conditions of this Policy, including terms and conditions contained in any Endorsements.  If You fail to comply with these conditions, and if that failure causes:

 

  1. A reduction in the prospects of success of defending any Claim (as defined in that Insured Event),
  2. A reduction in the prospects of success in a Dispute,
  3. c) An increase in the amount required to settle or otherwise resolve any Claim or Dispute (as defined in that Insured Event),
  4. d) An increase in the amount of Defence Costs and Expenses or Your Legal Costs and Expenses required to investigate or resolve any matter,

 

then We are entitled, at Our discretion, to proportionately reduce the amount of indemnity We will pay in relation to that Claim or Dispute.  This does not affect our right to decline to provide indemnity if a condition precedent is not complied with.

Notification

  • You must give Us notice during the Period of Insurance without delay after You are aware of any cause, incident, event or Circumstance that has given rise or that may give rise to a Claim or Dispute under this Policy.

 

  • Where You have during the Period of Insurance given notice of any cause, incident, event or Circumstance that may give rise to a Claim or Dispute under this Policy including full particulars of the circumstances, including the dates and persons involved and the reasons for believing that they may give rise to a Claim or Dispute, any Claim or Dispute to which that notice or cause, incident, event, or Circumstance may give rise, after the expiration of the Period of Insurance, will be considered for the purpose of this Policy to have been made on the date of notification.

 

  • Notwithstanding any Excess, any Claim or Dispute must be notified to Us without delay and handled and controlled by Us in accordance with and subject to these Conditions or no indemnity will be provided by this Policy in respect of any such Claim or Dispute.

 

No Admission of Liability/Claims Control/Dispute Control

 

  • You must not make any express or implied admission of liability (whether to a potential claimant, Your employer or anyone else) or other arrangement, offer, promise or payment without Our

 

  • If Your employer asks You to provide any written or oral report on any incident, event or Circumstance that may give rise to a Claim or Dispute under this Policy, You must not provide any such written or oral report to Your employer without Our

 

  • If You receive an offer to settle any Claim or Dispute, You must inform Us as soon as possible after the offer is received. You must not make or accept any offer to settle any Claim without Our  You must not reject an offer to settle any Dispute without Our consent.

 

  • In considering any offer to settle a Claim or Dispute, You must have regard to Your Legal Costs and Expenses incurred or to be incurred in the Claim or Dispute, including the proportionality of the amount of Your Legal Costs and Expenses (both incurred and to be incurred) compared to the remedy sought, and the likelihood of recovery of those Legal Costs and Expenses where applicable. You must not unreasonably reject an offer to settle to which We have given Our

 

  • Subject to Your right to choose Your Legal Representative in accordance with paragraphs 7.31 to 7.35, We are entitled at Our absolute discretion to take control of the investigation, defence, progression and settlement of any Claim or Dispute or to prosecute in Your name for Our own benefit any Claim or Dispute for indemnity or otherwise against any third party.

 

  • We shall not settle any Claim or Dispute without Your If, however, You refuse to consent to any settlement recommended by Us and instead elect to contest a Claim or progress a Dispute, then our liability for such Claim or Dispute (including in respect of Defence costs and Expenses or Your Legal Costs and Expenses) will not exceed that amount for which such Claim or Dispute could have been resolved (inclusive of Defence costs and Expenses or Your Legal Costs and Expenses) incurred up to the date of such refusal, and then only up to the applicable Limit of Indemnity for the Insured Event in question

 

Insolvency

  • If You become insolvent or are placed in liquidation, receivership, administration or bankruptcy or enter into a voluntary arrangement or deed of arrangement, or if any application is made to the court or meeting convened for any such purpose, We have the right to immediately cease to provide indemnity under this Policy.

Value Added Tax

  • If You are registered for VAT, We will not indemnify You for the VAT element of any Defence Costs and Expenses or Your Legal Costs and Expenses.

Dishonest and fraudulent requests for indemnity

  • If You seek indemnity under this Policy knowing that Your request for indemnity is false, fraudulent or exaggerated as regards amount of indemnity to which You are entitled or in any other way, We are not liable to indemnify You in respect of any part of that request for indemnity, including any part of that request for indemnity which may be legitimate, and including in respect of any Claim, Dispute, Defence Costs and Expenses or Your Legal Costs and Expenses connected to that request for indemnity. We are also entitled, at Our discretion, to give notice to You to terminate the Policy, with effect from the date of the false or fraudulent act or event, and to retain the Premium in its entirety.

 

  • If We have indemnified You and We subsequently discover that any part of Your request for indemnity was false, fraudulent or exaggerated, We are entitled to recover from You any sums paid in respect of that request for indemnity, and/or to retrospectively terminate the Policy with effect from the date of the false or fraudulent act or event, and/or to retain the Premium in its entirety.

 

  • If You seek indemnity under this Policy in respect of a Dispute knowing that the allegations You intend to make in that Dispute are false, fraudulent or exaggerated as regards amount of compensation or other remedy which You are seeking or in any other way, We are not liable to indemnify You in respect of that Dispute, or Your Legal Costs and Expenses connected to that Dispute. We are also entitled, at Our discretion, to give notice to You to terminate the Policy, with effect from the date You first made allegations that were false, fraudulent or exaggerated, and to retain the Premium in its entirety.

Avoidance of Policy

  • In the event of Our being entitled to avoid this Policy (whether by reason of Your breach of the duty of Fair Presentation or otherwise), We may instead elect, at our discretion, to give notice in writing to You that We still regard this Policy as of full force and effect except that We will not indemnify You in respect of any Claims or Disputes that We consider to be connected to our right to avoid the Policy. The Policy shall then exclude indemnity for those matters as if such an exclusion had been specifically included in an Endorsement from the outset.

 

Cancellation

 

  • This Policy may be cancelled any time by Us or on Our behalf by 30 days’ notice in writing to You at the address stated in the Certificate or at Your last known address or Registered Office (if a Company), and the Premium will be adjusted on the basis of Us retaining pro rata Premium.

 

Registration and Licensing

 

  • You must ensure that throughout the Period of Insurance that You hold all the necessary valid registrations, licences and permits to practise Your Activities, and maintain records of all those registrations, licences and permits.

 

Loss Avoidance

 

  • You must at all times take all reasonable steps to avoid or minimise loss including (but not limited to) the following.
  1. all clinical waste is disposed of by an appropriately qualified waste disposal contractor;
  2. no Prescription Only Medicine (POM) will be supplied and/or administered to a patient except in accordance with the prescription of an appropriate practitioner (as defined in the Medicines Act 1968), or if the medicine is being supplied and/or administered under the emergency supply regulations, or under a Patient Group Direction;
  3. any device or instrument used or intended for use in the performance of Your Activities and which is intended to be in contact with bodily fluids, (whether human or animal) or penetrate tissue (whether human or animal) will be:

handled, used and stored in accordance with the manufacturers’ instructions and where approved by the manufacturers and the Department of Health or equivalent to be used more than once sterilised prior to such use:

  1. using only sterilising apparatus specifically approved by the manufacturer and in accordance with instructions, recommendations or guidelines of such manufacturer;
  2. in accordance with the Department of Health guidelines or equivalent.

In addition, any surface which such device or instrument are likely to come into contact with or has been in contact with any bodily fluid (whether human or animal) or tissue (whether human or animal) must be disinfected by the use of an effective disinfectant in accordance with the manufacturers’ instructions and Department of Health guidelines or equivalent.

  1. full and appropriate records must be kept of any emergency supplies and/or Patient Group Direction transactions.
  2. that You have successfully completed all training required to perform the roles, services and/or activities that You undertake and/or have undertaken and to be able to evidence certification to Us upon request;
  3. You consider the appropriateness of Your competency to undertake specific tasks and You can evidence Your competence to undertake that task if required;
  4. that You will notify Your employer of any inadequate environmental conditions relating to the Premises (pharmacy or otherwise as soon as these become apparent, were possible in writing, records of such notification must be retained by You);

Maintain records

  • When You are undertaking Business Consultancy, and where the following areas fall within Your duty, responsibility or control, You will:
  1. maintain accurate descriptive records of all professional services and equipment used in procedures which are available for inspection and used by Us or Our representatives insofar as they relate to any Claim or Dispute under this Policy; and
  2. retain the records referred to in paragraph (a) above for a period of at least seven (7) years from the date of treatment and, in the case of a minor for a period of at least seven (7) years after that minor would have attained majority; and
  3. give to Us or Our representatives such information, assistance, signed statements or depositions as We may require; and
  4. assist in the defence of any Claim or in the bringing of any Dispute without any charge to Us.

 

Contracts (Rights of Third Parties) Act 1999

  • A person who is not a party to this Policy has no right under the Contracts (Rights of Third Parties) Act 1999 to enforce any term of this Policy but this does not affect any right or remedy of a third party which exists or is available apart from that Act.

Data Protection Act 2018

  • It is agreed by You that any information provided to Us regarding You will be processed by Us, in compliance with the provisions of the Data Protection Act 2018 for the purposes of providing insurance in handling Claims and complaints, if any, which may necessitate providing such information to third parties.

‘QC’ Clause

  • You will not be required to contest any legal proceedings unless Counsel of not less than 15 years standing (to be selected by Us after consultation with You) should advise that such proceedings can be contested with a Reasonable Prospect of success.

Single Policy and Company Authorisation

  • Save as expressly provided to the contrary, this Policy is considered to be a single unitary policy and not a severable policy or a series of individual policies with each of the Insureds. The Insureds and each of them agree that We may deal with the Company (or if there is more than one Company, the Company named first in the Certificate) who will act on behalf of all other Insured in respect of all matters under and in connection with this Policy.

Conflicts of Interest

7.24  Where a conflict of interest emerges between You and another Insured, then the procedure followed will be as described in the ‘Statement on the handling of conflicts of interests’.

The following Conditions apply only to Insured Events C-E of the Policy:

Consent to incur Your Legal Costs and Expenses – Criminal Prosecution and Civil Proceedings, Employment Disputes, Professional Disciplinary Episodes and appeals

  • Where a Claim, Dispute or appeal falls to be covered under Insured Events C-E of the Policy, We will give Our consent to incur Your Legal Costs and Expenses provided that You can satisfy Us that:

 

  • it is reasonable to incur Your Legal Costs and Expenses having regard to the proportionality between the remedy or sanction claimed and Your Legal Costs Expenses to be incurred; and

 

  1. where You are seeking to bring a Dispute under clause 4.1, there are Reasonable Prospects of proving the other party’s liability and of recovering the damages claimed or other legal remedy sought; or

 

  • where a Claim is made against You, the other party does not have Reasonable Prospects of proving Your legal liability.

 

  • If during the course of a Claim or Dispute in Our assessment clause 7.25i ceases to apply or either clause ii or clause iii ceases to apply then We will be entitled to withdraw the indemnity under this Policy.

 

  • We will determine whether to grant Our consent in accordance with clause 7.25 on the basis of:

 

  • A fully completed claim form;
  • the information We reasonably request from You in relation to the circumstances from which the Claim or Dispute arises;
  • a legal opinion from the Legal Representative as to the matters set out in clause 7.25 above;
  • such other advice as We may consider necessary in order to make Our

 

  • We may, at Our discretion, require You to obtain an opinion as to the merits of the subject matter of the Claim or Dispute having regard to the issues raised at clause 7.25 above. If, on consideration of that opinion We are satisfied in respect of the matters set out at clause 7.25 then the costs of obtaining that opinion shall be Your Legal Costs and Expenses covered by this Policy. We will pay the fee for obtaining that opinion, if You and We jointly agree on the expert or Counsel to provide that opinion, and the terms of the reference to that expert or Counsel.  If You and We cannot agree, then You must pay the fee for obtaining an opinion from a suitably qualified barrister of England & Wales of not less than 15 years’ relevant experience.

 

  • In granting Our consent to incur Your Legal Costs and Expenses We may grant such consent for a limited period of time or a limited amount of expenses in the context of the Claim or Dispute and on such limit being reached We will then review the progress of the Claim or Dispute against the criteria in clause 7.25 before confirming Our consent to incur further Your Legal Costs and Expenses.

 

  • Our Liability to indemnify You under this Policy will be triggered only by compliance with this condition precedent.

Choice of Legal Representative and Counsel

  • Where recourse to a Legal Representative is necessary in in order to defend, represent or serve Your interests in relation to a Claim or Dispute covered under this Policy We will recommend a Legal Representative who We determine to be appropriately qualified and experienced to represent Your interests in the relevant Claim or Dispute. That Legal Representative must be agree to Our Standard Terms of Appointment.

 

  • If You do not wish to instruct our recommended Legal Representative You shall be free to choose another Legal Representative, and You must have regard to:

7.32.1   Our Standard Terms of Appointment and instruct the Legal Representative to comply with it;

7.32.2   the proportionality between the complexity of the Claim or Dispute, the importance of the Claim or Dispute to You and the cost of appointing the relevant Legal Representative; and

7.32.3 Your duty to use all reasonable endeavours to minimise the cost of any Claim or Dispute.

7.32.4   Before appointing a Legal Representative You must notify Us in writing of their name and address.  We will accept Your nomination of Legal Representative if We are satisfied, acting reasonably, that the proposed Legal Representative is appropriately qualified and experienced to represent You in the relevant Claim or Dispute, will enable You to comply with the terms of this Policy, and that the proposed Legal Representative’s charging rates comply with Our Standard Terms of Appointment.

  • You must not without Our consent enter into any agreement with the Legal Representative as to the calculation of or liability for Your Legal Costs and Expenses.

 

  • Any dispute between You and Us as to the appointment of the Legal Representative will be referred to arbitration in accordance with Section 9 of this Policy.

 

  • In all cases the Legal Representative shall be appointed in Your name and on Your If in the course of any Claim or Dispute the Legal Representative wishes to instruct counsel or an expert, You, or Your Legal Representative on Your behalf, must submit to Us details of the relevant counsel or expert together with an explanation of the reason why the appointment of such party is necessary for the proper management of the Claim or Dispute and an estimate of such Counsel’s or expert’s likely professional fees to be incurred.  Such counsel or expert must not be appointed without Our consent which We shall not unreasonably withhold.

Appeal Procedure

  • If, following legal proceedings to which We have consented, You wish to appeal the judgment or decision of a court of tribunal, the grounds for such appeal must be submitted to Us through the Legal Representative as soon as is practicable so that We may consider whether to grant Our consent to such further action. If an appeal is lodged against a judgment or decision of a court or tribunal made in favour of You, You must notify Us without delay.

 

  • We will consider whether to provide indemnity in relation to that appeal in accordance with the process set out at clause 7.25.2.

 

Co-operation with Us and Legal Representatives

 

  • You must give the Legal Representative and Us all necessary help and information in relation to any Claim, Dispute or Circumstance, including providing a complete and truthful account of the facts of the Claim, Dispute or Circumstance and all documentary or other evidence in Your possession which is relevant to the Claim, Dispute or Circumstance. You must, at Your own cost, provide, obtain and execute all documents and information, and attend any meetings or conferences, and promptly provide any instructions that may be necessary for the efficient investigation or conduct of the Claim, Dispute or Circumstance.

 

  • You must instruct the Legal Representative to provide Us with any information, documents or advice that We may reasonably require in connection with the Claim, Dispute or Circumstance or Our obligation to provide indemnity in relation to it, even if that information, documentation or advice is otherwise subject to legal advice privilege, litigation privilege or any other confidentiality arrangement. In addition You must instruct the Legal Representative to provide such updates on the progress of the investigation or conduct of the Claim, Dispute or Circumstance and to inform Us immediately if any circumstance adversely affects the factors taken into account by Us in whether to provide indemnity under this Policy.

 

Recovery of Costs

 

  • Where You are awarded costs or under the terms of any settlement where costs are included, those costs will be repaid to Us. You and Your Legal Representative must make every effort to make a full recovery of costs.  Where a settlement purports to be a global or a without costs settlement or where costs are awarded but not recovered, You agree that a fair and reasonable proportion of that settlement will be considered as costs and shall be payable to Us.  Where a settlement is paid in instalments We will be paid Our costs before any amount is paid to You.

Payment of Legal Costs and Expenses

  • You must forward to Us all bills that You receive from the Legal Representative as soon as reasonably practicable following receipt. If We require You must ask the Legal Representative to submit any bill of costs for assessment or certification by the appropriate Law Society, court or tribunal.

 

  • You are responsible for the payment of all Legal Costs and Expenses. We will settle Legal Costs and Expenses direct with the Legal Representative if You ask Us to do so.

8 COMPLAINTS

We aim to provide You with a high standard of service at all times, although We appreciate that there may be occasions where You feel it is necessary to make a complaint.

 

If You wish to make a complaint about Your insurance policy, please contact:

The PIA

The Old Fire Station

69 Albion Street

Birmingham

B1 3EA

Tel: 0121 236 0031

E-mail: kayleigh.mapstone​@​pharmacyinsurance.co.uk

 

Alternatively, You can refer Your complaint to the Complaints team at Lloyd’s at any time:

Complaints

Lloyd’s

One Lime Street

London

EC3M 7HA

Tel: 020 7327 5693

Fax: 020 7327 5225

E-mail: complaints@lloyds.com

Website: www.lloyds.com/complaints

 

Details of Lloyd’s complaints procedures are set out in a leaflet “Your Complaint – How We Can Help”, which is available from www.lloyds.com/complaints. You can also ask Lloyd’s for a copy of this leaflet using the contact details shown above.

 

If You are dissatisfied with the outcome of Your complaint, You may have the right to refer Your complaint to an alternative dispute resolution body.  If You live in the United Kingdom or the Isle of Man, the contact information is:

The Financial Ombudsman Service

Exchange Tower

London

E14 9SR

Tel: 0800 023 4567 (calls to this number are free from “fixed lines” in the UK)

Tel: 0300 123 9123 (calls to this number cost the same as 01 and 02 numbers on mobile phone tariffs in the UK)

Email: complaint.info@financial-ombudsman.org.uk

 

If You live in the Channel Islands, the contact information is:

Channel Islands Financial Ombudsman

PO Box 114

Jersey

Channel Islands

JE4 9QG.

 

Tel: Jersey +44 (0)1534 748610; Guernsey +44 (0)1481 722218; International +44 1534 748610.

Fax +44 1534 747629

Email: enquiries@ci-fo.org

Website: www.ci-fo.org

 

This complaints procedure does not affect Your right to take legal action.

 

  1. DISPUTE RESOLUTION

This Policy is governed by the laws of England and Wales.

 

In relation to Insured Event A, in the event of a disagreement between You and Us about what the “usual duties of a registered pharmacy professional” are, then We will appoint an independent expert adjudicator to decide the disagreement, and both We and You shall be bound by that adjudicator’s decision.  The independent expert adjudicator that We will appoint must be a Pharmacist regulated by the Pharmacy Regulator, with not less than ten years of professional experience as a Pharmacist, including at least two years of experience of managing or supervising other registered pharmacy professionals.  We will pay the fee of that independent expert adjudicator, but if the adjudicator decides the disagreement in Our favour, then You are obliged to reimburse us for that fee.

Any other disagreement between You and Us in relation to the application of this Policy will be referred to a single arbitrator who will be a barrister with not less than ten years’ experience in insurance policy coverage disputes in England & Wales.  We and You will make reasonable attempts to agree the barrister to be appointed as the single arbitrator.  If We and You cannot agree on a barrister after a reasonable period, then We will ask the President of the Bar Council to appoint a barrister to act as the single arbitrator.  That single arbitrator will decide the disagreement on the basis of such documentation and written submissions as they request, and without any oral submissions or hearing, and will provide a written decision summarising their reasoning succinctly.  We will pay the fee of that independent arbitrator, but if the arbitrator decides the disagreement in Our favour, then You are obliged to reimburse us for that fee.  We will be bound by the decision of that arbitrator, but You have the right to reject the decision of that arbitrator.

If You reject the decision of that arbitrator and wish to commence court proceedings, and You and We agree to the exclusive jurisdiction of the English courts.

 

 

10 Definitions

Wherever the following words appear in bold in this insurance they will have the meanings shown below:

Aggregate Limit of Indemnity Aggregate Limit of Indemnity means the limit of the total indemnities under each respective Insured Event of this Policy that We are liable to pay, and as separately specified for each Insured Event or group of Insured Events in the Certificate.
Annual Aggregate Limit of Indemnity Annual Aggregate Limit of Indemnity means the amount specified in the Certificate which is the maximum total combined amount of all indemnities We will pay under all the specified Insured Events and any Endorsement(s) of this Policy.
Business Consultancy Consultancy work undertaken on behalf of a client which is related to offering business/commercial advice associated with (and limited to) the practice of Your profession for the benefit of that client’s business activities.
Certificate The document entitled “Certificate” and attached to and forming part of this Policy setting out certain details in relation to the Policy that are specific to You.
Circumstance Circumstance means anything that may lead to a Claim being made against You or to a Dispute being brought by You in relation to Your Activities or a Good Samaritan Act carried out by You including:

1.      You realise that You have or may have failed to comply with any of Your legal duties or responsibilities, whether by act or omission; and/or

2.     You realise that a third party has or may have failed to comply with any of its legal duties or responsibilities arising from Your dismissal or the ending of Your employment; and/or

3.     Your receipt of oral or written indication or notice from any professional body or statutory or regulatory authority of an intention to investigate Your professional conduct or competence; and/or

4.     Your receipt of oral or written indication or notice of an inquiry by a Coroner’s Court or of an inquiry under the Fatal Accidents Act into Your Activities or a Good Samaritan Act carried out by You; and/or

5.     Your receipt of oral assertion, allegation, suggestion or intimation that You have committed a criminal act, or any act, error or omission in violation of any criminal act or equivalent regulation in the provision of Your Activities or in carrying out a Good Samaritan Act; and/or

6.     Your receipt of notice of intended prosecution in relation to Your Activities or a Good Samaritan Act carried out by You.

Conditions Those Conditions set out at clause 7 of this Policy.
Coverholder The Pharmacy Insurance Agency.
Damage accidental loss or accidental damage to tangible property.
Defence Costs and Expenses legal costs and the expenses reasonably incurred by or on Your behalf in the investigation in defence of the Claim with Our prior written and continuing consent.  It does not include Your own costs and expenses.
Dispute If the word “dispute” is not in bold type in this Policy then it has its normal meaning in English.

Dispute means any proceedings brought by You against Your employer, arising from or related to a contract of employment or contract for services entered into by You in connection with Your Activities.

End Date the last day of this Policy specified in the Certificate.
Endorsement a written document formally recording any change or amendment to this Policy.
Excess Excess means the amount specified in the Certificate that you must pay at our direction towards any Liability, Loss or Your Legal Costs and Expenses indemnified under an Insuring Clause in this Policy.
Exclusion

 

Those matters excluded from cover under this policy being set out in section 6 of this Policy.
Good Samaritan Act/s any first aid or emergency medical assistance provided by You when present at an emergency by chance or in response to any call to emergency assistance, but it does not include any assistance provided for any valuable consideration unless that consideration forms part of Your normal income.
HMRC Her Majesty’s Revenue and Customs.
Injury death, bodily injury, illness or disease of or to any person.
Insured Events Insuring Clause(s) means the clause(s) that set out the scope of our obligations to make any payments or to provide You with indemnity in respect of any Claim, Dispute or Circumstance, as long as You also comply with all of the other terms and conditions of this Policy.
Legal Representative(s) the legal service providers, expert witnesses, investigation agents and other suitably qualified persons, who has been appointed to act for You in accordance with the terms of this Policy.
Limit of Indemnity The limit of the indemnity set out in the Certificate.
Malicious If the word “malicious” is not in bold type in this Policy then it has its normal meaning in English.  Malicious means that:

You have admitted that the words were said or published in bad faith or recklessly, or that You knew they were untrue; or

a court has made a finding that the words were said or published in bad faith or recklessly, or that You knew they were untrue.

Period of Insurance The period for which We have agreed to provide insurance cover to You under this Policy as shown in the Certificate, or until cancelled.
Pharmacy Regulator Means the General Pharmaceutical Council, or such other body which at the time is officially recognised as the independent regulator for pharmacists, pharmacy technicians and pharmacy premises in Great Britain, or the Pharmaceutical Society of Northern Ireland (PSNI).
Policy this Policy wording, the Certificate and Endorsements and any other documents expressly incorporated into this Policy.
Premises any hospital, clinic, office or building which You occupy and control (whether temporarily or permanently) for the purposes of carrying out Your Activities.
Premium The amount stated in the Certificate, which is subject to Insurance Premium Tax at the rate from time to time in force.
Reasonable Prospects A chance that is 51% or greater.
Retroactive Date Retroactive Date as specified in the Certificate.
Standard Terms of Appointment The written terms and conditions in place from time to time that We require Legal Representatives to comply with, including in relation to providing information and reports to Us and in relation to hourly rates or other remuneration arrangements.
Start Date The date this Policy starts (incepts), as specified in the Certificate.
Territorial limit The United Kingdom of Great Britain and Northern Ireland, the Isle of Man and the Channel Islands.
VAT Value Added Tax
We, Us, Our Those providing this insurance; the underwriters at Lloyd’s who have a share in this insurance.  Our Firm Reference Number(s) and other details can be found on the Financial Services Register at www.fca.org.uk.
Wrongful Act Wrongful Act means any negligent act, negligent error or negligent omission in the practice of Your Activities.
You, Your, Yours, Insured The insured person declared to Us and named on the Certificate.
Your Legal Costs and Expenses Your Legal Costs and Expenses means the professional fees and disbursements (together with VAT or other taxes if applicable) or Your Legal Representatives reasonably and necessarily incurred in representing You in investigations or proceedings covered under an Insured Event in this PolicyYour Legal Costs and Expenses include those professional fees and disbursements incurred in representing You in proceedings to enforce a judgment or order in Your favour, obtained at the conclusion of proceedings that are covered under an Insured Event in this Policy, where there are Reasonable Prospects of success in the opinion of Your Legal Representatives or a suitably qualified independent expert or leading counsel appointed by UsYour Legal Costs and Expenses does not mean or include Your personal business, internal or overhead expenses, including wages, salaries, commission, bonuses or other remuneration or the cost of Your time.  Your Legal Costs and Expenses does not mean or include any costs or expenses incurred in the course of You acting as a litigant in person.
Your Activities Your Activities means Your professional activities undertaken in connection with the business, professional services specifically described and as shown in the Certificate (including any “Available Policy Extensions” listed in that Certificate), so long as such activities, if considered by the Pharmacy Regulator, are or would be deemed to be a usual activity for a regulated pharmacy professional.

Your Activities can include Your activities as a student of pharmacy and as a pre-registration trainee.

Your Activities does not include acting as a superintendent pharmacist if You are carrying out that role for eight or more branches or locations of any pharmacy business.

 

The Pharmacists' Defence Association is a company limited by guarantee. Registered in England; Company No 4746656.

The Pharmacists' Defence Association is an appointed representative in respect of insurance mediation activities only of
The Pharmacy Insurance Agency Limited which is registered in England and Wales under company number 2591975
and is authorised and regulated by the Financial Conduct Authority (Register No 307063)

The PDA Union is recognised by the Certification Officer as an independent trade union.

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