Our article on the prospects assessment described the process – this one is its contract-anatomy counterpart: how all of this appears in the wording of the policy terms, and what is worth looking for in the clause before you sign. Because the assessment exists everywhere – its quality depends on the wording.
- The prospects-assessment clause sets out when and how the insurer may weigh up a case's chance of success.
- The hallmarks of a good clause: a transparent standard, a duty to give reasons, and a genuine route for review.
- Comparing offers on this point calls for a wording-level comparison – it does not show up in headline terms.
What does the clause set out?
Three things are worth identifying in the wording. The first is the standard: what level of chance the policy terms require – phrases like "reasonable chance" or "likelihood of success" can hide different degrees of strictness. The second is timing: whether the assessment applies only when the case is first taken on, or can also be carried out along the way – after new developments, for example. The third is scope: whether it applies to every service, or whether the advice-type elements are available without it – the latter is a customer-friendly pattern, and an increasingly common one.
The safeguards: what makes a clause a good one
The quality of a clause is not shown by the fact that it exists, but by the safeguards around it. The duty to give reasons: good policy terms require a written, substantive explanation when a claim is refused. The review mechanism: several sets of terms offer an external-expert or arbitration-panel route for settling a dispute about the chance of success – this is the strongest safeguard for the customer, because it takes the question out of one-sided decision-making. And handling new information: fair wording allows for reassessment if the state of the case changes. The practical use of these options is described in the when the insurer says no article.
Why is this a key point of comparison?
Because it is through this clause that the promise of legal expenses insurance becomes reality or illusion. Two packages with identical modules and a similar premium are worth radically different amounts if one has a transparent chance-of-success assessment surrounded by safeguards, while the other has broad, one-sided discretion. That is why, in our comparison table, the prospects-assessment rules get their own line – and here we compare not headline terms but the actual content of the policy wording. This is the point where a broker's work is not a convenience but substantive value: reading through the wording takes time – but it is exactly what determines what the paper is worth when real trouble comes.
Common question: "Could this clause not simply be left out?"
A fair question: if the prospects assessment raises so many issues, why isn't there a product without one? The answer lies in the economics of insurance: legal expenses cover without a chance-of-success assessment would end up financing hopeless cases too – the cost of which would show up in every customer's premium, making the product significantly more expensive, while the cases financed this way would typically also bring a loss to the customers involved (time, energy, the other side's costs). The clause, then, is not a flaw but a condition for an affordable price and sensible operation – much like the principle of medical necessity in health insurance. The real question, therefore, is not whether the clause exists, but its quality: how transparent the standard is, the duty to give reasons, and how genuine the route for review is. These three elements are what need to be compared across offers – and that is exactly what we do in our comparison table.
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