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Your legal assistance provider considers proceedings hopeless, while you want to continue. Or you disagree substantively with the chosen approach. The dispute procedure in your policy may then be the appropriate route. An independent adviser assesses the defined disagreement. Preparation deserves attention: an incomplete file or incorrectly formulated question can affect a binding opinion. An insurance lawyer can help you use the policy procedure correctly while monitoring deadlines in your original case.

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1. Identify the substantive disagreement

Write down precisely what outcome you seek and why the legal assistance provider considers it unachievable. Does it concern starting proceedings, an appeal, a particular defence or choosing between negotiation and litigation? Keep the substantive assessment and request a written position if the case handler gave an opinion only by telephone.

The dispute procedure generally concerns the legal approach or reasonable prospects of success. Dissatisfaction with a slow response or unfriendly communication requires a different assessment. A refusal because the subject falls outside the insured module is also not automatically a dispute about prospects. Where there are several grounds for refusal, establish which issue must be resolved first.

2. Find the procedure in your own policy

Collect the policy schedule and applicable general and special conditions. Find the provision on disagreement with the legal assistance provider and read how to invoke it. Pay attention to the subjects covered, appointment of the adviser, the file to be supplied and the consequences of the opinion. A website summary does not replace this text.

Then send an identifiable request citing the provision and briefly describing the disagreement. Ask who will handle the request and which next steps are proposed. Also make clear which documents you consider necessary. Keep the acknowledgement in your file so it remains apparent when you requested application of the procedure.

3. Formulate a useful question together

A question such as 'did my case handler do everything wrong?' offers little guidance. A question about the specific legal choice is better: does the current file show reasonable prospects of a particular claim being upheld? Identify the decision sought, relevant opposing party and issue on which assessment should focus.

Check whether the legal assistance provider’s proposal actually covers your objection. State in writing if a sub-question is missing or a fact is inaccurately described. A lawyer can organise your counterarguments without overloading the question with all correspondence. Keep drafts and the final version and record which question was agreed.

4. Check the file before dispatch

Prepare contents listing contracts, relevant messages, procedural documents, earlier advice and evidence. Separate established facts from facts disputed by the opposing party. For each key document, indicate which part of your position it supports. Also include adverse documents relevant to prospects; an adviser must be able to assess weaknesses.

Ask which documents will actually be sent to the adviser and check that your written response is included. A missing attachment may matter more than a lengthy new explanation. If further evidence arrives, discuss promptly whether and how it can be submitted. Do not assume unlimited opportunity to supplement the file after the final opinion.

5. Arrange independence, instructions and costs

Read how the independent adviser is appointed under your terms. This may involve an appointment procedure and need not mean an unrestricted choice of your own lawyer. Ask beforehand who gives instructions, who contacts the adviser and how the parties can explain their positions. Report a possible conflict of interest specifically and with substantiation.

Kifid describes the dispute procedure as a second opinion paid for by the legal assistance provider. Have the practical cost arrangement confirmed in your case. Instructing an external lawyer yourself does not automatically constitute the same engagement. Therefore first discuss reimbursement, scope and whether the adviser may later act as the lawyer handling the case.

6. Protect the original case during the advice process

A dispute with the legal assistance provider does not remove deadlines involving your own opposing party. Separately list the next hearing date, limitation issue, response deadline or final date for a legal remedy. Ask in writing who will take necessary measures while the dispute procedure is pending. Specify which step you believe cannot wait.

If you receive no clear confirmation, immediately have the necessary emergency measure and who can perform it assessed. A lawyer can help coordinate the substantive insurance dispute and urgent original case. Agree beforehand on costs of separate assistance. A pending second opinion does not itself promise payment of all external work.

7. Understand what a binding opinion means

Ask beforehand what consequences the policy attaches to favourable and unfavourable opinions. Often handling must continue after a favourable outcome, whereas an unfavourable outcome may lead to closure of the file. Check how continuation is organised and whether reimbursement conditions apply if you continue independently after an unfavourable opinion and ultimately achieve a result.

An unfavourable opinion cannot easily be repeated simply because you continue to disagree substantively. In Kifid decision 2023-0223, review of the opinion was limited to serious defects. Therefore have any possible defect precisely identified: what essential information was missing, which agreement was not followed and why could that have influenced the decision? Disappointment with the outcome alone is insufficient.

8. Choose focused help when the procedure stalls

If the provider refuses to apply the procedure, request a reasoned response to your specific policy request. Also keep proposals on the question, your additions and the document dispatch list. This enables a lawyer to assess whether application should be demanded, correction of the procedure is appropriate or a complaint about its implementation becomes necessary.

The dispute procedure does not provide a general right to unlimited external legal assistance. Free choice of lawyer and a complaint to Kifid each serve their own purpose. Therefore bring the policy, prospects assessment, request for advice and main deadlines to the first meeting. Ask the lawyer for a defined proposal for the next step, with a cost estimate and possible consequences for your original case.

Frequently asked questions

Is the dispute procedure the same as free choice of lawyer?

No. The procedure assesses a substantive disagreement about approach or prospects. Free choice of lawyer concerns, subject to its own conditions, choosing the person providing legal assistance. Record reimbursement arrangements beforehand.

Can I demand another second opinion after an unfavourable opinion?

That does not follow automatically. Check the policy and have specific defects assessed. A binding opinion generally receives limited review in a subsequent complaint; a different opinion alone is insufficient.

Should I already pay an external lawyer myself?

Agree on instructions and reimbursement beforehand. Separate external assistance does not automatically fall within the dispute procedure. An urgent deadline also requires assessment of the protective step needed.

Sources

These sources relate to this page. For a specific case, check current rules and your own documents.

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Editorial team Insurance law in the Netherlands

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Ricardo van der Spoel

Ricardo van der Spoel

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