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What routes of challenge are available to an insurer’s rejection of my business interruption claim?

Many policies will only provide business interruption cover if it arises from property damage. The FCA has acknowledged that insurers are entitled to reject claims in relation to such policies, notwithstanding the success of the FCA’s test case in the Supreme Court, and which was generally favourable to policyholders [Insert a link here to our update on the test case]. In other cases the policy wording will be less clear and businesses may legitimately feel that their insurer is wrongly withholding payment.

One route of challenge to an insurer’s decision is via one of the well-publicised class actions. Another route of challenge is by a complaint to the Financial Ombudsman Service (FOS). This service is open to consumers and small and medium-sized businesses, ‘micro-enterprises’, charities and trusts. The service will be an attractive option for many businesses, as it is free and relatively quick (although it remains to be seen how the service keeps up with an increase in demand as a result of the pandemic). You will need to have complained to your insurer before bringing a complaint with the FOS.

Further details can be found here.

Related FAQs

How do I reduce employment costs? Are we talking about redundancy?

The obvious option to reduce the cost of your workforce is redundancy. However, that also reduces the number of employees and therefore your capacity.

Can employees on Flexible Furlough work as union or non-union representatives or as pension trustees?

Employees who are union or non-union representatives may undertake duties and activities for the purpose of individual or collective representation of employees or other workers. However in doing this, they must not provide services to or generate revenue for, or on behalf of your organisation or a linked or associated organisation.

Employees who are pension scheme trustees or trustee directors of a corporate trustee may also undertake trustee duties in relation to the pension scheme. However, a professional, independent pension scheme trustee who has been furloughed by the independent trustee company cannot undertake trustee work that would provide services to or generate revenue for, or on behalf of, the independent trustee company or any organisation linked or associated with that independent trustee company during hours when they are recorded as being on furlough.

Can employees with caring responsibilities be placed on Flexible Furlough?

Employees who are unable to work because they have caring responsibilities resulting from the coronavirus can continue to be furloughed. For example, employees that need to look after children can be furloughed, as you have previously submitted a claim for them in relation to a furlough period of at least 3 consecutive weeks taking place any time between 1 March 2020 and 30 June.

As more people return to work, there is an increased chance of more parents having childcare issues until Schools are fully open. However, they can’t be placed on furlough unless they had been on it before. So it would likely be unpaid leave, unless the government amends the scheme to grant an exemption.

Can I continue to operate from my commercial premises during the crisis?

The Government guidance does not require any business to close except some non-essential shops and public venues, so in theory, all businesses can continue to occupy and operate from their existing premises. However, government guidance strongly encourages businesses to arrange for everybody able to work from home to do so. The majority of office sector business will fall into this category.

In the industrial sector, the majority of businesses will not be able to operate via home working and will, therefore, need to retain employees on site though in some cases this may be able to be scaled back.

Any tenants continuing to operate from their premises should consider whether or not they need to make any alterations to the premises to facilitate social distancing of employees and whether or not such works would require a consent from the Landlord under the terms of the lease.

Can I apply a Force Majeure clause?

If a contract contains a force majeure clause this may become operative due to the coronavirus pandemic and related emergency legislation. Such clauses exist to ensure that if some unforeseen event prevents a party from being able to perform their obligations under a contract, either on time or at all, they will be excused from their obligations and not be held liable for non-performance.

The clause must actually be written into the contract to have effect – a force majeure clause cannot be implied into a contract. Whether it can be relied on by a party will depend on the wording of the clause itself as it may only be applicable in certain limited circumstances.

You should seek legal advice at an early stage if you think that force majeure is relevant, because a number of potentially complex issues must be addressed, many of which will turn upon the exact wording of the force majeure clause in the contract in question:

  • Has a force majeure event actually arisen?
  • What notification process do you have to follow to rely on the provision?
  • What mitigation steps do you have to take?
  • What is the effect of the force majeure event – is the contract suspended, or can it be terminated (which might not be what you want)?