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
Privacy policy – You must make sure the relevant privacy policies deal with how you will process Covid-19 data. You should have an employee privacy policy and this may already deal with health data (if it doesn’t, it should). You might also need to look at privacy policies for customers, visitors and suppliers. This ensures that processing is lawful, fair and transparent.
Lawful processing conditions – You will need to consider which processing conditions you are relying on (remembering that you need both an Article 6 condition and an Article 9 condition – this is the part of the GDPR which deals with special category data). As a lot of the data you collect will be about employees, you can’t use consent so you will have to find another lawful reason under GDPR which allows you to process the data.
Appropriate policy document – When you are considering your Article 9 processing conditions, remember you must also have an “appropriate policy document” in place.
Processing record – Finally make sure your processing record is up to date with information on what data you collect and use.
The Bill allows the Secretary of State to make regulations to temporarily extend various filing date deadlines for companies. These include deadlines for filings accounts, confirmation statements, charges register, director and secretary appointments and resignations. The extended period must not exceed 42 days where the existing period is up to 21 days, or 12 months where the existing period is 3, 6 or 9 months.
If an employee is self-isolating (as a result of the pandemic) they may be entitled to SSP. Employers should not furlough employees in this category just because of their absence, but they can furlough if there are genuine business reasons for doing so and other eligibility requirements are met. In these cases the employees should no longer receive sick pay and they would be classified as furloughed.
The guidance has specified that those on long term sick leave or who are ‘shielding’ for 12 weeks in line with public health guidance can also be furloughed. But it is important that you clarify that they do fall in the category of extremely vulnerable (https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19). It is up to employers to decide whether to furlough employees who are shielding or on long-term sick leave.
You can claim from the CJRS and also for the two week SSP rebate scheme (see below) for the same employee but not for the same period of time. Therefore if you have a furloughed employee who becomes ill and you subsequently move them to SSP you cannot claim the furlough rate of pay. If you keep the employee on the furloughed rate you can continue to claim this under CJRS.
Conduct risk assessments! Your RA must cover every foreseeable risk arising from a return to the workplace, including the impact of reduced staff levels and any operational/administrative changes necessary to ensure social distancing.
Appropriate steps should be taken to manage and mitigate identified risks. Where this is not possible, businesses need to decide whether certain activities are necessary for the business to operate or if they can be temporarily put on hold.
Keep a close eye on the comprehensive Government guidance: https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19
In particular focus on social distancing and workplace health measures. This guidance will evolve over time and you will need to be sure that your organisation is sticking to it AND reviewing and updating its risk assessment.
It would be prudent to take legal advice early in relation to any issue you foresee in performing a contract. This will allow you to:
- Ensure that initial contact with your counterparty is framed in the correct way
- Ensure that any variations are fully documented so that both parties are fully protected