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
Yes. The Government continues to support the construction industry and the Prime Minister’s recent statement supports the return to work of those who cannot work from home, if they can work safely. This has seen an immediate surge in industry workforce returning to work. Banks and storage and distribution businesses are permitted to operate as essential businesses.
Solicitors and estate agents may still not permit members of the public to enter their premises, but can operate remotely via website, phone, email and other methods, as normal. The Government’s latest guidance published on 13 May now advises that moving house need not be postponed, provided social distancing and safe ways of working can be adopted. Restrictions remain for those who are infected or who are self-isolating or vulnerable, and they should not move house or accept visitors.
Obtaining an employee’s Covid-19 test result will amount to processing personal data for the purposes of the General Data Protection Regulation 2016/679 (GDPR) and information about an employee’s health is a special category of data (sensitive personal data under the Data Processing Act 2018 (DPA)).
In accordance with the GDPR and DPA, there must be lawful grounds for processing such information. Most employers rely on employees’ consent to obtain medical information and process sensitive personal data and if the employee is unwilling to give consent, you will not normally be entitled to the information.
Special category data can be processed lawfully if it is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the data controller. Employers may be able to require an employee to disclose their Covid-19 test if there is a substantial public interest, such as ensuring that the employee self-isolate if they have a positive test. However, there is a risk that this measure could be considered disproportionate particularly if it is enforced on all employees as a blanket measure.
- Remember that employees will also be making contributions on any reduced wage under the Coronavirus Job Retention Scheme. The amount contributed may be less, but the contribution rate will be the same, unless the following applies.
- Employees may reduce their DC employee contributions if their scheme rules allow them to do so, but no further than the statutory minimum if the scheme qualifies as the employer’s auto-enrolment vehicle.
- Employees might choose to opt-out or cease active membership of their scheme, which might cause a spike in administration at a time when administrators are likely to be understaffed. It is important that employers remember they must not do anything to encourage or induce employees from leaving an auto-enrolment vehicle as this may constitute an offence.
- Employees who leave their scheme in this way will have to be re-enrolled in due course as and when required by law.
- For DB schemes, specific considerations apply (see the last section, below).
Suspension should always be a last resort and not a knee jerk reaction. We would not advise suspension unless a the above steps around the risk assessment have been undertaken. Depending on your local policies, suspension could then be an option on the basis that their health and safety and the health and safety of others are put at risk by their actions.
Business operators such as travel operators, hotels and restaurants remain vulnerable to claims of failure to protect against contracting the virus. There is a high chance of claims from employees, clients and members of the public. These are likely to be covered under public liability and employer’s liability insurance.