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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

I pay child maintenance and half of my children's private school fees to my ex-partner but I have been placed on Furlough, with no top-up from my employer, so my income has dropped significantly. Is there anything I can do?

a. You should first try and discuss this with your ex-partner, either directly or through a Solicitor, to see whether an amicable agreement can be reached.

If you contribute to private school fees voluntarily, it is a matter for you and your ex-partner to resolve the issue with the school, depending whose name is on the bills. You may need to speak to the children’s school to see whether they can offer any reductions or remedies in relation to those payments. If you contribute to the school fees as part of a Court Order, you will need to ensure you do not breach the Order and you may need to consider applying for a variation of the Order if you can no longer afford the payments or reach a compromise agreement with your ex-partner.

You can use the Child Maintenance Service (CMS) calculator (https://www.gov.uk/calculate-child-maintenance) to recalculate your child maintenance obligations using your amended income. This recalculation can then be used in your discussions and you can formally instruct the CMS to verify that calculation if you and your ex-partner cannot reach an agreement about it. If you have already formally involved the CMS, they do carry out an annual review of child maintenance payments, however, they will also recalculate payments outside of the review period where there has been a change in income of 25% or more. We expect the CMS will be experiencing a high volume of enquiries at the present time so anticipate there may be delays in them assisting.

The position on child maintenance payments included in a Court Order are slightly more complicated and how you approach this will depend on how much time has passed since the date of the Order.

Last updated on 28th April, 2020

What if you want to terminate the contract completely?

If changed circumstances mean that a business wants to exit from a contractual arrangement, then before trying to terminate it, a careful review should be carried out to see whether a right to terminate actually exists. For example:

  • Not every contract for the sale of goods contains the right for the buyer to terminate in circumstances where the supplier hasn’t done anything wrong. If a business has entered into a contract on the supplier’s standard terms, it is unlikely to contain any such provision
  • A contract for the provision of services is unlikely, if drafted by the customer, to contain a provision that allows the supplier to walk away from the arrangement at short notice, or perhaps at all

If a party tries to terminate a contract when it doesn’t have the right to do so, the other party will likely claim breach of contract and could sue for damages. In the case of a long term or high-value contract, this could amount to a very significant liability.

Even if the right to terminate the contract does exist, there might be particular rules about the following:

  • How much notice has to be given
  • How such notice has to be served (for example, it might have to be in writing to a particular address)
  • When the notice can be served (perhaps on an anniversary of the start of the contract)
  • How much a party has to pay if it cancels (for example, for raw materials, for work done to date, or even the whole contract price)

All of these factors must be taken into account, and any contractual processes for termination are followed.

Last updated on 7th May, 2020

What is the Clinical Negligence Scheme for Coronavirus?

The Government has recently passed the Coronavirus Act 2020 in a response to the challenges posed by the pandemic, especially in relation to those facing the NHS during this time of crisis.  NHS Resolution worked closely with the Department for Health and Social Care to draft a clause within the Coronavirus Act providing indemnity for clinical negligence for any coronavirus related activity not currently covered by an existing arrangement.  In order to implement this clause, NHS Resolution has launched the Clinical Negligence Scheme for Coronavirus (“CNSC”).

It is intended that the CNSC will cover new contracts put in place for healthcare arrangements to respond to coronavirus, such as organisations supporting testing arrangements or Independent Contractors making agreements with NHS England and NHS Improvement to release capacity to the NHS.  Membership is not required for this scheme and the contracts entered into will automatically provide indemnity under the scheme.

The CNSC will not replace existing indemnity provisions made under the Clinical Negligence Scheme for Trusts (“CNST”) and it has been confirmed that the new Nightingale Hospitals will be covered by CNST rather than CNSC.  Similarly, NHS Resolution have confirmed that those doctors and nurses returning to practice from retirement, or those joining as students will be covered by the CNST or, where applicable the Clinical Negligence Scheme for General Practice (“CNSGP”).  The CNSC will not cover returning midwives to the profession, but the Royal College of Midwives have confirmed that they will extend all of the benefits of membership including Medical Malpractice Insurance to returning retired midwives.

For more information regarding this please click here.

Last updated on 7th April, 2020

Should my apprentice continue their training during the coronavirus outbreak, even if they’re furloughed?

The Government maintains that apprenticeships will be an important part in the economic recovery post-lockdown and therefore ESFA is encouraging training under apprenticeships to continue, even where an apprentice is furloughed, provided that the training does not provide services to or generate income for their employer. E-learning is being encouraged as a method of delivery.

Last updated on 7th April, 2020

Can I dismiss an employee who refuses to return to work?

Potentially. The first question is why the person is not able to return, as their individual circumstances will be very relevant in terms of whether they can be safely dismissed.

Employers should ask themselves 2 questions in this situation:

  1. Have I done everything I am required to do in order to make the workplace safe for the individual to return; and
  2. Is what the employee saying reasonable?

If the answer to question 1. is no then a dismissal is unlikely to be fair. However, even if the answer to question 1. is yes, then there is still question 2. to address. If the employee has reasonable grounds as to why they are unable to return to work, e.g. due to health issues, childcare responsibilities etc then the dismissal is unlikely to be fair. It is only if you can answer yes to question 1. and no to question 2. that you can have some confidence in the potential safety of the dismissal.

Dismissals based on objections to returning to work on health and safety grounds will very often be risky and are highly fact specific, therefore please contact one of the employment team for further advice prior to dismissal.

Last updated on 6th May, 2020