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
The Coronavirus Statutory Sick Pay Rebate Scheme will repay employers the SSP paid to current or former employees and will be available from 26 May 2020. See here.
The scheme covers all types of employment contracts and employers will be eligible to claim if they:
- Are claiming for an employee who is eligible for sick pay due to coronavirus
- Had a payroll scheme that was created and started on or before 28 February 2020
- Had fewer than 250 employees on 28 February 2020
The repayment will cover up to 2 weeks starting from the first qualifying day of sickness, if an employee is unable to work because they either:
- have coronavirus (COVID-19) symptoms
- cannot work because they are self-isolating because someone they live with has symptoms
- are shielding and have a letter from the NHS or a GP telling them to stay at home for at least 12 weeks
- have been notified by the NHS or public health bodies that they’ve come into contact with someone with coronavirus
- they have been notified by the NHS to self-isolate before surgery
You can claim for periods of sickness starting on or after:
- 13 March 2020 – if your employee had coronavirus or the symptoms or is self-isolating because someone they live with has symptoms; or
- 16 April 2020 – if your employee was shielding because of coronavirus.
- 28 May 2020 – if your employee has been notified by the NHS or public health bodies that they’ve come into contact with someone with coronavirus
- 26 August 2020 – if your employee has been notified by the NHS to self-isolate before surgery
Employees do not have to give you a doctor’s fit note for you to make a claim. But you can ask them to give you either:
- an isolation note from NHS 111 – if they are self-isolating and cannot work because of coronavirus
- the NHS or GP letter telling them to stay at home for at least 12 weeks because they’re at high risk of severe illness from coronavirus
- the evidence from the NHS or public health body requiring them to self-isolate
You must keep the following records in relation to a claim you make under the scheme for three years:
- The reason for the employee’s absence
- Details of each period the employee could not work, including start and end dates
- Details of the SSP qualifying days when the employee could not work
- National insurance numbers for each employee you have paid SSP to
You’ll need to print or save your state aid declaration (from your claim summary) and keep this until 31 December 2024.
Transparency is considered to be central to the philosophy of the COP. The guidance provides details on issues concerning transparency of proceedings and involvement/attendance of P. Whilst there will be some difficulties with ensuring that remote hearings are accessible to the public as an ‘open court’, provisions have been made for the continued presence of the press where the facilities can accommodate this.
There is not currently a requirement for MHFAs to be DBS checked.
If you don’t want to make redundancies, or if you can’t reduce employee resource, either in a particular department or across the workforce as a whole, then you need to think about alternatives to redundancy.
Equally, you may want to flex the resource you have available to you – without making drastic changes. For example you may want to consider:
- unpaid leave and sabbaticals
- retraining and redeploying
- forcing annual leave
- flexible working
- capability issues
- lay off
- short time working
- reductions in salary
- reductions in working hours
- changing to shift working
Maintenance Orders embodied in a Court Order are variable. If you have lost a very large part of your income, then the Courts ought to take that into consideration when looking at a Court Application to reduce or end spousal maintenance payments. The outcome of any Court Application will, however, depend on a number of factors.
Technically, you should not just stop paying or reduce the maintenance payments, as your ex-spouse could then make an Application to Court for enforcement and payment of the arrears. You could ask the Court to forego you having to pay those arrears if you had evidence to prove that you could not make the payments, however, the Court will need to take a fair approach and you should not assume this request will be agreed.
You should first try to negotiate a reduction or termination of the maintenance with your ex-spouse, either directly or through a Solicitor. If this is possible, you should obtain a Court Order reflecting that agreement. Where a sensible compromise cannot be reached, a Court Application may be necessary.