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
As mentioned earlier, if an agency is involved you must send them a copy of the status determination statement for each contractor, and they will also have the right to dispute the outcome.
If the agency pays the contractor, they will be responsible for the operation of PAYE and NIC’s deductions and any apprenticeship levy. The agency may try to recover these costs from the end user client.
If workers are supplied by an agency or umbrella company and are already treated as employees by the agency, they will remain unaffected by IR35.
One of the key legislative requirements of EMI is that the employee satisfies the working time requirement, which is that they work at least 25 hours per week in the company or, if less, 75% of the employee’s total working time. If the working time requirement ceases to be met, then there is a “disqualifying event”. That means that the tax benefits of EMI ceases. It may also mean that the option lapses, but that depends on the specific terms of the option.
An employee who has been furloughed is by definition no longer working 25 hours/week and therefore on the face of it, there is a disqualifying event. However, the Government has tabled an amendment to the Finance Bill currently going through Parliament providing in effect that time not worked because an employee has been furloughed counts as working time, both for determining whether the working time requirement is met initially and whether there is a disqualifying event. Provided this amendment is enacted, this should address the issue.
The European Commission has reintroduced its “comfort letter” system for cooperation in relation to shortage of supply. This allows cooperating businesses to check what the Commission’s view of their proposals are before implementing them.
In the UK context the SMA has introduced an exemption for suppliers of healthcare services to the NHS. This allows:
- Sharing information about capacity
- Coordination of staff deployment
- Joint purchasing of goods, services and facilities
- Sharing or lending of facilities
- Division of activities, including agreeing whether to expand or reduce the volume or type of services provided by suppliers
In relation to whether the CMA will investigate cooperation, it has indicated:
- The CMA will use its discretion as to the prioritisation of its enforcement action to permit some agreements/collaboration which would otherwise potentially give rise to enforcement action (including potentially attracting fines of up to 10% of group worldwide turnover)
- The CMA will use its existing power to exempt certain agreements under the Competition Act 1998 where these are in the public interest
Individual contractors who are not operating via an intermediary (eg sole traders) do not need to be assessed under IR35. However, you will always have the risk with those individuals that there is no intermediary – therefore if their tax status is wrong, HMRC are very likely to consider that responsibility for this would fall on the hiring company in any event.
The obvious option to reduce the cost of your workforce is redundancy. However, that also reduces the number of employees and therefore your capacity.