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 now defunct Guidance for the Tier system suggested that the clinically extremely vulnerable would be treated in the same way as those who were shielding in Lockdown 1. This means that anyone who is clinically extremely vulnerable and cannot work remotely, will be entitled to SSP. These employees should receive a letter confirming that they are deemed to be clinically extremely vulnerable/shielding and you should ask for a copy of it as evidence to support a claim for SSP. It is likely that the Lockdown 3 Guidance will be the same.
You could also furlough an employee in the clinically extremely vulnerable category. Again we do not anticipate this changing.
Under CBILS, for the purposes of calculating the applicant’s annual turnover, approved lenders have been aggregating turnover across the whole of the private equity investor’s portfolio meaning they failed to qualify for the scheme as they were deemed to exceed the £45 million threshold.
For private equity-backed businesses, the removal of the upper limit on annual turnover criteria for CLBILS seemingly avoids the issue of turnover aggregation across investment portfolios seen with the CBILS, potentially enabling more private equity sponsor portfolio companies to be able to access the CLBILS funding.
Yes. You should be able to furlough a suspended employee subject to all other eligibility requirements however we recommend that you take advice on this before doing so.
Employees with visas should be treated consistently with the wider workforce. When their furlough leave ends, they should return to work and their pay should be reinstated. If you agree a pay cut or reduction in working hours, you need to ensure that sponsored workers are still earning above the minimum salary for their role and working in excess of the minimum number of hours (see above).
The flexible furlough scheme is now in place and can be used for employees who have previously been furloughed for a consecutive period of at least three weeks. The flexible furlough scheme remains in place until 31 October 2020.
The guidance is non-statutory and is not binding on business. However, businesses should be aware that there might be reputational consequences if they do not follow the guidance; we have already seen in the context of taking advantage of furlough funding that not being in breach of the law is no protection against negative publicity. Further to the extent a contract expressly requires parties to act reasonably, it could be expected that this guidance is one of the factors a court would consider in determining what is reasonable.