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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

Should you rely upon Statutory Demands issued after 1 March to present a Winding Up petition?

No. No action need be taken in relation to the demand but we would advise against presentation of a petition based upon any Statutory Demand issued between 1 March 2020 and the end of the restrictions. As you may be aware, with Winding Up there is no requirement to issue a Statutory Demand notice before proceeding so this is unlikely to create too many issues – click here to see whether you should issue petitions on other grounds.

There is nothing to prevent statutory demands being served at this time. However, there may be limited benefit as it cannot form the basis of a future winding up petition.

ONLINE EVENT: Global Clinic: Covid-19 and International Trade

Hosted by The North East England Chamber of Commerce, this webinar discussed practical advice on Covid-19 and the specific challenges for International Trade.

Partner Damien Charlton along with Andrew Needham,from Haines Watts and Grant Murray from XE Finance, provided an update on the challenges and potential solutions in their field, as well as a look forward for the “New Normal”.

To watch the full recording, please click here or to view the slides, please click here.

 

 

What are the NICE protocols around a patient’s ongoing treatment whilst in critical care during the pandemic?
  • Start critical care treatment with a clear plan of how the treatment will address the diagnosis and lead to agreed outcomes.
  • Review critical care treatment regularly and when the patient’s clinical condition changes.
  • Stop critical care treatment when it is no longer considered able to achieve the desired outcomes. Record the decision and the discussion with family, carers and the patient (if possible).
What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

What is the NHS coronavirus Test and Trace scheme and how does it work?

The NHS Test and Trace service is operated by the NHS in England to track and help prevent the spread of COVID-19. Where an individual displays symptoms of coronavirus they can be tested to determine whether or not they have the disease. Those with the disease will then be contacted by NHS contact tracers and asked who they have come into close contract with.
Close contact is defined as:

  • Face to face (within 1 metre)
  • Spent more than 15 minutes within 2 metres of another person
  • Travelled in a car or on a plane with another person

The contact tracer will then contact those people with whom the individual has come into close contact and tell them to self-isolate for 14 days.