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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

What guidance has the Government given in relation to contracts in relation to Covid-19?

On 7 May the Government published guidance on how contracting parties can act responsibly in order to assist the effort to deal with Covid-19. The guidance seeks to persuade contracting parties to act reasonably and recognise the impact of Covid-19 on contractual counterparties. This will continue to be relevant as business begins to emerge from lockdown.

What guidance has the CMA issued about how it expects businesses to behave in response to the global pandemic?

On 30th April 2020, the CMA issued a guidance note setting out its views about how the law operates in relation to refunds.

Where a contract is not performed as agreed, the CMA considers that in most cases, consumer protection law will generally allow consumers to obtain a refund.

This includes the following situations:

  • Where a business has cancelled a contract without providing any of the promised goods or services
  • Where no service is provided by a business, for example because this is prevented by Government public health measures
  • A consumer cancels, or is prevented from receiving any services, because Government public health measures mean they are not allowed to use the services.

In the CMA’s view, this will usually apply even where the consumer has paid what the business says is a non-refundable deposit or advance payment.

This positon reflects the CMA’s previous guidance which they had issued in relation to the requirement of fairness in consumer contracts under the Consumer Rights Act 2015, which was that a clause in a contract that gives a blanket entitlement to a trader to cancel a contract and retain deposits paid is likely to be unfair, and therefore unenforceable – it would be unfair to a consumer to lose their deposit if the contract is terminated without any fault on their part, and if they had received no benefit for the payments made.

The CMA’s latest guidance therefore confirms their view that the Covid-19 outbreak does not change the basic rights of the consumer, and that they should not have to pay for goods or services that they do not receive.

Will holiday entitlement continue to accrue for a period of furlough?

The guidance has confirmed that all remaining employment rights and terms continue while an employee is furloughed. Holiday will continue to accrue during furlough however you may reach agreement with employees on reducing entitlement provided that it does not fall below the statutory minimum of 5.6 weeks per year.

Is there a matched funding scheme for the National Emergencies Trust?

The government has also confirmed it will match donations to the National Emergencies Trust as part of the BBC’s Big Night In fundraiser on 23 April – pledging a minimum of £20 million.

What can I do to make sure my home-working people are doing so safely?
  1. Keep in touch. If contact is poor, workers can feel disconnected, isolated or abandoned. This can adversely affect stress levels and mental health – especially in the current crisis when everyone is feeling more anxious.
  2. Think about the use of laptops/devices (DSE) at home. Provide a basic form of risk assessment for self-completion.
  3. Remind workers of simple steps to reduce the risks from display screen work:
    • take regular breaks (at least 5 minutes every hour) or change activity
    • avoid awkward, static postures by regularly changing position
    • get up and move or do stretching exercises
    • avoid eye fatigue by changing focus or blinking from time to time