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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

Do the usual publicity requirements for planning applications still apply?

The Government has introduced new regulations, which took effect on 14 May 2020, to relax the publicity requirements in respect of planning applications.

Planning applications are usually required to be publicised by way of site notices and local newspaper notices and applications are to be made available for public inspection. The Government has recognised that these actions may not always be possible in accordance with social distancing guidelines and in order that Councils do not delay applications as a result of an inability to comply with the publicity requirements, the Government has relaxed the requirements.

A Local Planning Authority is now required to “take reasonable steps” to publicise a planning application, which may be through use of online newspapers, social media, or other electronic measures. What is considered reasonable will depend upon the circumstances of an individual application and will be proportionate to the scale and impact of the development. A large development that has previously generated significant interest will require more steps to bring the application to the attention of all of those with an interest than a householder application. The guidance emphasises the role of the publicity requirements, namely to enable those with an interest to make representations and to effectively participate in the decision making process and therefore community engagement remains key. It is recommended that the officer’s report refers to the steps taken where a Council has relied upon the temporary publicity arrangements.

The requirement to make planning applications available for public inspection has also been temporarily suspended providing that the applications are available for online inspection. In reality most LPAs already provide such an online facility. Where individuals are unable to access an application online LPAs should make alternative arrangements, for example providing information over the phone or providing a hard copy set of documents by post.

The regulations however only amend the statutory publicity requirements. In addition to these, all LPAs are required to have a Statement of Community Involvement which may provide for additional publicity requirements and the LPA will be bound by these regardless of the temporary relaxation of any statutory requirements. Where a Statement of Community Involvement does go beyond the statutory requirements, the Government guidance suggests that LPAs update these to ensure that local communities can continue to be consulted in the current climate.

The regulations are currently due to expire on 31 December 2020.

What will happen with inquests during the coronavirus outbreak?

The Chief Coroner adopts the approach taken by the Lord Chief Justice in that no physical hearing should take place unless it is urgent and essential business, and it is safe for all involved. If a hearing is to take place, social distancing must be maintained. All hearings that can take place remotely should do so, if it is not possible for social distancing requirements to be met. The expectation is that some hearings will go ahead, most notably Rule 23 hearings. Coroners are reminded that they must however conduct any remote hearings from a court. Decisions as to the most appropriate approach will be left to the senior coroner in that jurisdiction.

As we have already seen, some inquests will be adjourned, most notably those with multiple witnesses and/or a jury.

The guidance stresses the need, when dealing with medical professionals, for coroners to recognise their primary clinical commitments, particularly in these high-pressured times. This could mean avoiding or deferring requests for lengthy reports/ statements and accommodating clinical commitments if clinicians are called as witnesses.

The guidance encourages proactive reviews of outstanding responses to Prevention of Future Death reports and extending timescales for Trusts to respond.

What should an employer do when an employee has been told to self-isolate under the coronavirus Test and Trace scheme?
  • Do not require them to work
  • Continue to communicate with and support them
  • Allow them to work from home, is there alternative work for them to do if they can’t do their work from home
  • Offer SSP or allow them to take holiday if they want to.
How do you ensure clinical governance around MHFAs?

MHFAs are not qualified mental health medical professionals and they should not be diagnosing or giving medical advice, however, their training will equip them to provide initial support to those experiencing symptoms of mental ill health, and to signpost to further professional help when needed. The MHFA training makes the boundaries of the MHFA role very clear and there should be clearly defined role specifications, procedures and support pathways in place to ensure that individuals are referred on appropriately. There should be peer support in place for MHFAs and a system in place to ensure no individual or individuals are overloaded.

Can I argue that my contract has been frustrated?

It could be possible depending on your contract. If there is no force majeure clause in a contract, it may be possible that the contract may have been “frustrated” by emergency legislation. In legal terms, a contract can be frustrated where an event occurs after it is entered into which was not contemplated by any party at the outset, is not due to the fault of any party, and which makes the performance of the contract impossible.

If this is the case, the contract could be “discharged”, meaning that the parties’ obligations under the contract are no longer binding.

It is possible that a contract could be frustrated within this particular legal doctrine by a change in the law that makes performance of a contract illegal. However, if it simply becomes more difficult, or more expensive, then the legal tests for frustration might not be satisfied. There are also limits to the application of the rule if the frustrating event was already known about at the time the contracted was entered into.

Again, careful legal advice will be required at an early stage. The rules about force majeure or frustration might help businesses that find themselves unable to perform a contract because of the coronavirus outbreak.

Any new contracts that are concluded should expressly deal with the possibility that performance might become more difficult, more costly, or impossible to perform.