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 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.
Yes, however holiday pay during furlough must remain at the normal rate of pay and not the reduced furloughed rate. You can still claim for this period under the scheme but you will be responsible for any amounts beyond the maximum you can claim. Employers have flexibility to restrict when leave can be taken both during and after period of furlough in the normal way.
If an employee usually works bank holidays then the employer can agree that this is included in the grant payment. If the employee usually takes the bank holiday as leave then you would either have to top up their usual holiday pay, or give the employee a day of holiday in lieu.
- 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).
Employees on any type of employment contract including full-time, part-time, agency, flexible or zero hours and foreign nationals who are eligible to work in the UK on any visa can be furloughed subject to the following excluded categories:
- Anyone who was not employed prior to 30 October 2020
- Anyone for whom you haven’t made a PAYE Real Time Information submission to HMRC between 20 March 2020 and 30 October 2020.
- Employees who are working but on reduced hours or for reduced pay
- Employees currently receiving SSP (see FAQ on SSP and self-isolation below)
- Public sector employees
- Employees of businesses or organisations in receipt of public funding for staff costs (except for those who are not primarily funded by the government and whose staff cannot be redeployed to assist with the Covid-19 response)
Yes. For further guidance, please see our FAQs section on Furlough.