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
An employee on Flexible Furlough can take part in volunteer work during hours which you record your employee as being on Flexible Furlough as long as it is for another employer or organisation.
To be clear, if on Flexible Furlough and you’re claiming the grant for them, then they cannot work for you.
As people work part-time and ease back into the business, this is likely going to be a key risk area. You need very clear lines as to working time and non-working time. No replying to emails on days off.
Read more about thisIt is envisaged that employees of organisations falling into the first two categories set out above and won’t be eligible for the job retention scheme in relation to the majority of their employees. It is envisaged that NHS Trusts for example are going to require their staff to be working at full capacity where possible. However, the guidance doesn’t definitely exclude public sector organisations from furloughing employees and notably the government expects such organisations to use public money to continue to pay staff and not furlough them, rather than say requires. In reality, it is difficult to see how such an organisation will be able to rely on the scheme, but the guidance doesn’t completely rule it out.
Read more about thisWe have developed a toolkit to assist with compliance. The Toolkit contains a specimen contract; detailed guidance; step by step guides and flowcharts; details of the factors to take into account for the status determination test; procedures for challenging the determination; and standard letters for the process. Click here to fill in a form and register your interest in the Toolkit, which contains:
- Detailed guidance in the form of Key Facts
- Employment status checklist
- Employment status assessment flowchart
- Status questionnaire and guidance
- Letter confirming self-employed status (agency)
- Letter confirming employed status (agency)
- Letter confirming self-employed status (direct with PSC)
- Letter confirming employed status (direct with PSC)
- Status disagreement process guidance
- Status disagreement process flowchart
- Letter confirming outcome of status disagreement process
- Consultancy agreement
No one factor will determine status and the outcomes will differ depending on the nature of the work being carried out and the business of the end user client.
When you have carried out an assessment based on the relevant factors you can either get in touch with us to discuss further, check your answers against HMRC’s CEST tool or do both before making a final determination.
Read more about thisSpecialist healthcare lawyers from Ward Hadaway ran a free webinar looking at the practical and legal considerations if required to treat healthcare workers from a BAME background or other vulnerable groups differently in the fight against the Covid-19 pandemic.
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