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
The vast majority of disputes settle without ever reaching a final hearing with something in the region of 2-5% of all cases actually ending up in court at a final trial. So whilst it is very unlikely you would need to attend a court hearing, it is always a possibility.
Whilst many employees may now have the resources and equipment to work from home, an employee may struggle to effectively work from home for a number of reasons. For example, an employee may not have a suitable working environment where they can work without being disturbed or alternatively, working from home for prolonged periods of time may be having a detrimental impact on the employee’s mental well-being.
In circumstances such as these, employers must carry out a careful assessment. Unfortunately, there is not any specific guidance as to when an individual cannot ‘reasonably’ work from home – it is likely that each case will be fact specific.
In relation to employees who are struggling with their mental well-being, employers owe their employees a duty of care. It is crucial that procedures are in place which will enable an employer to recognise the signs of stress as early as possible. In the circumstances, it may be appropriate to allow an employee to attend their place of work if this would help alleviate work-related stress or to prevent mental health issues.
Unfortunately, losses caused by pandemics are not often covered expressly under standard policies, as the risk has been difficult for insurers to price and understand.
Even where additional cover in respect of notifiable diseases has been purchased, it typically will not include Covid-19 within the range of diseases covered by the policy. If the policy includes a list of notifiable diseases, and which does not include Covid-19, it is very unlikely that cover will be available for pandemic-relates losses.
The most common types of covers that could be afforded by insurance policies for coronavirus-related losses and liabilities are traditional business interruption insurance, contingent business interruption insurance, liability insurance, as well as cancellation and abandonment insurance.
This may be a good idea – whatever name they are given, it is essential that MHFAs are empowered to take a proactive approach to organisational mental health and that they have the bandwidth to be able to discharge their responsibilities. The name should reflect the culture of the organisation, the key aspect is awareness and accessibility – identifying a name for your company that supports this is key.
- Delays in preparing and submitting applications to comply with pre-commencement conditions. In this respect there can be lengthy timescales gathering evidence to support applications to comply with pre-commencement conditions, ecology, contamination and archaeology are examples of matters which can require significant periods of survey work
- Following on from the above the ability to get required experts on the site necessary to undertake the required survey work
- Delays in the determination of applications to comply with pre-commencement conditions. In this respect whilst there are deemed discharge provisions/procedures concerning certain matters, the provisions cannot be used to discharge all types of conditions
- The ability to get people on site to undertake material operations
In the circumstances, it is advisable to start considering the implementation of the planning permission early and the earlier the better. Under current legislation whilst it is possible to vary conditions, albeit potentially leading to wider issues, it is not possible to extend the life of a planning permission meaning that lawful implementation is essential to avoid the loss of that permission.
If a planning permission is lost, amongst other things it may not be granted again or may not be granted on similar terms. In the circumstances, it is advisable to seek advice given the specific facts of the case to minimise the risk of a planning permission not being lawfully implemented and expiring.