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 extension to the traditional business interruption insurance, “contingent business interruption insurance” often covers areas such as business interruption due to damage to property of a customer or suppliers. Nonetheless, proving loss can be problematic.
Claims for loss of use of the property may be possible as a result of forced business closure due to lockdown. Accordingly policies should be carefully reviewed to see if cover is available.
Many planning permissions contain a condition restricting the hours within which a developer can carry out construction work or are subject to an approved construction management plan setting out the permitted construction hours.
The Business and Planning Act 2020 entered the statute books on 22 July 2020. Section 16 of the Act incorporates a new S.74B into the Town and Country Planning Act 1990. The effect is that any condition/approved document which limits construction hours on a site could be amended through an application to the local planning authority. The application to the local planning authority must set out the date on which the proposed extension to construction hours shall cease (such date being no later than 1 April 2021, after which the original conditions over construction hours will resume). The local planning authority must determine the application within 14 days (beginning with the day after the application was submitted) otherwise there is deemed approval.
New guidance has been published alongside the Act and is available here
The basics of health and safety law requires that employers take “all reasonably practicable steps” to ensure workers’ safety and that a suitable and sufficient assessment of risk is undertaken. It is the individual assessment of Covid-19 risk in each workplace that will be central. Employers will be required to conduct a robust risk assessment and then, following the hierarchy of controls, put robust processes and safeguards in place to address those risks.
UK government guidance and HSE advice is continually evolving, which in practice means that any risk assessment will need to be reviewed very regularly as that guidance develops. There is flexibility for individual businesses within the overall government framework and there will need to be a process of evaluation to ensure that the measures in place continue to meet the requirements.
The starting point of avoid, eliminate and control means looking at individuals continuing to work from home where possible (the fewer the number of people back in the workplace the lower the risk), and if not look at risk management, which leads to administrative controls – i.e. changing work practices before ending up at PPE. PPE is generally seen as control of last resort but in practice – facemasks, disposable gloves and constant prompts to wash hands for example.
In terms of changing working practices, employers should be thinking about:
- the workspace and how this is laid layout
- how do we make sure it is kept clean and hygienic
- how do we keep people apart
- how can we use toilets, canteens or other shared spaces/facilities safely
- how do we promote and enable higher levels of workplace hygiene
- if we are going to rely on PPE – can we get it, and is it suitable
- what about limiting customer interactions
- will there be enough first aiders on site
- can we manage fire safety, deliveries etc
- what about higher risk workers
- should work tools and equipment be allocated on an individual basis to employees.
These decisions need to be recorded and clearly communicated to staff members.
The guidance gives numerous examples of the types of performance adjustment which parties should consider. For example this includes:
- Varying deadlines (e.g. for performance or payment)
- Varying compensation (e.g. to recognise increased costs)
- Varying the nature of performance (e.g. allowing substitute goods, allowing pert delivery of services)
The guidance also encourages a reasonable approach to enforcement, which might encourage delaying issuing formal proceedings, increased use of mediation or providing more information to the other party than would be volunteered under normal circumstances.
The Regulations do not require any prior agreement between an employer and employee that it was not reasonably practicable for holiday to be taken for it to be carried over.
However, if an employee requests holiday then an employer must have ‘good reason’ for refusing it due to coronavirus. The term ‘good reason’ is not defined so the Government will expect employers, employees and (if necessary on any dispute) the Courts to apply common sense.
The Regulations are not confined to key workers so could, in principle, be used by employers for a wider range of employees.
The Government guidance suggests that the following factors should be taken into account when considering whether it was reasonably practicable to take the leave in the relevant year:
- Whether the business has faced a significant increase in demand due to COVID-19 that would reasonably require the worker to continue to be at work and cannot be met through alternative practical measures.
- The extent to which the business’ workforce is disrupted by COVID-19 and the practical options available to the business to provide temporary cover of essential activities.
- The health of the worker and how soon they need to take a period of rest and relaxation.
- The length of time remaining in the worker’s leave year.
- The extent to which the worker taking leave would impact on wider society’s response to, and recovery from, the effects of COVID-19.
- The ability of the remainder of the available workforce to provide cover for the worker going on leave.