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
Employers had until 31 July 2020 to make any claims for claim periods up to 30 June 2020. That was the end of the old scheme.
From 1 July 2020, claim periods must start and end within the same calendar month and must be for at least 7 days unless you are claiming for the first few days or the last few days in a month.
You can only claim for a period of fewer than 7 days if the period you are claiming for includes either the first or last day of the calendar month, and you have already claimed for the period ending immediately before it.
For example, if an employee is furloughed for 7 days spanning a month. You can claim the last 3 in one month, and 4 from the next.
The crucial point is that you cannot make claims that cross calendar months.
The first time that you could make a claim for days in July 2020 was 1 July 2020. You could not claim for periods in July 2020 before this point.
Office holders who provide services under an intermediary (such as a service company consultancy agreement) and whose services relate to the office held, would fall under the IR35 regime and must be assessed accordingly.
The Home Office has provided useful guidance on how to carry out a compliant Right to Work check using the temporary adjustments in place for Covid-19. In summary:
- You will need to ask the job applicant to send you digital copies of their original documents, for example by scan, photo or mobile app.
- Hold a video call with the job applicant and ask them to show their original documents on camera so you can check them against the digital copies you have already received.
- On the date you made the check, record that you have done this by using the following wording “adjusted check undertaken on [insert date] due to Covid-19”. Evidence of right to work checks still need to be held securely either in paper or electronic format.
- You can use the online RTW checking service where the job applicant has Biometric Residence Permit or pre-settled or settled status under the EU Settlement Scheme. You should do this whilst on the video call with the applicant/employee, and you must first obtain their permission to view their details on this scheme.
- Yes, and this includes furloughed employees under the Coronavirus Job Retention Scheme.
- Employers must continue to assess their new employees or newly eligible existing employees and enrol them where required, but can make use of the statutory postponement procedure which allows them to delay for up to three months the assessment of new employees for the purpose of enrolment (see further details here on the Pensions Regulator’s website). Declarations of compliance for new employers must still be completed in the normal way.
- Postponement cannot be used for re-enrolment. The Regulator recommends employers use the re-enrolment date tool on the Regulator’s website to choose a date up to three months after the third anniversary of enrolment to assess staff for re-enrolment. Further information about employers’ obligations about reenrolment from the Pensions Regulator can be found here. Re-declarations of compliance for new employers must still be completed in the normal way.
An employee can refuse to attend work but their refusal to do so will have to be based on a reasonable belief that their health and safety is in danger. Whether or not their refusal is reasonable will take into consideration factors such as the employee’s own health and whether they are at a higher risk of becoming seriously ill if they contract Covid-19 and the steps their employer has out in place to mitigate the danger of contracting Covid-19 at work.
In such circumstances where the employee’s belief is deemed to be reasonable, they will be entitled to stay at home and receive full pay.
If an employee is subsequently dismissed for refusing to attend work in these circumstances, they may be able to bring a claim for unfair dismissal.