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 Construction Leadership Council (with backing from the Government) has issued practical guidance and draft pro-forma documents to enable all parties involved in the construction supply chain to enter into collaborative and open dialogue about applications for extensions of time and additional payment and to minimise potential disputes. The guidance can we downloaded here
The draft letters and notices included in the guidance have been prepared on the basis of the standard JCT Design and Build 2016 and NEC 3/4 Engineering and Construction Contract (Option A) and parties will need to make sure that they are completed/adjusted to comply with their own specific contracts.
The Cabinet Office has also issued a general statement calling on parties to contracts adversely affected by C-19 to act responsibly and fairly and to support national efforts to protect jobs and the economy.
Potentially, yes. If someone refuses to follow the health and safety measures that have been put in place to protect them, colleagues and possibly their customers, including (where appropriate) the use of PPE then this is a disciplinary issue and should be dealt with as such. Repeated failure to comply with the requirement to follow these measures, or a one off significant failure, may be sufficient to justify dismissal, depending on the circumstances.
If you are eligible you will get a taxable grant of 80% of the average profits from the following tax years (where applicable):
2016-2017
2017-2018
2018-2019
HMRC will add the total profit in each of the three tax years (if applicable). This will then determine the monthly payment, subject to the cap of £2500.
For those with variable pay, if the employee has been employed for a full 12 months before the period claimed for you, can take the higher of:
- The same month’s earnings in the previous year; or
- Average monthly earnings from the 2019/20 tax year.
For those who have been employed for less than one year you can use the average of their monthly earnings since they began their employment until the date they were furloughed.
If they have been employed for less than a month, work out a pro rata for their earnings so far, and claim for 80%.
The Coronavirus Statutory Sick Pay Rebate Scheme will repay employers the SSP paid to current or former employees and will be available from 26 May 2020. See here.
The scheme covers all types of employment contracts and employers will be eligible to claim if they:
- Are claiming for an employee who is eligible for sick pay due to coronavirus
- Had a payroll scheme that was created and started on or before 28 February 2020
- Had fewer than 250 employees on 28 February 2020
The repayment will cover up to 2 weeks starting from the first qualifying day of sickness, if an employee is unable to work because they either:
- have coronavirus (COVID-19) symptoms
- cannot work because they are self-isolating because someone they live with has symptoms
- are shielding and have a letter from the NHS or a GP telling them to stay at home for at least 12 weeks
- have been notified by the NHS or public health bodies that they’ve come into contact with someone with coronavirus
- they have been notified by the NHS to self-isolate before surgery
You can claim for periods of sickness starting on or after:
- 13 March 2020 – if your employee had coronavirus or the symptoms or is self-isolating because someone they live with has symptoms; or
- 16 April 2020 – if your employee was shielding because of coronavirus.
- 28 May 2020 – if your employee has been notified by the NHS or public health bodies that they’ve come into contact with someone with coronavirus
- 26 August 2020 – if your employee has been notified by the NHS to self-isolate before surgery
Employees do not have to give you a doctor’s fit note for you to make a claim. But you can ask them to give you either:
- an isolation note from NHS 111 – if they are self-isolating and cannot work because of coronavirus
- the NHS or GP letter telling them to stay at home for at least 12 weeks because they’re at high risk of severe illness from coronavirus
- the evidence from the NHS or public health body requiring them to self-isolate
You must keep the following records in relation to a claim you make under the scheme for three years:
- The reason for the employee’s absence
- Details of each period the employee could not work, including start and end dates
- Details of the SSP qualifying days when the employee could not work
- National insurance numbers for each employee you have paid SSP to
You’ll need to print or save your state aid declaration (from your claim summary) and keep this until 31 December 2024.