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
As an occupier of premises, you owe a duty of care to your visitors to take reasonable care to see that the visitor will be reasonably safe in using your premises.
It is therefore essential that you are taking reasonable steps and strictly adhering to up-to-date Government advice in all aspects of your business to avoid any potential liability.
Failure to follow Government advice could leave you vulnerable to claims for compensation for pain and suffering should a visitor on your premises contract Covid-19.
However, each case will be fact-specific and it would be very difficult for a visitor to establish that they contracted Covid-19 specifically from those premises (as opposed to being exposed to the virus anywhere else).
If someone suggests that they are going to make a claim make sure that you report matters to your insurer or insurance broker immediately.
Most rent suspension clauses in commercial property leases are unlikely to come to the assistance of the tenant. These clauses normally apply only where the premises has suffered substantial physical damage and are, as a consequence, incapable of being occupied, used or accessed. The coronavirus pandemic does not involve any physical damage to a property, loss from the crisis will be purely financial. Such losses then will not be covered by the landlord’s buildings insurance policy in a way that will allow a tenant to claim rent suspension.
Some of these can be implemented by you, some need agreement or consultation and some depend on the wording of contracts. We’ll explain more in relation to each option.
If the duties are so fundamentally different from their contracted role, then yes. For example, if you are asking a frontline clinical member of staff to undertake administrative tasks in another area, then this will be a fundamental change to their terms and conditions for which you need their consent.
If there is a minor alteration to their duties, or the clause within their contract is wide enough to cover their amended duties, then arguably to do not need their consent but best practice would be to obtain their agreement.
Be careful, there is now a cap on the number of employees you can have on furlough at one time.
The number of employees you can claim for in any claim period starting from 1 July cannot exceed the maximum number of employees you claimed for under any claim ending by 30 June 2020. So this cap is going to be specific to each employer.
It may catch out, in particular, employers who had been rotating employees on furlough.