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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

What is the Government’s Coronavirus Job Retention Scheme?

All employers in the UK are eligible to participate in the scheme. The purpose of the scheme is to allow employers to claim back employment costs if they have furloughed employees arising from the coronavirus crisis. Importantly this means the scheme is not limited to cases where the employee would otherwise have been made redundant.

Key points:

  • Between 1 November 2020 – 30 June 2021, the government will reimburse employers for 80% of wage costs, up to a cap of £2,500 per month, with employers expected to contribute 10% of that 80% in July 2021 and 20% of that 80% in August and September 2021. Employers will still need to pay employer NICs and employer pension contributions (these cannot be claimed for).
  • The scheme now also allows employees to return to work part time being on furlough for the remainder. See flexible furlough above for more information.
  • The employer can agree to pay the employee more than it will be reimbursed but it cannot reclaim the additional amount or any other costs associated with the additional amount.
  • The workers covered by the scheme are those who have been “furloughed” which is a leave of absence.
  • Workers must be told about and agree to this change of status (see below).
  • Employers have to continue to pay the furloughed workers and the Government will reimburse the employer.
  • HMRC is administering the scheme and it has been extended until the end of September 2021
  • Those who left employment and are re-employed and subsequently furloughed by agreement are eligible (please see the FAQ regarding redundancy and furlough above).
  • Payments may be withheld if claims are based on inaccurate or dishonest information, or are found to be fraudulent. HMRC has put in place an online hotline for employees and the general public to report suspected fraudulent claims.
  • The Government has made alternative help available for employers to continue to pay employees while the scheme is set up.
Can apprentices be furloughed?

The government has stated that the scheme will apply to apprentices and that they can continue to train whilst they are furloughed. However you must pay at least the Apprenticeship Minimum Wage, National Living Wage or National Minimum Wage for all periods of training during furlough leave, taking into account the rate increases from 1 April 2020 and the increases which will take effect from 1 April 2021. This means that you will be responsible for any shortfall in the amount claimed under the scheme and the appropriate minimum wage.

We recommend that you get in touch to discuss any queries on furloughing apprentices.

Can I be investigated or prosecuted by HSE if one of my workers contracts Covid-19?

The reality of these unprecedented times is that enforcement of health and safety legislation by the HSE (particularly through the criminal courts) in relation to Covid-19 is an extremely unlikely outcome.

Do leaseholders who have more than three properties in the UK have to pay the full contribution for building safety works and is there a way of finding out how many properties out leaseholders have in the UK?

The first point to note is that it is the position as at 14 February 2022 which is relevant, as whether or not a lease is a ‘qualifying lease’ for the purposes of recovering costs under the Building Safety Act was effectively frozen at that time.

If a leaseholder owned more than three properties in the UK (and the property in question was not their principal home) at that time, then the lease will not be a qualifying lease. The protections under the Act which prevent or restrict the landlord’s ability to recover the cost of remedial works through the service charge will not therefore apply to that lease (save potentially for the provision that costs cannot be recovered where the landlord is responsible for the defects, which does not expressly refer to qualifying leases).

The lack of a searchable database to assess how many properties a leaseholder has in the UK is however one of the difficulties to be resolved in this regard, as there is currently no way of searching the Land Registry to obtain a list of properties owned by one individual. The guidance appears to rely on the leaseholder completing the leaseholder deed of certificate being open and honest in this regard, and that deed of certificate being passed onto subsequent owners. Making false representations or failing to disclose required information in the deed of certificate may be a criminal offence, although reliance on this to discourage mis-reporting is clearly less satisfactory than having a searchable register.

Can I rotate staff who are furloughed? Can I put someone on furlough, bring them back when I need to, and then put them back on furlough, as demand requires? And practically how can we deal with this for those who want to rotate?

You can rotate staff on furlough or flexible furlough.

One option is to make it clear in the letter agreeing to being furloughed that there is an open ended right to rotate and to be able to take them off furlough and bring them back and put them back on.

So the employer reserves the ability to rotate by building into the agreement, but only exercises it if it is permissible.

Rotation is quite key for employers who need to make a temporary reduction to their overheads but want to retain the skills base to call back when work picks up. Having furloughed staff return on a part-time basis may reduce the need to rotate.

It also helps in the employer being able to show that they are treating the workforce as fairly as possible and everyone is taking a reduction. Get in touch if you need help preparing the documentation for furlough that will permit rotation or flexible furlough.

Read more about flexible furlough and how this can be used as part of the CJRS.