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
If you sponsor migrants under Tier 2 or Tier 5, you will not be required to report a sponsored employee’s absence if it is linked to coronavirus and you have authorised this absence e.g. they are self-isolating and you have received an online isolation note.
The Home Office has confirmed that sponsors do not need to withdraw sponsorship for affected employees who have been absent from work for more than 4 weeks if they consider these are exceptional circumstances, which would include absences related to coronavirus. It does however remain extremely important to know where your sponsored workers are and to have up to date contact details.
Because they all have devolved governments, when there are changes to spending levels in England, the Government makes adjustments to the amount of public expenditure allotted to Scotland, Wales and Northern Ireland. In this case £60 million will be made available for all of the devolved administrations as a result of the £370 million funding allocated to charities in England. This is broken down as follows:
- £30 million for the Scottish Government
- £20 million for Welsh Government
- £10 million for the Northern Ireland Executive
There may be further allocations, dependent on the final projects funded, through the £360 million direct grant pot.
Employers and employees can decide the split of the hours of work and the hours of furlough. There is no maximum or minimum requirements. You can change the arrangement, by agreement, from time to time.
When claiming for employees who are flexibly furloughed, you should not claim until you are sure of the exact hours they will work during the claim period.
The Government introduced shielding in the peak of the pandemic. Current advice is that shielding is not required. However, those who have been shielding are likely to be the most vulnerable and will likely be nervous about a return to work. They may also be disabled under the Equality Act 2010. You should therefore consider any concerns that are expressed and take action to mitigate any risks. For example, it may be possible to keep these employees on furlough until the scheme runs out or they may be able to work from home. If you would like to discuss any specific scenarios then please contact one of the team.
The now defunct Guidance for the Tier system suggested that the clinically extremely vulnerable would be treated in the same way as those who were shielding in Lockdown 1. This means that anyone who is clinically extremely vulnerable and cannot work remotely, will be entitled to SSP. These employees should receive a letter confirming that they are deemed to be clinically extremely vulnerable/shielding and you should ask for a copy of it as evidence to support a claim for SSP. It is likely that the Lockdown 3 Guidance will be the same.
You could also furlough an employee in the clinically extremely vulnerable category. Again we do not anticipate this changing.