Other Decision Reference 2022-0326

• Case Outcome: Rejected
• Subject Matter: Other
• Reference: 2022-0326
• Date: 26 September 2022
• Finantial Sector: Insurance
• Conducts Complained Of: Claim handling delays or issues

Decision Ref:

2022-0326

Sector:

Insurance

Product / Service:

Other

Conduct(s) complained of:

Claim handling delays or issues

Outcome:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant, trading as a dental surgery, held a Business Insurance Policy with the

Provider. The policy term in which this complaint falls, is from 14 February 2020 to 13

February 2021. This complaint concerns the Provider’s decision to decline the Complainant’s

business interruption claim.

The Complainant’s Case

The Complainant notified the Provider on 10 April 2020 of a claim for business interruption

losses as a result of the temporary closure of his dental surgery for three weeks, due to one

of his staff testing positive for COVID-19 and the rest of the staff self-isolating as close

contacts, in accordance with health measures announced by the Government at the time to

help curb the spread of the coronavirus.

In making such a claim, the Complainant relied upon the following ‘Business Interruption

Section Extensions’ wording at pg. 52 of the Business Insurance Policy Document:

6. Notifiable Disease

The insurance by this Policy will extend to include loss resulting from interruption or

interference with the Business carried on by the Insured at the Premises in

consequence of:

1. (i) any occurrence of a Notifiable Disease at the Premises …