Other Decision Reference 2023-0248

• Case Outcome: Rejected
• Year: 2023
• Date: 15 November 2023
• Reference: 2023-0248
• Subject Matter: Other
• Finantial Sector: Insurance
• Conducts Complained Of: Claim handling delays or issues,Failure to process instructions, Failure to process instructions in a timely manner, Rejection of claim

Decision Ref:

2023-0248

Sector:

Insurance

Product / Service:

Other

Conduct(s) complained of:

Claim handling delays or issues

Failure to process instructions in a timely manner

Failure to process instructions

Rejection of claim

Outcome:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant is a sole trader trading as a public house, and she held a Commercial

Combined Insurance Policy with the Provider. The policy period in which this complaint

falls, is from 23 October 2019 to 23 October 2020. This complaint concerns the Provider’s

decision to decline the Complainant’s business interruption claim.

The Complainant’s Case

The Complainant says that she notified the Provider, by email on 6 July 2020, of a claim for

business losses arising from the temporary closure of her public house, as a result of

measures imposed by the Government to help curb the spread of the coronavirus (COVID-

19).

In making her claim, the Complainant relied upon the following wording of Section 2,

‘Business Interruption’, at pg. 36 of the applicable Commercial Combined Insurance Policy

Document:

“EXTENSIONS TO THE BUSINESS INTERRUPTION SECTION …

(6) Murder, Suicide & Notifiable Diseases

Interruption of or interference with your Business in consequence of Damage as

insured by this Section shall include loss resulting from Murder, Suicide or notifiable

Diseases. For the purpose of this extension notifiable diseases are those listed under

The Infectious Diseases (Amendment) Regulations 2011.