Other Decision Reference 2023-0164

• Case Outcome: Rejected
• Subject Matter: Other
• Reference: 2023-0164
• Date: 11 August 2023
• Finantial Sector: Insurance
• Conducts Complained Of: Delayed or inadequate communication,Claim handling delays or issues

Decision Ref:

2023-0164

Sector:

Insurance

Product / Service:

Other

Conduct(s) complained of:

Delayed or inadequate communication

Claim handling delays or issues

Outcome:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant, a sole trader trading as a public house, held a Commercial Combined

Insurance Policy with the Provider. The policy period in which this complaint falls, is from

28 May 2019 to 28 May 2020. This complaint concerns the Provider’s decision to decline

the Complainant’s business interruption claim.

The Complainant’s Case

The Complainant says that Representative A notified the Provider on his behalf, by way of

email on 31 March 2020, of a claim for financial losses arising from the temporary closure

of his public house since 15 March 2020, as a result of measures imposed by the

Government to help curb the spread of the coronavirus (COVID-19).

In making his claim, the Complainant relied upon the following Notifiable Diseases

Extension 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”.