Service Decision Reference 2022-0242

Case OutcomeRejected
Subject MatterService
Date25 July 2022
Finantial SectorInsurance
Conducts Complained OfRejection of claim
Decision Ref:
Product / Service:
Conduct(s) complained of:
Rejection of claim
The Complainants trade as a public house and hold a commercial insurance policy with the
The complaint concerns a claim for business interruption losses arising from the outbreak
of coronavirus (COVID-19).
The Complainants’ Case
By email dated 17 March 2020, the First Complainant contacted the Complainants’ Broker
to advise, amongst other matters, that the Complainants had closed their business “in
accordance with current legislation.”
On 26 March 2020, the Broker emailed the First Complainant with the following update
regarding the cover provided under the policy, as follows:
[The Provider] has issued the attached advice document to all insurance brokers in
respect of all their Commercial Property & Business Interruption policyholders.
Their position is very similar to most other insurers as I explained previously in that
COVID19 losses are not covered by their policies.
It will be interesting to see if they will change position as the Insurance Industry in
Ireland comes under external pressure from Government & Central Bankers to be pay
COVID19 claims.”
- 2 -
The Broker notified the Provider on 17 April 2020 of a claim for business interruption losses
as a result of the temporary closure of the First and Second Complainant’s public house on
16 March 2020 due to the outbreak of COVID-19, as follows:
“The insured wishes to make a formal business interruption claim due to their losses
suffered from COVID-19.”
By email dated 21 April 2020, the Provider wrote to the Broker to advise that the claim was
not covered by the policy, as follows:
“I am very sorry to hear about the difficulties your client is experiencing at this time.
Unfortunately, the Business Interruption section of the policy does not respond to
closure as a result of COVID-19, and I am writing to explain why this is the case.
Having reviewed your client’s policy (attached for your ease of reference), the cover
available to them under the policy includes an extension to the Business Interruption
section for losses due to the prevention of access to insured premises, see Business
Interruption - Extension 1 Prevention of Access.
However, despite this, the losses in this case are due to an excluded cause, that being
the decision of Government to take certain measures to seek to control the spread of
the pandemic. This action is not an event which is insured under the policy.
Whilst, therefore, there is cover for prevention of access there is an express exclusion
as follows:
Page 48, Extension 1 Prevention of Access, Exclusion (iii):
“...closure or restriction in the use of the premises due to the order or advice of the
competent local authority as a result of an occurrence of an infectious disease (or the
discovery of an organism resulting in or likely to result in the occurrence of an
infectious disease) food poisoning defective drains or other sanitary arrangements or
vermin or pests”
Therefore, our Prevention of Access extension excludes business interruption losses
due to prevention of access caused by the occurrence of an infectious disease, where
the closure is on the order or advice of the competent local authority.
Unfortunately, subject to any further information or representations you may wish
to provide us with on behalf of your client, for this reason it appears that your client's
claim is not covered under the policy.

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