Service Decision Reference 2023-0247

• Case Outcome: Rejected
• Year: 2023
• Date: 15 November 2023
• Reference: 2023-0247
• Subject Matter: Service
• Finantial Sector: Insurance
• Conducts Complained Of: Rejection of claim,Poor wording/ambiguity of policy

Decision Ref:

2023-0247

Sector:

Insurance

Product / Service:

Service

Conduct(s) complained of:

Rejection of claim

Poor wording/ambiguity of policy

Outcome:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant is a limited company trading as a hotel, hereinafter ‘the Complainant

Company’. It held a Commercial Combined Insurance Policy with the Provider. The policy

period in which this complaint falls, is from 15 May 2019 to 15 May 2020. This complaint

concerns the Provider’s decision to decline the Complainant Company’s business

interruption claim.

The Complainant Company’s Case

The Complainant Company says that its Representative notified the Provider, by email on

30 March 2020, of a claim for business interruption losses arising from the temporary

closure of its hotel, as a result of measures imposed by the Government to help curb the

spread of the coronavirus (COVID-19).

In making its claim, the Complainant Company 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