Service Decision Reference 2023-0251

• Case Outcome: Rejected
• Year: 2023
• Date: 15 November 2023
• Reference: 2023-0251
• Subject Matter: Service
• Finantial Sector: Insurance
• Conducts Complained Of: Rejection of claim,Claim handling delays or issues, Failure to process instructions

Decision Ref:

2023-0251

Sector:

Insurance

Product / Service:

Service

Conduct(s) complained of:

Rejection of claim

Claim handling delays or issues

Failure to process instructions

Outcome:

Rejected

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

The Complainant, a sole trader trading as a hair salon, held a Shops, Offices and Surgeries

Policy with the Provider. The policy period in which this complaint falls, is from 21

February 2020 to 20 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 of a claim for business interruption losses arising

from the temporary closure of her hair salon from 18 March 2020, ‘the March 2020 claim’,

as a result of measures imposed by the Government to help curb the spread of the

coronavirus (COVID-19).

In making this claim, the Complainant relied upon the following Business Interruption

Murder, Suicide or Disease Extension at pg. 26 of the applicable Shops, Offices and

Surgeries Policy Document:

“The Company shall indemnify the Insured in respect of Damage as defined in this

Section resulting from interruption of or interference with the Business during the

Indemnity Period following

a) any human infectious or human contagious disease (excluding Acquired Immune

Deficiency Syndrome (AIDS) or an AIDS related condition) an outbreak of which

the local authority has stipulated shall be notified to them manifested by any

person whilst in the Shop Office or Surgery or within a 40 kilometres radius of it

…