Service Decision Reference 2025-0177

• Case Outcome: Upheld
• Year: 2025
• Reference: 2025-0177
• Date: 10 December 2025
• Subject Matter: Service
• Finantial Sector: Insurance
• Conducts Complained Of: Rejection of claim

Decision Ref:

2025-0177

Sector:

Insurance

Product / Service:

Service

Conduct(s) complained of:

Rejection of claim

Outcome:

Upheld

LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN

Background

In 2020, the Complainant Company, a limited company was trading as a children’s activity

play centre and pet farm, and it held a business insurance policy with the Provider.

The Complainant Company’s Case

The Complainant Company says that it temporarily closed its business on 12 March 2020

following a recommendation from its industry group, as follows:

“Following advice from the Dept of Health, the Dept of Business and [the then

Minister of State for Housing and Urban Development] we as your [industry]

committee are recommending that centres within our group close during this COVID

19 virus. One of the stipulations from the Dept of Health was that children of school

age do not mix in any social setting. Having weighed up everything and listened to

how all sports clubs and classes associated with children are closing we feel it is

best for our types of business to follow suit.

This is going to be such a difficult time for all of us and its unprecedented what has

happened but we need to do what is right for the safety of all children and adults

that they may be in contact with. …”

- 2 -

/Cont’d…

In this regard, the Complainant Company says that its Broker subsequently received an

email from the Chief Executive of the industry group on 25 March 2020 to clarify that:

“As Chief Executive of [the industry group] it was very important that we received

the correct information in regards to closing our businesses. On March 12th [the

Taoiseach] announced that all schools, creches and childcare facilities were to close

their doors from 6pm that evening. As a group we are a facilities (sic) whose

customer base is largely children.

On Friday March 13th I rang the Dept of Finance and the HSE for clarity on whether

we should close. We felt we were in the same classification but needed clarity. Both

the dept of Finance and the HSE recommended we close immediately. In fact the

HSE called out bullet points asking did any of them represent out types of business.

One of them was “if children are in a similar setting to a classroom/school

environment then they should be closed”. (Obviously in all our centres children play

together, sit down together to eat party food in large groups, do activities, etc)

Following on from this I then called [the then Minister of State for Housing and

Urban Development] and he reiterated the point that we should be closed. A press

release was drafted and issued to all [industry group] members. All member closed

their doors.”

The Complainant Company says that its Broker notified the Provider by email at 10:03 on

25 March 2020 of a claim for business interruption losses as a result of the Complainant

Company’s temporary closure on 12 March 2020, due to the outbreak of coronavirus

(COVID-19).

In making such a claim, the Complainant Company noted that the ‘Property – Business

interruption (Office)’ section of its business insurance policy wording stated, as follows:

“What is covered

We will insure you for your financial losses and any other items specified in the

schedule, resulting solely and directly from an interruption to your business caused

by: …

Public authority

5. your inability to use the office due to restrictions imposed by a public

authority during the period of insurance following:

b. an occurrence of a notifiable human disease”.

- 3 -

/Cont’d…

The Complainant Company says that following its assessment, the Provider emailed the

Complainant Company’s Broker at 12:47 on 25 March 2020 to advise that it had declined

the claim, as follows:

“…whilst there is additional cover under the Public Authorities section of our policy

for mandatory closures by a Public Authority this cover only applies to a mandatory

closure order issued by a Public Authority which specifically applies to the insured’s

premises and which has arisen as a result of an occurrence of a notifiable human

disease at the insured’s premises. This situation has not occurred and therefore this

cover has not been triggered.”

The Complainant Company says that it made a complaint to the Provider on 22 April 2020

regarding the Provider’s decision to decline indemnity, on the basis that:

“… in section 5 [public authority]…the ‘on/at the premises’ limitation…clearly does

not apply to subsection b [notifiable human disease] from the plain English reading

of those words …

It is our understanding that terms cannot be implied into an insurance contact

where they do not exist. [The Provider] seem to have taken a blanket decision to

deny such claims by quoting limitations and exclusions that do not apply to this

specific policy”.

The Complaint Company says that by letter dated 18 June 2020, having carried out an

interval review, the Provider wrote to the Complainant Company, as follows:

“Many policyholders including you consider that the policy wording should trigger

cover. We disagree. The policy wording is clear and unambiguous. It does not

provide cover for pandemic risk where restrictions and measures imposed are in

response to the global pandemic and are of national and general application for the

purposes of protecting public health and have resulted in a very significant

economic slowdown. To assist in understanding the scope of cover under the Policy

we set out below an explanation of the relevant clauses in the Policy.

Business Interruption cover

In the first instance, the business interruption cover is provided as part of the

policyholder’s Property insurance, and the core business interruption cover provided

by our business insurance policies responds to physical property damage at the

insured premises resulting in the business being unable to trade.