High Court rules on Business Interruption Insurance test case


10th February 2020

The High Court has this week (Tuesday 15 September 2020) handed down judgment in the Financial Conduct Authority’s (FCA) business interruption insurance test case, which will no doubt be of high interest to insurers and insureds alike. The FCA has estimated this test case could affect some 370,000 policyholders who have been heavily impacted by the effects of the Covid-19 pandemic.

Since this article was first published in September 2020, the case was subject to an appeal to the Supreme Court on 16 November 2020. So, an additional paragraph has been added below and there has been some minor revision to reflect the Supreme Court’s final Judgment.

The background

Business interruption insurance became a hot topic at the outset of the Covid-19 pandemic as some insurers refused to offer cover to their insured for losses in connection with the pandemic, citing the business interruption clauses in certain policies as not covering the particular circumstances of the unprecedented government response to the threat of the pandemic and resultant lockdowns and closures of businesses.

This caused a great deal of consternation and worry amongst commercial enterprises, some of whom feared there would be no recourse for the losses they had suffered and would undoubtedly continue to suffer, which in many cases they may have believed they were covered against.

Business interruption insurance cover & the FCA

Business interruption insurance is intended to cover the policyholder for loss of profits and expenses during periods where business cannot be conducted as usual due to damage caused by certain perils referred to in the insurance policy. Business interruption clauses are usually used in respect of physical damage, such as flood or fire. Though, often, they also include extensions for loss caused by non-physical factors. It is these extensions that the test case was concerned with.

Due to the considerable issues faced by businesses (particularly SMEs), the FCA, which regulates the insurers, announced in May 2020 that it would bring a test case to the High Court to seek clarity on the meaning and effect of certain business interruption insurance policy wordings regarding claims made as a result of the effects of the Covid-19 pandemic.

The FCA advanced the case on behalf of policyholders, where 21 sample business interruption clauses from eight insurers were analysed in expedited proceedings in the hope of giving much needed guidance to policyholders and the industry.

The High Court's findings in the test case

In order to consider the issues and provide its view, the court grouped together certain types of clauses and commonly used wording.

The court, on the whole, found in favour of policyholders in welcome news for many insureds. Although, there were some circumstances where the judgment was not so favourable to policyholders.  Much will depend on the particular wording of a specific policy, however, in summary the court found the following:

Disease clauses

These clauses generally provide cover for business interruption as a result of a ‘notifiable disease’ within a specific radius of the insured’s premises. The court’s view was that these should mostly provide cover.

The High Court agreed with the FCA’s analysis of these clauses in that an outbreak of the magnitude of the Covid-19 pandemic is sufficient to find a causal link between the outbreak of the disease (which has been confirmed as ‘notifiable’ by UK governments) and interruption to business. In other words, it was not, as the insurers argued, that only local outbreaks would be covered, which would require distinction from the wider outbreak. Although, the Interpretation of disease clauses was also subject to appeal (on which see below).

The court confirmed that any individual localised outbreaks form an indivisible part of the wider outbreak, which was the cause of the business interruption. This sought to avoid the anomaly where cover could be provided for a local outbreak, though not if it was part of a wider outbreak where it would be virtually impossible to show that the local outbreak had made a material difference to the response of the local authorities or public.

Denial of access clauses

These are intended to provide cover where access to or use of an insured’s premises has been prevented or hindered due to government or other authority action or imposed restrictions. The court’s view was that these should sometimes provide cover.

The court was generally more restrictive on the interpretation of these clauses. Where “prevention of access” is referred to on the policy, the court declared that a closure of premises was required (and a physical prevention of being able to open was not), although a complete ceasing of activity was not required (it is interruption that is required). However, whether a claim will be covered is likely to rely on whether there was a government mandated closure or the closure was simply an effect of the ‘stay at home’ guidance. Although, the interpretation of these clauses was also subject to appeal (described below).

The instructions by the UK government on 16, 20 and 23 March were characterised as advice or action, and not mandatory instructions. As a result, cover would likely not be provided where clauses require action which “prevents” access – as these require the force of law. As such, the Coronavirus Regulations issued on 21 and 26 March may, however, mean that cover is provided.

Hybrid clauses

These operate, as the name suggests, as a hybrid of the above and where restrictions are imposed in respect of a premises in connection with a notifiable disease.

The court largely mirrored its interpretation of the above clauses, in a wide assessment of the disease element, though narrowly interpreting the denial of access element, requiring mandatory restrictions and any “inability to use” requiring more than simply inability to use to normal standards.

The full judgment runs to over 160 pages, but can be found here in case of interest.

The appeal

The Framework Agreement between the FCA and the eight insurers entered into prior to the test case contained an appeals provision – which was invoked by the FCA, certain of the insurers and the Hiscox Action Group (a grouping of parties insured by Hiscox), once permission to appeal was obtained. The appeal was “leapfrogged” to the Supreme Court (avoiding a Court of Appeal hearing).

The Appeal was heard in mid-November 2020 and Judgment was handed down on 15 January 2021. The Judgment was described by the FCA as “complex” as it ran to 112 pages. Though in summary, the Supreme Court unanimously dismissed the insurers appeals and allowed those from the FCA and Hiscox Action Group (in part).

In brief, the Supreme Court held that Disease clauses provide cover only where cases of COVID-19 have occurred within the specified radius of the insured premises, which is a narrower view than that taken by the High Court. It is therefore necessary to identify a case of coronavirus within the radius specified in the policy for the clause to apply. Notwithstanding this narrowing of interpretation of the clause, the net result is that such clauses still do provide cover.

In relation to Denial of Access clauses and Hybrid clauses, the Supreme Court agreed with the FCA and considered that government or local authority instructions (e.g., to close businesses) need not be legally binding. This was a slightly wider interpretation than the High Court and the Supreme Court confirmed that losing access to part of a business would be satisfactory for a policy to be enacted (removing the previous distinction under the High Court’s view where a restaurant with no takeaway facility would have been covered but one offering takeaway would not). The Supreme Court also confirmed that “Trends” clauses (often used by insurers to adjust downwards the level of cover provided based on a counterfactual scenario where the loss would have occurred in any event) should, as far as possible, be construed in a manner consistent with the insuring clauses (i.e., they should not be seen as a ‘get out’ for insurers to reduce the level of cover given the heavy impact of Covid-19 and the various measures that have applied anyway).

Similarly, the Supreme Court also confirmed that there was sufficient causation as a result of the Covid-19 cases in the country as a whole and that the insurers argument that “but for” the occurrence of COVID-19 in the vicinity, the same or similar loss would have happened anyway (due to other cases elsewhere in the country) was rejected.

Conclusion

The result of the Court Judgments on the test case is likely to be pleasing reading to the majority of policyholders and has been welcomed by the FCA and action groups. Using the guidance the court has now given, a review of specific policy wording will result in many policyholders having good grounds for a claim that may have previously been refused.

Of the High Court Judgment, the FCA’s Interim Chief Executive Christopher Woolard said “insurers should reflect on the clarity provided here and, irrespective of any possible appeals, consider the steps they can take now to progress claims of the type that the judgment says should be paid. They should also communicate directly and quickly with policyholders who have made claims affected by the judgment to explain next steps.”

Reflecting on the Supreme Court decision, Sheldon Mills, Executive Director, Consumers and Competition at the FCA, said: “Coronavirus is causing substantial loss and distress to businesses and many are under immense financial strain to stay afloat. This test case involved complex legal issues . Our aim throughout this test case has been to get clarity…As we have recognised from the start of this case, tens of thousands of small firms and potentially hundreds of thousands of jobs are relying on this. We are grateful to the Supreme Court for delivering the judgment quickly. The speed with which it was reached reflects well on all parties.”

Case: The Financial Conduct Authority v Arch Insurance (UK) Limited and Others [2020] EWHC 2488 (Comm)

This case study has been co-written by David Moore and Lee Fisher. The article was first published on 17 September 2020 and updated on 10 February 2021.

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