400 Hiscox policyholders, embarked on an expedited arbitration process, seeking indemnities for BI claims relating to coronavirus. [1] Customers of the CMC have referred to “threatening texts and emails” which threaten court action if fe Nevertheless, if the test case results in policyholders being unable to recover simply because of the practical evidential difficulty of distinguishing loss caused by A from that caused by B, insurers stand to make what might be regarded as a windfall saving at the expense of policyholders. FRN: 838865. This may be the correct analysis, but as ever the devil is in the detail. Not pushy I completed the form to claim which they acknowledged. This is of course true, but a scenario in which a hotel is left unscathed while everything around it is destroyed seems more ‘unreal’ than a more typical BI loss scenario, such as a kitchen fire at a hotel. There were many issues in the test case but those relating to causation are fundamental. Over the last few weeks, Twitter has been awash with angry consumers asking Allay to stop sending nuisance, and often incorrect text messages to their phones:- Their sister company, Real Time Claims is no longer authorised by the FCA:- Furthermore. No matter the timing, the FOS will have to deal with the logistical challenges caused by the backlog of complaints and the competing demands of policyholders, who having waited (at least) several months, and will be likely to expect rapid decisions when the moratorium is eventually lifted. But from a practical perspective, how long can the FOS put off its substantive review of such cases? By reference to contemporaneous Scientific Advisory Group for Emergencies minutes, he argued that nationwide business closures, lockdown and social distancing were imposed by the government in response to a single cause, being the nationwide coronavirus outbreak, or, alternatively, that all of the outbreaks comprising the nationwide outbreak comprise a multitude of concurrent causes of the same, or similar efficacy. Had such a conversation arisen, however, is it more likely that the broker would have explained that the insurance was against outbreak or closure, subject to further requirements such as proximity of the virus? In some quarters this frustration gave way to anger as policyholders compared notes and came to the conclusion that insurers were trying to have it both ways. Pamela Freeland and the LexisPSL Insurance & Reinsurance team consider the implications of this impasse for coronavirus BI claims advanced in other forums, such as the Financial Ombudsman Service (FOS), arbitration or separate actions in the county Court and the High Court—all the time while the coronavirus saga continues to unfold and produce new conundrums, such as the gradual withdrawal of government support through the coronavirus job retention scheme. Allay did a great job in getting me my… Allay did a great job in getting me my mis-sold PPI back. Company reg. This FCA authorised firm that fraudsters are claiming to work for has no association with the ‘clone firm’. It is hoped that the widely anticipated decision in the FCA test case will provide some clarity to policyholders and insurers as to the extent to which certain types of non-damage BI policies will respond to the losses caused by the closure of businesses to tackle the spread of coronavirus. Information for firms on coronavirus response. The impact that the decision will have. I did have to wait a considerable time to get my cheque from my bank though and Allay were phoning me daily for their commission which did become onerous. However, only by settling claims in accordance with the terms of the contract, properly construed, can the rule of law be upheld. Copyright © 2021 FCA. For many, who have made complaints to the FOS or who have, or are considering litigating or arbitrating, the decision in the FCA test case will not be the final word on the subject. Once again, this line of reasoning tends to come back to the question of what, exactly, the relevant insured peril is. Allay were perfect for my claim, it was almost handled completely silently in the background apart from one request for a little further information to help progress. For many, the obvious answer is an insurance system backed by government. Taking a step back (putting the law and policy wording aside for a moment), purchasers of BI insurance probably would, rightly or wrongly, have conceived of their insurance policy as protecting them against perils of disease outbreak or closure by public authority. The ‘pipework’ obviously depends on the wording in any relevant policy but the analogy is apt to describe insurers’ analysis of the relevant insured peril. This has negative consequences for the national and global economy at large. Allay Claims Ltd. is authorised and regulated by the Financial Conduct Authority in respect of regulated claims management activity. Arnold Schwarzenegger in the FCA's promotional campaign on PPI; the deadline for claims is August 29. Will the FOS resume its assessment of BI related complaints when the first instance decision in the FCA test case is published or will it wait until the case has run its course, including any and all appeals that may be pursued? Now, with the risk of a second wave of coronavirus and with the knowledge of the significant impact a pandemic can have on many sectors of commerce, the question of how this issue can be addressed in the future is a top priority for the government, businesses and insurers. However, given the importance of the case, an appeal on at least some of the issues in dispute is likely meaning that, for many, uncertainties will remain. Some policyholders with BI cover responsive to closure by order of a public authority state that they were informed that their losses were not covered because they would have been suffered anyway, because of the pandemic, and all the fear, lockdown and social distancing that it entails. While the result of the FCA test case is awaited, complaints that have been made by policyholders to the FOS regarding BI policies are being held in abeyance so as to ensure that decisions are consistent and are not at odds with judicial authority. Shareholders’ interests are of course harmed if the insurer pays substantial amounts in respect of invalid claims. no: 6836398 | VAT no: 221 656 917. Allay Claims Ltd. Counsel for both sides debated colourful hypothetical scenarios with the judges. An industry levy (like that applied to property insurance, which helps finance Flood Re to make property insurance in high risk areas affordable) may also be required. All the claims would also have 20% tax deducted. The delay will mean that some cash-strapped businesses will fail before the test case has concluded. Registered Office: Studio 20, The Kiln, Hoults Yard, Walker Road, Newcastle upon Tyne, NE6 2HL Tel: 0191 462 0000. The cap applies to all agreements that were entered into on or … Complaints data published by FOS revealed that Allay was the most complained about CMC in the July - December 2019 quarter, yet Allay Claims (and its 27 trading names) continued to apply to the FCA for full authorisation and … One can readily understand policyholders’ anger and frustration, especially in light of the Prime Minister and Chancellor’s assurances on 17 March 2020 that insurers would make payments to companies forced to close as a result of the coronavirus pandemic, if they had policies to that effect. This is of course why the FCA and the insurance industry acted swiftly in getting the test case afoot and expediting its progress. Registered Office: Studio 20, The Kiln, Hoults Yard, Walker Road, Newcastle upon Tyne, NE6 2HL Tel: 0191 462 0000. Since institutional investors such as pension funds account for a sizable proportion of the ownership of insurers, the impact on shareholders will have an indirect but negative effect on fund performance. The FCA submitted that Orient Express Hotels, which insurers rely on in support of the ‘but for’ test, was wrongly decided because the tribunal had incorrectly identified ‘Damage’ (as defined) as the relevant peril, not hurricane, and that this error led the tribunal to a misconceived application of the ‘but for’ test. Or is it more likely that the broker would have explained that such further requirements were inextricable elements of the insured peril itself? This result would do little to allay policyholders’ perception that insurers are trying to have it both ways when denying claims on the grounds that the loss would have happened anyway, whether because of mandated closures or because of the coronavirus outbreak, depending on the insuring clause in the relevant policy. FRN: 838865. Insurers seldom elicit sympathy, especially when declining claims. Some say that insurers are using the public purse to reduce indemnities paid under policies that do respond to claims relating to coronavirus. Litigation on this issue will be likely to follow, with HMRC seeking to claw back payments that should not have been made. Colin Edelman QC, for the FCA, vividly described the rapid emergence of the nationwide pandemic and showed the judges a map of the UK showing clusters of coronavirus outbreaks emerging at the same time across virtually all of England. it also seems Allay have lost their Managing Director, Steven Bell[1] w The Moneycheats project is designed to collect, collate, analyse and disseminate information and data about the scope and size of inflated or false compensation claims across the private and public sector. The Financial Conduct Authority (FCA) has set 29 August 2019 as the final deadline for consumers to make PPI complaints. If losses surpass those thresholds, Pool Re’s reserves will be deployed to pay the remainder. Discussions with government and insurers are afoot but for any scheme to succeed it will need the full support of government, insurers and businesses alike. The Moneycheats project is operated by a group with longstanding communications, research and public affairs experience and expertise. Registered Office: Studio 20, The Kiln, Hoults Yard, Walker Road, Newcastle upon Tyne, NE6 2HL Tel: 0191 462 0000. Policyholders’ interests are diminished if their insurer pays invalid claims to other policyholders because the insurer will have to martial its remaining funds more cautiously in order to maintain its regulatory solvency margin. However, furlough payments could also feature in claims relating to BI policies. equally effective causes (ie the aggregate of all known and presumed coronavirus infections in the country). Will the courts use their general case management powers to adopt the same approach as the FOS and stay such claims until the ultimate outcome of the FCA test case is known? Does the inclusion of further requirements or limitations further delineate the insured peril itself, or is it the nature of an insured peril that it is apt to cause loss in a particular way, with any further requirements or limitations being simply conditions rather than part of the peril? Registered Office: Studio 20, The Kiln, Hoults Yard, Walker Road, Newcastle upon Tyne, NE6 2HL Tel: 0191 462 0000. “The claims deadline has led to a recruitment drive, but these are long-term jobs as we’re already looking into new products and services that can benefit from our claims services from miss-sold payday loans to home improvements, meaning a positive future for consumers.” For more information on careers with Allay visit www.allay.co.uk. Insights, events and opinions on the latest law, legislation and policies. The FCA’s approach has the attraction of simplicity—the insured peril is simply the outbreak of an infectious disease, or mandatory closure of premises because of the outbreak of an infectious disease, depending on the particular policy. In the event of an insured loss resulting from an act of terrorism, insurer members of Pool Re pay out claims up to certain thresholds. The challenge of a new regulator was perhaps too much for some as 253 CMC’s chose not to re-register. The amount was stunning and made a real difference to my life. Updated reveiw Updated reveiw . It is authorised to offer, promote or sell services or products in the UK and its correct details are: Firm Name: Allay Claims Ltd. Firm Reference Number: 838865 Flaux LJ, (presiding over the FCA test case alongside Butcher J) was leading counsel in the Silver Cloud case for the (largely) successful party. One of the claims has paid me and i paid allay the second has not paid at all and now i am being bombarded by allay claims for paymen, i have told them that as soon as the money is in my account they will be paid. That privacy and/or confidentiality and the window of opportunity between the hearing and the decision in the FCA test case may have given the parties to the arbitration an opportunity to ‘de-risk’ these claims. Allay claims has won 2 cases for me… Allay claims has won 2 cases for me which i am grateful. This is deeply regrettable. As the PPI claims deadline loomed, the compensation industry was just getting started. The delay in resolving coronavirus BI claims has been deeply frustrating for policyholders, many of which are small businesses struggling to survive the economic impact of lockdown and the coronavirus pandemic. See: Local lockdowns—complex implications for coronavirus (COVID-19) business interruption insurance cover. Accordingly, the ‘but for’ counterfactual becomes A minus B, (or, to put it another way, ‘X, Y and Z’), if pipelines C and D are again left out of the equation for simplicity. Implicit in this argument is a different analysis of what the relevant insured peril is. The FCA cited the Silver Cloud as authority, in which case the insured loss was found to have been caused equally by advice to US travellers regarding the dangers of cruise holidays in the wake of the 2001 terrorist attacks on the United States (an insured peril), and also by the fact of the attack itself causing worried US citizens to avoid going on cruises (not insured against, but not excluded either). Counsel for Hiscox, Jonathan Gaisman QC, imagined a system of pipes as a metaphor to describe the relevant peril for the purposes of the non-damage businesses interruption section of a given policy. On this view, the further requirements of the BI insuring clauses, such as a requirement for there to have been an outbreak within 25 miles of the premises, are not part of the insured peril but merely pre-requisites for cover. Some reasons are fairly obvious—it would be unfair for insurers to pick and choose who gets paid and who does not on an arbitrary basis. In this instance Allay first approached me in a low key way. It would seem, therefore, that a straightforward ‘but for’ causation test produces particularly strange counterfactuals where more than one concurrently operative peril (some insured, some not) is considered to have caused the loss. Unfortunately for the reputation of the insurance industry, not all of the reasons for this are widely understood. Coronavirus (COVID-19) business interruption test case - pre-judgment analysis and the future of pandemic claims, Construction frameworks and facilities management, Partnerships and Limited Liability Partnerships, Employment contracts, policies and procedures, Management of trade disputes and industrial action, Financial advice on marriage and dissolution, Disputed wills, trusts and estates solicitors. However, the costs of the Pool Re scheme would be dwarfed by the potential costs of a scheme providing cover for a pandemic. Of the remaining CMC’s, just over half of them (56%) have obtained full authorisation by 26th May as the Coronaviru no: 6836398 | VAT no: 221 656 917. If a significant number of such claims are made, the courts may also face resourcing challenges as they too begin to deal with the backlog of certain types of cases (such as possession and eviction hearings) which have been paused as a result of the pandemic. A more precise understanding of what the insured peril is might make future questions of what loss was caused by an insured peril much easier to answer. We also take a step back and consider the essence of the parties’ respective positions on the critical issue of causation, and the implications that the courts’ final reckoning on the issue might have for insurance law. Restrictions on the availability and scope of insurance cover also diminishes the role that the insurance industry plays in de-risking the global economy and international commerce. Both sides averred that their respective positions proceed from the proper construction of the relevant policies, but they diverged significantly regarding the appropriate legal test for causation. Outsiders can only speculate, highlighting the stark contrast between litigation and arbitration as forums for dispute resolution. They were thorough and kept me informed at every step. Company reg. Thank you Allay. FCA authorised firm details. They said an agreement had been reached with insurance companies to ensure businesses received payouts where appropriate. Accordingly, the wait for the legal certainty needed to adjust and settle valid coronavirus BI claims is set to continue for several months yet. Any claims management company constituted under law of part of Great Britain (ie, England, Wales and Scotland) or serving customers in Great Britain must have permission to carry out regulated activities by the FCA. On 1 April 2019 the FCA will become the regulator of claims management companies in England, Wales and Scotland. EU Traders Monitoring Team (clone of FCA authorised firm) Email: [email protected] Firm Name: Allay Claims Ltd Firm Reference Number: 838865 Address: Generator Studios, Trafalgar Street, Newcastle upon Tyne, Tyne and Wear NE1 2LA Telephone: 01914620000 Website: www.allay.co.uk Britannia Credit Union (clone of FCA authorised firm) Allay Claims said: “We do have the right to charge for work done, but only after a 14-day cooling off period. This article was first published byLexis®PSL Insurance & Reinsurance. They might have been quite confused if their broker had explained to them that the actual peril insured against was loss caused by the outbreak of infectious disease within 25 miles minus any part of its loss attributable to qualitatively indistinguishable outbreaks of the same disease at the same time as the disease spread in virtually all parts of the country. FCA authorised firm details. Contact us by web chat, email, phone or post: See the latest news stories, speeches, statements, press releases and warnings. ; 2 of which were successful and for which they have been duly paid. Insurance & Reinsurance analysis: The High Court’s decision in the Financial Conduct Authority’s (FCA) coronavirus (COVID-19) business interruption (BI) test case will be published on 15 September 2020. Despite multiple requests to cease contact they persist and escalate their threats of extortion based on fraudulent claims. Allay Claims Ltd. is authorised and regulated by the Financial Conduct Authority in respect of regulated claims management activity. This result would do little to allay policyholders’ perception that insurers are trying to have it both ways when denying claims on the grounds that the loss would have happened anyway, whether because of mandated closures or because of the coronavirus outbreak, depending on the insuring clause in the relevant policy. In a sense, the approaches of both sides beg the question of what the relevant insured perils are and indeed it may be instructive to ask oneself that question when considering a particular BI policy. There has been some criticism in the press about the categorisation of furlough payments as a ‘saving’ to be deducted from any indemnity paid as part of the loss adjusting process pursuant to the terms and conditions of BI policies. In the event that Pool Re’s reserves are depleted, the government will step in and provide an unlimited loan to pay the remainder. Find out more. Allay Claims Ltd. Our Objective Allay Claims is committed to the maintaining of our service to our clients during this challenging time, whilst meeting its duty of care to our staff and their families alongside our regulatory obligations.. What we are doing We are taking several key steps to enable us to continue acting on your behalf in supporting your PPI and other complaints with lenders and in … Keep up to date with our claims management-related news including upcoming publications, consultations and events. The FCA characterised the resulting counterfactual analysis as being unreal—whereby the insured hotel’s insured BI loss was found to be that amount it would have earned had it not sustained ‘Damage’ but where the surrounding area has nevertheless been heavily damaged such that guests would not be able to get to it. Following in the footsteps of Allay Claims, Fast Track Reclaim appears to be the latest fully FCA-authorised claims management company who has received some rather diabolical customer reviews on Trustpilot of late. Company reg. Company reg. It is authorised to offer, promote or sell services or products in the UK and its correct details are: Firm Name: Allay Claims Ltd. Firm Reference Number: 838865 This does of course mean that policyholders whose losses do not fall within the scope of their policy will have to bear their own losses. Andie Stokoe, director of claims management company Allay, hoped the FCA would scrap the end date altogether. On the other hand, other policyholders with BI cover responsive to the outbreak of an infectious disease state that they were informed that their losses were not covered because they would have been suffered anyway, because of the government’s instruction to business to close their doors. That is not to say that insurers were remiss for not having foreseen the construction issues to which the parties were joined in the test case—the insurance industry has a long history of responding to crises by adapting policy wordings to cater for unprecedented developments. Allay Claims Ltd. is authorised and regulated by the Financial Conduct Authority in respect of regulated claims management activity. How long however will this moratorium last? The FCA should withdraw their licence and they should be shut down for improper practices, fraudulent activities, extortion with menaces and harassment. Again if so, how long is too long to hold such cases in abeyance? Policyholders may need to share the burden by way of higher policy excesses for damages relating to or arising from a pandemic and/or may have to pay more for other insurance products so that funds can be diverted to assist with the financing of pandemic risk. In reality there were few, if any, conversations of this nature because nobody was very concerned about the possibility of an outbreak of this scale. The decision is widely expected to be appealed, whatever the High Court decides. Lord Justice Flaux and Mr Justice Butcher have a challenging task indeed and there are many issues to be decided, but it is hoped that the result of the test case will not only facilitate the proper adjustment and settlement of valid claims, quickly, but perhaps also provide guidance on the nature of insured perils and causation. Both sides also provided vivid analogies to illustrate the logic of their competing cases on causation and, in so doing, their competing analyses of the insured perils under the relevant policies. For any further information or advice on the above please don't hesitate to contact us. No doubt that dealing with the backlog of cases, while continuing to address complaints unrelated to BI policies presents the FOS with an unprecedented challenge. Allay Claims Ltd. This FCA authorised firm that fraudsters are claiming to work for has no association with the ‘clone firm’. Claims could therefore make their way into county Courts and High Courts up and down the country. It remains to be seen whether HMRC and/or policyholders will have the appetite to pursue this issue with insurers now that the immediate issues presented by coronavirus have been addressed and the focus shifts to the more medium to long term challenges in its aftermath. In support of the latter position, the FCA relied on the Silver Cloud as authority that a policyholder is entitled to an indemnity where its loss was caused by an insured peril and a concurrent uninsured peril of equal efficacy. These assurances, while caveated, may unhelpfully have raised many policyholders’ expectations of having claims paid when they did not in fact have a valid claim on any view, irrespective of the issues in the test case. The legal uncertainty had to be resolved urgently, for the sake of policyholders and to preserve the reputation of the insurance industry. Of particular interest would be guidance on how to discern the insured peril when construing a complex insuring clause. Allay handled three claims for me. He said: “This decision is great news for consumers and we hope that this is the first step towards an acceptance that it is entirely unacceptable to put an end date on PPI claims. Having waited for the first instance decision, it would seem unlikely that the FOS would resume its assessment of complaints in circumstances where any central issues that would feature in its decision-making process were the subject of an appeal. Other issues, such as the imposition of local lockdowns, complicate the landscape still further. The interests of these other stakeholders are diminished when invalid claims are paid. Pandemic cover was incredibly scarce and largely unavailable outside of the US prior to the outbreak of coronavirus and only a small minority of businesses had obtained such cover, most probably due to pricing and/or the perception that the risk of a pandemic was remote in modern times. FRN: 838865. The focus has to some extent shifted to the question of how the government, businesses and insurers can be better prepared for the next pandemic (having considered it unlikely or not even having contemplated at all that a pandemic would occur most people now believe that more will follow). 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