Insurers 0, customers 3: the balance tips against insurers once again on another lockdown claim



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All the decisions of the Court on cases of claims for business interruption have been in favor of the clients.

All the decisions of the Court on cases of claims for business interruption have been in favor of the clients.

Guardrisk has lost another lockdown claim case, this time against a popular Woodstock restaurant, the Fat Cactus Cafe.

The second blow comes when Momentum-owned Guardrisk must present its case to the Supreme Court of Appeals over why it refuses to pay business interruption claims caused by the closure. The Western Cape Superior Court, the same court that ruled against Guardrisk in the Café Chameleon case, is also the one that ruled against Santam. His stance is consistent: the loss of revenue caused by the lockdown would not have occurred had there been no Covid-19.

“This court has recently considered the proper interpretation of the same sickness clause … I am bound by that decision unless I find it distinguishable,” the ruling reads, citing the Café Chameleon case and the Ma-Afrika Hotels victory. and Stellenbosch Kitchens v. Santam that both insurers are appealing.

The Court said that Guardrisk has admitted that Covid-19 is a notifiable disease, the presence of which triggers a business interruption insurance claim event.

Additionally, it was not mentioned in the policy that the government’s response to a reportable illness, which in this case was a lockdown, was excluded from the business interruption coverage.

Additionally, positive cases of Covid-19 were identified within the 50km radius of the restaurant, as required by Guardrisk policy for policyholders to have a successful claim.

The Court noted that the National Health Law recognized that a notifiable disease “may require immediate, appropriate and specific action on the part of the national government,” among other things.

For this and other technical reasons based on the wording of the insurer’s policy, the Court said Guardrisk was responsible for paying the Fat Cactus claim and was also ordered to pay the restaurant costs.

“The defendant is ordered to make payments in respect of losses that applicants can calculate and quantify from time to time,” the order said, leaving Guardrisk’s liability amount open.

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