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Frankreich
France – COVID19 and Insurance in case of Business Interruption
23 April 2020
- Versicherung
The current situation in Europe and in France in particular has emerged as a major concern for most businesses. The order of governmental authorities to suspend “non-essential” activities has generated business interruption and consequently strongly hit the businesses. The debate is harsh in France on whether insurance companies should cover their insureds’ losses.
Business Interruption (“BI”) coverage (in French “pertes d’exploitation”) is most often included in property insurance contracts. The coverage is usually triggered when the insured’s business is interrupted by a physical damage to the insured’s property. Contamination which spreads to become pandemic does not correspond to a physical damage.
In order to be covered the business should be affected in itself by a physical damage, for instance if a listeria bacteria affects the premises and renders them unusable for the business (one can imagine a food industry plant where sanitary and hygienic constraints are very stringent): in this example, one could most probably consider that there is a physical damage, which is the cause of the BI. However, if the BI is caused by a disease which affects employees to the extent that the business must be interrupted, it is doubtful that it would be covered, considering that the BI is a part of property insurance, which means that the BI is covered provided it is a consequence of a damage affecting the property of the insured (not his employees).
One should consider thoroughly each insurance policy on a case by case basis. Some policies include BI coverage without a physical damage (in French: “sinistre sans dommage”), for instance in case of a “denial of access” due to a physical damage in the “vicinity” of the insured premises, and not in the premises themselves, or if the denial of access is the result of an order of governmental authorities (as is currently the case in relation to COVID 19).
Based on this kind of policies, a court case has been recently initiated before French Courts against AXA by an insured party (source: BFM Business), whereas other insurers (like BPCE) have been reported to accept in principle that these kind of policies could be triggered. Even in this situation, lots of policies provide for exclusion of indemnification in case of pandemic due to viruses.
AXA’s defence against this action, as we know it, is not based on an exclusion clause, but on fundamental principles of insurance, in particular that the coverage should be admitted only when the cause of interruption is not systemic, i.e. It does not impact all the companies or businesses in one or several countries (or around the world as in the situation we are currently facing) but only some of them in specific places and due to specific events. The reason is that insurance’s function is to mutualise risks. This principle would be flouted if insurance could be triggered in systemic situations. According to Laurent Granier, CEO of GENERALI in France, admitting systemic events such as the COVID 19 pandemic in property insurance would use up equity capital of all insurance companies in France (source: Argus de l’Assurance, 9 April 2020).
Participation of insurance companies in systemic risks is an exception. Therefore, it does not stem from the contracts but from legal dispositions. An example is given in the event of natural disasters. Article L125-1 of the French Insurance Code stipulates that if an insurance policy covers BI, this cover is extended to natural disasters, provided the event is recognized as such by a decision of the governmental authorities. This example of a systemic risk covered by insurance shows that the coverage does depend on a decision taken by state authorities. From an insurance standpoint, the systemic nature of the event justifies that the government should assess if the insurance sector must be mobilized to cover it, precisely because it is not the purpose of insurance to cover systemic risks. This is why this specific risk is financed by a specific premium, which is added to the standard premium, and a percentage of the premiums are paid by insurers to a special fund set up by the State, which acts as a “last resort insurer” for systemic risks.
From the French perspective again, it is worth noting that there is little of not no doubt that sanitary disasters do not fall within the definition of natural disasters as defined in article L125-1 of the Insurance Code. There are currently discussions going on between the government and insurers to set up a legal regime for pandemics similar to the one for natural disasters, which would be financed by a supplementary premium, the whole system being guaranteed by the State in last resort.
Are insurers liable for breach of the GDPR on account of their appointed intermediaries?
Insurers acting out of their traditional borders through a local intermediary should choose carefully their intermediaries when distributing insurance products, and use any means at their disposal to control them properly. Distribution of insurance products through an intermediary can be a fast way to distribute insurance products and enter a territory with a minimum of investments. However, it implies a strict control of the intermediary’s activities.
The reason is that Insurers in FOS can be held jointly liable with the intermediary if this one violates personal data regulation and its obligations as set by the GDPR (Regulation 2016/679 of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data).
In a decision dated 18 July 2019 , the CNIL (Commission Nationale Informatique et Libertés), the French authority in charge of personal data protection rendered a decision against ACTIVE ASSURANCE, a French intermediary, for several breaches of the GDPR. The intermediary was found guilty and fined EUR 180,000 for failing to properly protect the personal data of its clients. Those were found easily accessible on the web by any technician well versed in data processing. Moreover, the personal access codes of the clients were too simple and therefore easily accessible by third parties.
Although in this particular case insurers were not fined by the CNIL, the GDPR considers that they can be jointly liable with the intermediary in case of breach of personal data. In particular, the controller is liable for any acts of the processor he has appointed, this one being considered as a sub-contractor (clauses 24 and 28 of the GDPR).
This illustrates the risks to distribute insurance products through an intermediary without controlling its activities. Acting through intermediaries, in particular for insurance companies acting from foreign EU countries in FOS under the EU Directive on freedom of insurance services (Directive 2016/97 of 20 January 2016 on insurance distribution) requires a strict control through enacting contractual dispositions whereas are defined:
- a clear distribution of the duties between insurer and distributor (who is controller/joint controller/processor ?) as regards technical means used for protecting personal data (who shall do/control what ?) and legal requirements (who must report to the authorities in case of breach of security/ who shall reply to requests from data owners?, etc.);
- the right of the insurer to audit the distributors’ technical means used for this protection at any time during the term of the contract. In addition to this, one should always keep in mind that this audit should be conducted efficiently by the insurer at regular times. As Napoleon rightly said: “You can govern from afar, but you can only administer closely”.
Are arbitration and jurisdiction clauses contained in insurance contracts enforceable against a third party which is acting directly against the insurer in third party liability insurances?
Such direct action is admitted by French law in liability insurances, as defined in article 124-3 of the Insurance Code.
In just a few months two radically different approaches have been taken by the French Cour de cassation (Civ.1, 19 December 2018, n°17-28.951) and the ECJ in Assens Havn v. Navigator Management UK Ltd (13 July 2017, C-368/16) and KABEG v. MMA IARD (20 July 2017, C-340/16).
The case submitted to the Cour de cassation represented a third party exercising a direct right of action before French Courts against the insurer of a floating barge which had caused him a damage. The Supreme Court accepted that the insurer could validly oppose the arbitration clause, which was in the policy against the third party, and therefore judged that French Court had no jurisdiction to decide on the case. The Supreme Court applied the well-established principle of Compétence-Compétence – materialized in article 1448 of the French Code de Procédure Civile – to stay the case, considering that the arbitration clause could not be set aside. The Court therefore judged that the applicability of the arbitration clause should be determined by the arbitrators by priority.
A year before, the ECJ had ruled in the opposite direction in a case where a jurisdiction clause was applicable in the insurance policy. In Assens Havn v. Navigator Management UK Ltd, the ECJ stated that the clause could not be opposed to the third party acting directly against the insurer. According to the Court, the insurers’ liability towards the insured has a contractual nature when based on the policy, whereas it is extra-contractual when the liability is based on a direct action from a third party. In a previous ruling the Court had considered (Sté financière et industrielle du Peloux (12 May 2005, C-112/03) that the jurisdiction clause cannot be opposed to the beneficiary of an insurance policy if he is not the policyholder (for instance in a collective insurance).
One sees a clear difference in treatment between arbitration clause and jurisdiction clause when it comes to deciding on their opposability to the victim exercising a direct action against the insurer.
Article 2061 paragraph 2 of the Civil Code states that an arbitration cannot be opposed to a party which has not contracted for the purpose of its business activity. The French Cour de cassation grounded its decision on the fact that the clauses of the main contract could be opposed to the third party. If the latter was entitled to apply the insurance contract, it was therefore entitled to invoke article 2061 paragraph 2 of the Civil Code.
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Insurance in FOS (Freedom of Service) – Joint liability with intermediaries for violation of GDPR
26 November 2019
- Vertrieb
- Versicherung
- Privatsphäre - Datenschutz
The current situation in Europe and in France in particular has emerged as a major concern for most businesses. The order of governmental authorities to suspend “non-essential” activities has generated business interruption and consequently strongly hit the businesses. The debate is harsh in France on whether insurance companies should cover their insureds’ losses.
Business Interruption (“BI”) coverage (in French “pertes d’exploitation”) is most often included in property insurance contracts. The coverage is usually triggered when the insured’s business is interrupted by a physical damage to the insured’s property. Contamination which spreads to become pandemic does not correspond to a physical damage.
In order to be covered the business should be affected in itself by a physical damage, for instance if a listeria bacteria affects the premises and renders them unusable for the business (one can imagine a food industry plant where sanitary and hygienic constraints are very stringent): in this example, one could most probably consider that there is a physical damage, which is the cause of the BI. However, if the BI is caused by a disease which affects employees to the extent that the business must be interrupted, it is doubtful that it would be covered, considering that the BI is a part of property insurance, which means that the BI is covered provided it is a consequence of a damage affecting the property of the insured (not his employees).
One should consider thoroughly each insurance policy on a case by case basis. Some policies include BI coverage without a physical damage (in French: “sinistre sans dommage”), for instance in case of a “denial of access” due to a physical damage in the “vicinity” of the insured premises, and not in the premises themselves, or if the denial of access is the result of an order of governmental authorities (as is currently the case in relation to COVID 19).
Based on this kind of policies, a court case has been recently initiated before French Courts against AXA by an insured party (source: BFM Business), whereas other insurers (like BPCE) have been reported to accept in principle that these kind of policies could be triggered. Even in this situation, lots of policies provide for exclusion of indemnification in case of pandemic due to viruses.
AXA’s defence against this action, as we know it, is not based on an exclusion clause, but on fundamental principles of insurance, in particular that the coverage should be admitted only when the cause of interruption is not systemic, i.e. It does not impact all the companies or businesses in one or several countries (or around the world as in the situation we are currently facing) but only some of them in specific places and due to specific events. The reason is that insurance’s function is to mutualise risks. This principle would be flouted if insurance could be triggered in systemic situations. According to Laurent Granier, CEO of GENERALI in France, admitting systemic events such as the COVID 19 pandemic in property insurance would use up equity capital of all insurance companies in France (source: Argus de l’Assurance, 9 April 2020).
Participation of insurance companies in systemic risks is an exception. Therefore, it does not stem from the contracts but from legal dispositions. An example is given in the event of natural disasters. Article L125-1 of the French Insurance Code stipulates that if an insurance policy covers BI, this cover is extended to natural disasters, provided the event is recognized as such by a decision of the governmental authorities. This example of a systemic risk covered by insurance shows that the coverage does depend on a decision taken by state authorities. From an insurance standpoint, the systemic nature of the event justifies that the government should assess if the insurance sector must be mobilized to cover it, precisely because it is not the purpose of insurance to cover systemic risks. This is why this specific risk is financed by a specific premium, which is added to the standard premium, and a percentage of the premiums are paid by insurers to a special fund set up by the State, which acts as a “last resort insurer” for systemic risks.
From the French perspective again, it is worth noting that there is little of not no doubt that sanitary disasters do not fall within the definition of natural disasters as defined in article L125-1 of the Insurance Code. There are currently discussions going on between the government and insurers to set up a legal regime for pandemics similar to the one for natural disasters, which would be financed by a supplementary premium, the whole system being guaranteed by the State in last resort.
Are insurers liable for breach of the GDPR on account of their appointed intermediaries?
Insurers acting out of their traditional borders through a local intermediary should choose carefully their intermediaries when distributing insurance products, and use any means at their disposal to control them properly. Distribution of insurance products through an intermediary can be a fast way to distribute insurance products and enter a territory with a minimum of investments. However, it implies a strict control of the intermediary’s activities.
The reason is that Insurers in FOS can be held jointly liable with the intermediary if this one violates personal data regulation and its obligations as set by the GDPR (Regulation 2016/679 of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data).
In a decision dated 18 July 2019 , the CNIL (Commission Nationale Informatique et Libertés), the French authority in charge of personal data protection rendered a decision against ACTIVE ASSURANCE, a French intermediary, for several breaches of the GDPR. The intermediary was found guilty and fined EUR 180,000 for failing to properly protect the personal data of its clients. Those were found easily accessible on the web by any technician well versed in data processing. Moreover, the personal access codes of the clients were too simple and therefore easily accessible by third parties.
Although in this particular case insurers were not fined by the CNIL, the GDPR considers that they can be jointly liable with the intermediary in case of breach of personal data. In particular, the controller is liable for any acts of the processor he has appointed, this one being considered as a sub-contractor (clauses 24 and 28 of the GDPR).
This illustrates the risks to distribute insurance products through an intermediary without controlling its activities. Acting through intermediaries, in particular for insurance companies acting from foreign EU countries in FOS under the EU Directive on freedom of insurance services (Directive 2016/97 of 20 January 2016 on insurance distribution) requires a strict control through enacting contractual dispositions whereas are defined:
- a clear distribution of the duties between insurer and distributor (who is controller/joint controller/processor ?) as regards technical means used for protecting personal data (who shall do/control what ?) and legal requirements (who must report to the authorities in case of breach of security/ who shall reply to requests from data owners?, etc.);
- the right of the insurer to audit the distributors’ technical means used for this protection at any time during the term of the contract. In addition to this, one should always keep in mind that this audit should be conducted efficiently by the insurer at regular times. As Napoleon rightly said: “You can govern from afar, but you can only administer closely”.
Are arbitration and jurisdiction clauses contained in insurance contracts enforceable against a third party which is acting directly against the insurer in third party liability insurances?
Such direct action is admitted by French law in liability insurances, as defined in article 124-3 of the Insurance Code.
In just a few months two radically different approaches have been taken by the French Cour de cassation (Civ.1, 19 December 2018, n°17-28.951) and the ECJ in Assens Havn v. Navigator Management UK Ltd (13 July 2017, C-368/16) and KABEG v. MMA IARD (20 July 2017, C-340/16).
The case submitted to the Cour de cassation represented a third party exercising a direct right of action before French Courts against the insurer of a floating barge which had caused him a damage. The Supreme Court accepted that the insurer could validly oppose the arbitration clause, which was in the policy against the third party, and therefore judged that French Court had no jurisdiction to decide on the case. The Supreme Court applied the well-established principle of Compétence-Compétence – materialized in article 1448 of the French Code de Procédure Civile – to stay the case, considering that the arbitration clause could not be set aside. The Court therefore judged that the applicability of the arbitration clause should be determined by the arbitrators by priority.
A year before, the ECJ had ruled in the opposite direction in a case where a jurisdiction clause was applicable in the insurance policy. In Assens Havn v. Navigator Management UK Ltd, the ECJ stated that the clause could not be opposed to the third party acting directly against the insurer. According to the Court, the insurers’ liability towards the insured has a contractual nature when based on the policy, whereas it is extra-contractual when the liability is based on a direct action from a third party. In a previous ruling the Court had considered (Sté financière et industrielle du Peloux (12 May 2005, C-112/03) that the jurisdiction clause cannot be opposed to the beneficiary of an insurance policy if he is not the policyholder (for instance in a collective insurance).
One sees a clear difference in treatment between arbitration clause and jurisdiction clause when it comes to deciding on their opposability to the victim exercising a direct action against the insurer.
Article 2061 paragraph 2 of the Civil Code states that an arbitration cannot be opposed to a party which has not contracted for the purpose of its business activity. The French Cour de cassation grounded its decision on the fact that the clauses of the main contract could be opposed to the third party. If the latter was entitled to apply the insurance contract, it was therefore entitled to invoke article 2061 paragraph 2 of the Civil Code.