What is business protection, and which businesses need it?

Regulator

Financial Conduct Authority[1]

Disclosure duty

Fair presentation[7]

Directors’ duty

Companies Act 2006, s172[13]

Complaints route

Financial Ombudsman[5]

What the contract actually does

Business and group protection are insurance contracts bought by a company rather than by an individual. In exchange for the premiumPremiumWhat you pay the insurer, monthly or annually, to keep the policy in force., the insurer agrees to pay a defined benefit when a defined event happens to a named person or a member of a scheme: death, a defined critical illness, or incapacity that stops someone working. What separates these products from personal cover is the plumbing around them — who owns the policy, who pays the premium, where the money lands, and which agreement or trust directs it afterwards. Get that plumbing wrong and a policy can pay the right amount to the wrong party. Before the cover starts, the FCA’s conduct rules require the insurer to provide pre-contract information and the full policy wordingPolicy wordingThe full contract document that decides what is and is not covered.. [3]Financial Conduct AuthorityAccessed 15 September 2026

Two structural points shape everything else. First, the company is usually the customer, so the commercial rules apply: the fair-presentation duty under the Insurance Act 2015 rather than the consumer duty of reasonable care. [7]UK Parliament (legislation.gov.uk)Enacted 12 February 2015 Second, the money has a job. Key person cover replaces lost trading income, death in serviceDeath in serviceA lump sum paid to an employee’s family if they die while employed, funded by the employer. cover supports an employee’s family, shareholder protection funds a change of ownership, and loan protection clears borrowing. Directors making these decisions are exercising their duty to promote the success of the company. [13]UK Parliament (legislation.gov.uk)Enacted 8 November 2006 This guide stays on business protection.

How a claim works

A claim starts when the company, the scheme administrator or the family notifies the insurer. The insurer then checks three things: that the person was covered on the date of the event, that the event meets the written definition in the scheme or policy, and that the evidence supports it. On group income protection, that means medical evidence tested against the scheme’s incapacity definitionIncapacity definitionThe policy clause that sets the test of being unable to work that a claim must pass. and against the deferred periodDeferred periodThe waiting time between stopping work and the first income protection payment. — usually far longer on a group scheme than on a personal policy. The Financial Ombudsman Service’s published group income protection decisions show all three tests in practice: one claim declined because the medical evidence did not support incapacity for the insured occupation, though the insurer was criticised on claims handling and £150 compensation recommended; one declined where a work-related-stress exclusion applied and the evidence did not show total incapacity through a 26-week deferred period; and one turning on the exact wording of an own-occupation definition where a return on reduced hours was supported. [19]Financial Ombudsman ServiceAccessed 15 September 2026[20]Financial Ombudsman ServiceAccessed 15 September 2026[21]Financial Ombudsman ServiceAccessed 15 September 2026 This guide discusses illness only as it relates to cover and claims — for anything clinical, see the NHS.

Your disclosure rights

Commercial insurance carries a different disclosure duty from personal cover. The Insurance Act 2015 requires a business buyer to make a fair presentation of the risk: to disclose every material circumstance it knows or ought to know, in a reasonably clear and accessible way, and the insurer’s remedies for a breach are proportionate to what it would have done had it known. [7]UK Parliament (legislation.gov.uk)Enacted 12 February 2015 In practice that means the company’s knowledge — what the directors and senior management know, and what a reasonable search of the business would have found — is the standard, not one person’s memory. Where an individual employee answers medical questions for their own cover under a scheme or a relevant life plan, the consumer duty to take reasonable care answering questions applies to those answers. [6]UK Parliament (legislation.gov.uk)Enacted 8 March 2012

Alongside the statutes, the FCA’s conduct rules require insurers to handle claims promptly and fairly and not to reject them unreasonably — the rule the Ombudsman quotes when deciding group protection disputes. [3]Financial Conduct AuthorityAccessed 15 September 2026[20]Financial Ombudsman ServiceAccessed 15 September 2026 The Consumer Duty applies to retail customers and, importantly for small companies, many micro-enterprises and small businesses can still bring a complaint to the Financial Ombudsman Service. [4]Financial Conduct AuthorityAccessed 15 September 2026[5]Financial Ombudsman Service2 July 2025 Check that any insurer, adviser or broker you deal with is authorised on the Financial Services Register. [2]Financial Conduct AuthorityContinuously updated; accessed 15 September 2026

Four questions that choose the product

Business protection only makes sense when you start from the damage, not the product list. Ask four questions in order. What would stop working if this person were gone tomorrow — sales, delivery, the banking relationship, the licence to operate? That points to key person cover, sized to lost profit and the cost of replacing the person. What happens to their shares — would the family want to sell, would the survivors want to buy, and with what money? That points to shareholder or partnership protection with a cross-option agreement. What debt would fall due, and does the lender have a personal guarantee or a covenant that bites on death or serious illness? That points to business loan protection. And what has the business promised its employees — a death-in-service benefit, sick pay beyond the statutory minimum, a health benefit? That points to group cover. Most businesses need more than one of the four, and the answers change as the company grows.

Write the four answers down at board level with dates, attach the current shareholdings and loan balances, and treat the document as the thing you review each year rather than the policies themselves. Whatever the specifics of business protection, the discipline that protects the business is always the same: record who owns the policy, who receives the money and which agreement directs it; get the insurer’s and the accountant’s position in writing; and review the arrangement whenever the people, the shareholdings or the borrowing change.

What moves the price

Premiums on business and group protection are built from the same ingredients as personal cover, plus a few of their own. For single-life business policies — key person, shareholder protection, relevant life, executive income protection — the price follows the individual’s age, health, smoking status and occupation, the sum assured or monthly benefit, the term, and any deferred period. For group schemes the insurer prices the whole population instead: the number of members, the age profile, the mix of occupations, the total salary roll, the benefit design and the scheme’s own claims history. Larger schemes are usually rated on that population rather than on individual medical questions, up to a free cover limitFree cover limitThe level of group scheme benefit an insurer will cover without individual medical underwriting. above which individual underwriting applies. Because those limits and scheme minimums vary by insurer and move with market conditions, we do not publish market-wide figures.

Two levers matter more than shopping around. The first is design: on group income protection, a longer deferred period and a limited benefit period — say five years per claim rather than payment to retirement — change the price materially, because they cap the insurer’s exposure. The second is tax: whether premiums are deductible, and whether a pay-out is taxable, can move the real cost far more than a small difference in quoted rate, which is why HMRC’s purpose test belongs in the conversation from the start. [8]HM Revenue & CustomsAccessed 15 September 2026[10]HM Revenue & CustomsAccessed 15 September 2026 Pay-out statistics are the counterweight to price: ABI and GRiD data shows 97.9 per cent of individual protection claims were paid in 2024 and again in 2025. [17]Association of British Insurers and GRiD, reported by Cover MagazineAccessed 15 September 2026[18]Association of British Insurers and GRiD, reported by Cover MagazineAccessed 15 September 2026

How to compare two quotes

• Fix the cover first: the amount, the term and whether premiums are guaranteed or reviewable.
• Ask for each quote in writing, with its date.
• Put the quotes side by side and mark every difference in terms before you look at price.
• Ask whether any exclusion or price increase was added because of your health answers.

If something goes wrong

If a claim is declined, delayed, or continuing benefit is stopped, complain to the insurer in writing first, and ask two precise questions: which clause of the scheme rules or policy wording the decision rests on, and exactly which evidence failed that clause. The insurer must investigate and give a final response. If the business is a micro-enterprise or small business — or where the complaint is brought by an employee or their family — the Financial Ombudsman Service can then decide the dispute free of charge, and its published group protection decisions show it awarding compensation for poor claims handling even where the underlying decline was fair. [5]Financial Ombudsman Service2 July 2025[19]Financial Ombudsman ServiceAccessed 15 September 2026 Larger companies outside the Ombudsman’s scope are left with the insurer’s process and, ultimately, the courts, which is one more reason to have the definitions and the ownership confirmed in writing before a claim ever arises. For the wider picture, read who regulates insurance in the UK.

1. 1

   Step 1: Decide what the money is for

   Lost profit, a share purchase, a loan repayment or a family benefit — each needs a different structure.

2. 2

   Step 2: Fix ownership and beneficiaries

   Record who owns the policy, who pays the premium and who receives the pay-out, in writing.

3. 3

   Step 3: Get the tax position in writing

   Ask your accountant to confirm deductibility and the treatment of the pay-out before the policy starts.

4. 4

   Step 4: Make a fair presentation of the risk

   Commercial cover requires disclosure of what the business knows or ought to know after a reasonable search.

5. 5

   Step 5: Read the definitions, not the brochure

   Incapacity definitions, deferred periods and exclusions decide claims on group schemes.

6. 6

   Step 6: Review after every change

   New shareholders, new borrowing, new headcount or a new salary roll all move the right answer.

Business protection, sick pay and the safety net

Business and group protection sits on top of statutory obligations the company already has. An employer must pay Statutory Sick Pay to eligible employees — £123.25 a week at the time of writing, for up to 28 weeks — and the employer guide sets out the qualifying rules and record-keeping. [14]GOV.UKAccessed 15 September 2026[15]GOV.UKAccessed 15 September 2026 Many employers add contractual sick pay on top, and a group income protection scheme is usually designed so its deferred period begins where that contractual sick pay ends. Health-related benefits the company provides also have their own tax reporting rules. [16]GOV.UKAccessed 15 September 2026 The individual products are complementary, not interchangeable: income protection replaces the monthly pay packet, critical illness cover pays a lump sum for defined conditions, and life insurance pays others after death. The group and business versions do the same jobs, with a company in the middle.

Written by

Stuart Hendy

PMI Expert and Head of Publishing, PremierPMI

• 20 years in UK private medical insurance
• Underwriting and corporate placement specialist

Stuart brings over 20 years of experience advising on UK private medical insurance. He is a key member of the private medical insurance team and Head of the Publishing Team, gathering detailed client requirements, liaising with insurers on tailored quotes, and running training on insurer product changes and underwriting nuance.

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Reviewed by

Emma Leadbetter

Editor and Copywriter, PremierPMI

• 15 years health, finance and consumer journalism
• PhD candidate, University of Chichester

Emma has written across health, finance and consumer-affairs journalism for more than 15 years, and has been part of the PremierPMI team since 2022. She is known for making complex topics easy to understand, and fact-checks every guide against current insurer wording before it goes live. She is completing a PhD at the University of Chichester researching how the NHS has changed since COVID-19.

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