For the latest information and resources on Coronavirus, please visit the RCM&D COVID-19 Resource Center at https://info.rcmd.com/covid19.
The coronavirus outbreak (COVID-19) brings about much concern and uncertainty. Of particular concern may be the financial impact and economic consequences that may be imposed on businesses.
We are in the early stages of the coronavirus pandemic. It is a very fluid and ever-changing environment. As a result, it is difficult to know what the full impact of these circumstances may present in time to come. With potential widespread illness and financial losses, questions are sure to arise concerning the possible role of insurance to mitigate the damages and/or to provide relief for such losses. While insurance policies vary for each line of business, the coverage provided by each policy also differs. There are exclusions in policies that may or may not address issues related to COVID-19. Likewise, insurance carriers’ interpretation of coverage often differs as well. At this time, we do not know what coverage decisions will be made by carriers in response to losses related to COVID-19, so we offer the following information as a general overview of the various insurance coverages and how they traditionally respond. But again, because states are now proposing legislative changes we cannot anticipate how these changes may impact your specific insurance coverage at this time.
Workers’ Compensation coverage is statutorily driven, meaning that each State has their own rules and regulations in determining whether or not a claim is compensable or not It is possible that the coronavirus could be treated like any other occupational disease under workers’ compensation, however, an injury/occupational disease typically has to arise out of the course and scope of employment, and generally speaking there is a requirement that the employee be able to establish that the exposure to the disease took place at work, or that they worked in a setting where exposure to the disease is inherent in the workplace. With the spread of this particular virus, it may be impossible to establish how or when a person contracted the disease. In Maryland and the District of Columbia, there is the possibility to see a compensable claim in a situation where an employee works in a healthcare setting and can prove a specific transmission and exposure to a patient diagnosed with coronavirus. However, it will likely be more challenging for an employee to show compensability merely because they work with a coworker who was diagnosed with the virus. In the State of Virginia, the injured worker must meet specific criteria in order to have a compensable occupational disease claim. Under these circumstances, it would be wise to report any situation where an employee is diagnosed as being positive for the Coronavirus and alleges that their exposure arose out of their work environment.
Example of a Non-Covered Claim: During a measles outbreak, an onsite administrative support employee noticed symptoms while at work. Employee was later diagnosed with measles and workers’ compensation benefits were denied because there was no link to employment. As a result, the infected employee put other employees at risk by bringing the disease to the workplace. The other employees’ measles-related workers’ compensation claims were not covered either because it was found those employees had not been put in a position of greater risk than that of the general public.
Foreign Voluntary Workers’ Compensation
Policies typically provide state or country-of-hire benefits for employees working outside of their home country, covering bodily injury by accident or disease (including endemic disease) when arising out of and in the course and scope of employment. Policies also frequently include repatriation coverage in the event an employee needs to be evacuated from any country. Majority of these policies offer a global medical assistance hot-line helping extract your employees from potential hot-spot regions.
When and Where Does this Coverage Apply:
- Short-term business travel for covered employees.
- Long-term assignment outside of the United States for covered employees.
- Travel outside the country of origin (the U.S. or another country) for covered employees.
We are in unchartered territory in the United States and internationally. If you believe that you may have a claim, or circumstance that could lead to a claim, we continue to recommend that you report all claims or potential claims to their appropriate carriers per the instructions provided in your Claim Reporting Manuals. While there may be exclusions in your insurance policies that could apply, as circumstances continue to change, we are starting to see States proposing new legislation surrounding various exclusions.
Be assured that RCM&D strives to advocate on behalf of every client. When coverage is denied or disputed, our team will assist in evaluating the carrier’s position against the policy language. Every effort is made in assisting our clients with negative coverage determinations. We will continue in that regard as well to COVID-19 related claims. Any valid and appropriate argument will be considered to advocate on behalf of our clients when coverage is disputed.
RCM&D is making every effort to anticipate our clients’ questions and concerns during these ever rapidly changing times. If there are any questions, or if further assistance is needed with the claim process, please let us know.