COVID-19 paperwork with a stethoscope on top

    What to know about coronavirus-related insurance claims

    Authored by Bukaty Companies on March 23, 2020

    The coronavirus outbreak continues to impact day-to-day business, and employers are seeking clarity on coronavirus-related insurance claims. Below, we have outlined basic guidance regarding coronavirus for workers’ compensation, business income insurance and health insurance.

    Workers’ compensation 
    Two tests must be satisfied before any illness or disease, including coronavirus, qualifies as occupational and thus compensable under workers’ compensation:

    1. The illness or disease must be “occupational,” meaning that it arose out of and was in the course and scope of employment.
    2. The illness or disease must arise out of or be caused by conditions “peculiar” to the work.

    Whether an illness qualifies as occupational is subject to interpretation. An illness or disease is “peculiar” to the work when the ailment is found almost exclusively in workers of a defined industry, or unique working conditions.

    Bukaty's Property & Casualty division believes the coronavirus does not meet these tests at this time, but each situation must be reviewed separately. Employees have the right to report any work-related injuries to their employer. Employers are responsible for reporting that information to their state’s Division of Workers’ Compensation and their workers’ compensation insurance carrier.

    Your insurance carrier will determine if a claim is compensable. If an employee disagrees with the carrier’s decision, they have redress through the Workers’ Compensation Division and the courts.

    Business income insurance

    Business income insurance traditionally pays lost income claims due to a disruption of business resulting from physical damage to insured property such as buildings, contents and equipment. While there may be exceptions, most insurance policies exclude business disruption losses due to diseases, including coronavirus.

    The coronavirus has quickly impacted our economy. In response, government regulators are issuing extraordinary measures. In the aftermath of Hurricane Katrina, insurance carriers were forced by the courts to pay claims that had previously been denied. Bukaty's Property & Casualty division encourages clients to report any circumstance which might give rise to a claim.

    Health insurance

    As coronavirus cases grow, health insurance carriers have been releasing carrier-specific provisions to protect members. Bukaty is awaiting additional guidance from carriers following the recently issued Families First Coronavirus Response Act, which ensures free coronavirus testing. Stay updated by signing up for our emails and checking our Bulletins page. 

    We will continue to update our clients with any new information.

    Blog Category: Insurance