Category Archives: Health & Safety

Is COVID-19 covered by disability insurance?

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Many people are wondering if disability insurance will cover them if they come down with COVID-19. The answer, as is often the case, is a qualified yes.

There are basically three types of disability income insurance: Employer-paid disability insurance, Social Security disability benefits and individual disability income insurance policies.

Short-term disability insurance may cover coronavirus if your illness requires medical quarantine that leaves you unable to complete your work.

For disability coverage to apply “there has to be a medical reason you can’t work” according to Nicholas Mancuso, manager of the disability and advanced planning team at Policygenius. Social quarantines, such as when states mandate that people work from home, do not qualify you for disability benefits.

Some survivors of COVID-19 are reporting lingering symptoms, including fatigue, joint pain, and shortness of breath. These people may be eligible for long-term disability.

“It’s generally more difficult to qualify for long-term disability benefits with the coronavirus because of elimination periods for long-term policies,” said Mancuso.

The elimination period of a disability insurance policy is how long you must be unable to work — for medical reasons — before you can start receiving benefits. Long-term disability policies have elimination periods of at least 90 days.

Employer-paid disability insurance is required in most states, and so is the most common. Most employers provide some short-term sick leave. Many larger employers provide short-term and long-term disability coverage as well, typically with benefits of up to 60 percent of salary lasting from five years to age 65. In some cases, long-term disability insurance is extended for life. Disability benefits from employer paid policies are subject to income tax.

However, individual disability income insurance policies are the best way to ensure adequate income in the event of disability for most workers, even those with some employer-paid coverage. When you buy a private disability income policy, you can expect to replace from 50 percent to 70 percent of income. Insurers won’t replace all your income because they want you to have an incentive to return to work. However, when you pay the premiums yourself, disability benefits are not taxed.

But unfortunately not many people have individual disability income insurance. More than half of U.S. workers forego disability coverage, according to a recent study. And baby boomers, who are more likely to get injured or sick, are even more likely to forego the coverage (7 out of 10).

If you are 40 years old, you have about a 40 percent chance that between now and age 65 you’ll be disabled for 90 days or more for any reason. Injury accounts for 10-15 percent of the reasons why people have long-term disability. Illness is the other 85-90 percent. And if you are disabled for 90 days or more, there is about a 50 percent chance that you’ll continue to be disabled for up to two years, according to Triple-I’s chief economist Dr. Steven Weisbart.

Wrap-up: COVID-19
and Workers Comp

Lauded for their service and hailed as heroes, essential workers who become infected with the coronavirus on the job have no guarantee in most states that they’ll qualify for workers compensation to cover lost wages and medical care, Associated Press reports

Fewer than one-third of the states have enacted policies that shift the burden of proof for coverage of job-related COVID-19 so workers like first responders and nurses don’t have to show they got sick by reporting for a risky assignment. 

And for most employees going back to job sites as the economy reopens, there’s even less protection than for essential workers. In nearly all states, they have to prove they got the virus on the job to qualify for workers comp. 

Workers comp is not health insurance, or an unemployment benefit. In exchange for coverage, workers give up the right to sue their employers for job-related harms. Employers pay premiums to support the system. Complex rules differ from state to state. 

Dealing with job-related injuries is fairly straightforward, but diseases have always been trickier for workers’ comp, and COVID-19 seems to be in a class of its own. 

“You don’t know per se where you inhaled that breath whereby you became infected,” said Bill Smith, president of the Workers’ Injury Law & Advocacy Group, a professional association of lawyers representing workers.  

Read more: 

Families of health workers killed by COVID-19 fight for denied workers comp benefits (Philadelphia Inquirer, July 16, 2020) 

Workers comp in the new world of the COVID-19 pandemic (Law.com, July 16, 2020) 

Report: Sharp drop in California workers’ comp premiums expected from COVID-19 (Insurance Journal, July 14, 2020) 

Gauging Pandemic’s Impact on Insurers

While COVID-19’s impact on the insurance industry will require time to fully understand, litigation, legislation, and concerns about pricing and policy language will be with us for some time to come.

“Significant” changes in policy language seen

The majority of respondents to an Artemis re/insurance market survey believe the COVID-19 pandemic will result in “significant changes” to business interruption (BI) policy wordings.

In fact,  the U.K. Financial Conduct Authority (FCA) is conducting a review focused on obtaining legal clarity on policies connected to the pandemic and which claims are valid and which aren’t.

FCA’s Interim CEO Chris Woolard said recently that while some BI policies are paying out for virus-related issues, others remain “within dispute” due to ambiguities in their wordings.

Outside of the 67.6% who stated a belief that COVID-19 will drive “significant changes” in BI policy wordings, 21.6% expect a “moderate amount” of change, while the remaining 10.8% said the effect will be “limited.”

Loss estimates vary

The Artemis survey also shows 67% of respondents expect the industry to face between $80 billion and $100 billion of underwriting losses due to the pandemic. This is roughly in line with Lloyd’s of London’s earlier estimate of a $107 billion global industry impact.

But analysts from investment bank Berenberg said they believe global COVID-19 claims will be more manageable, estimating a range from $50 billion to $70 billion for the total bill. The analysts don’t specify whether this includes both life and non-life insurance claims from the pandemic, but they do point to the estimate from Lloyd’s of London as being too high.

“We estimate $50-70bn for global COVID-19 claims,” Berenberg’s analysts state. “Significantly less than the $107bn estimate reported by the Lloyd’s of London market estimate on 14 May.”

Las Vegas Hospitality Union Sues Employers

Las Vegas Culinary Workers Union Local 226 is suing several employers on the Las Vegas strip over unsafe working conditions during the coronavirus pandemic, Business Insurance reported.

The union, representing 60,000 workers, said in a statement it is asking for injunctive relief under the Labor-Management Relations Act based on the “hazardous working conditions” workers face.

The lawsuit alleges casino hotels have not protected workers, their families, and their community from the spread of COVID-19 and that current rules and procedures in place for responding to workers contracting COVID-19 have been “wholly and dangerously inadequate.”

The Culinary Union made a number of requests for policy changes, including daily cleaning of guest rooms, mandatory testing of all employees for COVID-19 before returning to work and regular testing thereafter, adequate personal protective equipment for workers, and a requirement that guests wear face masks in all public areas.

Best Warning on COVID-19 Workers’ Comp Laws

Insurance rating agency A.M. Best has warned that legal efforts in several U.S. states to expand workers’ compensation coverage to allow employees to claim for COVID-19 will have a negative impact on re/insurers, Reinsurance News reports.

The crisis has resulted in many employees now working from home, but a significant part of the workforce still needs to be present and public facing, and this is the group new state laws aim to support. For these workers, some states are looking to shift the burden to the insurer to prove that an employee contracting COVID-19 did not do so while on the job.

“This shift in the burden of proof could lead to significant additional losses to a segment already under pressure and result in increased reserve estimates and higher combined ratios,” A.M. Best said.

Given that assumptions used in pricing and actual loss emergence diverge significantly, these legislative changes will result in an increase in loss estimates and could affect earnings.

Businesses Ask Patrons to Waive Right to Sue

As businesses reopen across the U.S. after coronavirus shutdowns, many are requiring customers and workers to sign forms saying they won’t sue if they catch COVID-19, Associated Press reported.

Businesses fear they could be the target of litigation, even if they adhere to safety precautions from the Centers for Disease Control and Prevention and state health officials. But workers’ rights groups say the forms force employees to sign away their rights should they get sick.

So far, at least six states — Utah, North Carolina, Louisiana, Oklahoma, Arkansas and Alabama — have such limits through legislation or executive orders, and others are considering them. Business groups such as the U.S. Chamber of Commerce are lobbying for national liability protections.

CORONAVIRUS WRAP-UP: Data and Visualizations (4/20/2020)

The coronavirus crisis continues to generate data that can be valuable for understanding and decision making. Below are just a few resources that may be of interest to insurers and the people and businesses they serve.

COVID-19 Mortality Projections for U.S. States
Graphs from the University of Texas COVID-19 Modeling Consortium show reported and projected deaths per day across the United States and for individual states.
The Verisk COVID-19 Projection Tool
The Verisk COVID-19 Projection Tool has been made available to enhanceunderstanding of the potential number of worldwide COVID-19 infections and deaths. It provides an interactive dashboard that leverages the AIR Pandemic Model.
How State Insurance Departments Are Responding to COVID-19
This interactive map from PC360 highlights bulletins and procedures released by state insurance departments as of April 15, 2020.
Tracking U.S. Small and Medium Business Sentiment During COVID-19
Small and medium-size businesses account for roughly 44% of the U.S. economy and provide employment to about 59 million people. McKinsey is tracking their sentiment to gauge how their views on economic activity, employment, and financial behavior—as well as their expectations about financial institutions and public authorities—change as a result of ongoing public and private interventions.

CORONAVIRUS WRAP-UP: PROPERTY AND CASUALTY (4/16/2020)

Legislation and regulation
Democrats Plan Legislation to Force Insurance Companies to Pay Out for Pandemic Losses
Thompson Introduces the Business Interruption Insurance Coverage Act
Lawmakers Advocate Stimulus Aid to Insurers on Business Interruption
SC Proposes Bill Over Coronavirus-related Business Interruption Claims
NJ offers grace period for insurance premium expenses
Coronavirus Regulations: A State-By-State Week In Review
Litigation
COVID-19, business interruption and bad faith litigation
P/C Industry Impact
No Evidence COVID-19 Industry Loss Will Match Large Catastrophe Years: Flandro
How Insurance Claims Pros Are Adjusting to Pandemic Complications
COVID-19 Response ‘Could Bankrupt the Insurance Industry’: Insurance Defense Lawyer
Coronavirus response: Short- and long-term actions for P&C insurers
Auto Insurance
Analysts: Auto Insurance Coronavirus Rebates a Solid Move in Short Term
Will Fewer Drivers on the Road Mean Lower Auto Losses? It Depends
Auto Insurers Offer Rebates as Traffic Abates During Pandemic
Business Interruption
Neglecting Idle Facilities Amid COVID-19 Will Cost Companies, Warns FM Global
Cyber
Working From Home? Don’t Let Cyber Criminals Break In
Hospital Hackers Seize Upon Coronavirus Pandemic
Workers Compensation
COVID-19 Comp Expansions Could Have Significant Impact on Industry

Dog Bite Prevention Coalition: Tips for Sheltering at Home with Pets

Most Americans are under stay-a-home orders at this stage of the coronavirus pandemic, and stress is running high for myriad reasons.

The pandemic has affected pets too. “Dogs that are used to kids being at school and adults at work are now finding themselves surrounded by their families 24/7,” according to Victoria Stilwell, CEO of Positively.com and the Victoria Stilwell Academy of Dog Training and Behavior. “Most welcome the company, but some dogs are having a hard time adjusting to the constant noise, attention and lack of space,” said Stilwell.

In some cases, dogs will exhibit anxious, aggressive, or destructive behaviors.

The National Dog Bite Prevention Week Coalition offers the following tips to help you and your pets cope while sheltering at home:

  • Create a den-like space or “safe zone” in your home that is a “dog only” zone. This can be a crate where the door always remains open or a quiet location your dog can go to when it needs some space.
  • Small children should be supervised around any dog. To make it easier, you can use baby gates to keep dogs and kids separated if you can’t actively supervise them.
  • This is the time to teach your dog some new skills. Challenge your dog to learn new cues. If you need the help of a trainer, many now offer virtual consultations.
  • If you can take your dog out for a walk, make sure you keep it on leash. Do not allow your pet to socially interact with other dogs or people. While humans are observing social distancing rules, they should help their dogs do the same.
  • Having a plan in place for your pets is important. Individuals who become too sick or require hospitalization will need to have someone to take care of their animals while they heal. Just like any disaster preparedness plan, have a “bug out” bag ready.

Members of the National Dog Bite Prevention Week Coalition will share information during several webinars this week focused on how COVID-19 is impacting pets and pet owners. Experts will provide safety tips for sheltering at home with dogs, how to support animal shelters and rescues, and release 2019 dog-related injury claims data.

The Next webinar will take place on Friday, April 17 at 1:00 PM CST/2:00 PM EST

Zoom webinar for the general public (Registration Required):
https://zoom.us/webinar/register/WN_9cO7OQTVQXSdZb2UXs9ufQ

In a previously recorded webinar, Janet Ruiz, Strategic Communications Director, Triple-I, explained that when it comes to dog bite claims, it’s important to note that these are just incidents that were reported to insurance companies and that the actual number of dog bites is likely to be much higher.  In 2019 homeowners insurers paid about $796.8 million as a result of 17,802 dog bite claims.

National Dog Bite Prevention Week (NDBPW) is April 12-18, 2020. Members of the National Dog Bite Prevention Coalition include the American Veterinary Medical Association (AVMA), State Farm®, Insurance Information Institute (Triple-I), American Humane, and the Victoria Stilwell Academy for Dog Training and Behavior. The coalition joins forces each year to draw attention to how people can reduce the number of dog bites.

Health Insurers Waive COVID-19 Cost Sharing

UnitedHealthcare (UHC) this week became the latest major insurer to waive members’ cost sharing for COVID-19 treatments. The health insurer said it would waive the associated costs for members in its fully insured commercial, Medicare Advantage, and Medicaid plans.

UHC added that it’s working with interested self-funded employer plans to offer the same waivers.

Anthem announced similar steps, saying it would cover the cost-sharing for COVID-19 treatment through May 31 for its Medicare, Medicaid, individual market and fully insured employer plans. The insurer also said it was “strongly encouraging” its self-funded employers to adopt the waivers.

Anthem has also taken other steps similar to its peers in the industry, such as waiving the cost-sharing for testing and tele-health, and easing prescription limits.

Aetna, Cigna and Humana all previously announced they would waive members’ cost-sharing for COVID-19 treatment. These insurers also waived copayments and other cost-sharing for testing and telehealth visits.

Regional health plans are taking similar steps. Florida Blue announced Tuesday it would waive cost-sharing for treatment, as did Harvard Pilgrim Health Plan.

Triple-I launches coronavirus issues and impacts webpage

The spread of the coronavirus and COVID-19 – and how governments, businesses, and individuals are dealing with it – raises many issues relevant to property/casualty insurers and their customers.

Triple-I has launched a webpage to help readers find what they need from the information we gather and curate. The issues we track range from operational challenges posed by the virus to likely impacts on claims and losses to the possible introduction of legislative and regulatory solutions that might affect insurance underwriting and pricing.

We discuss these multi-faceted issues and impacts from our position as a trusted source of unique, data-driven insights on insurance. The page will have links to Triple-I reports and presentations on the topic, and links to many of our blog posts grouped by the following categories:

To visit our coronavirus issues and impacts page click here. For all posts related to COVID-19 click here.

Will Workers Comp Claims for COVID-19 Be Paid?


While health workers and first responders might be more likely to be exposed, whether COVID-19 is compensable under workers comp is uncertain.

Whether workers compensation claims related to COVID-19 will be paid is a question to be answered case by case and state by state.

The world has seen numerous epidemics whose impact on public health is well documented, so you might expect to find guidance on compensability from these experiences. But according to the National Council on Compensation Insurance (NCCI), “You would be hard pressed to find meaningful information on how or even if the workers compensation system was affected” by the SARS, H1N1, Ebola, and Zika outbreaks.

Workers comp insurance typically covers employers for employee claims regarding “bodily injury by accident or bodily injury by disease.” Many state statutes, however, exclude “ordinary disease of life.”

While some occupations – for example, health care workers and first responders – might be said to have a higher probability than others for exposure to COVID-19, whether the disease is compensable under workers comp is uncertain.

“’Would time away from work during recovery be considered ‘temporary disability’,”’ NCCI asks, “or is it just normal ‘sick time’?”

Guaranteed benefits for some

Workers’ comp insurers in at least two states have said they will guarantee benefits for health workers and first responders.

Kentucky Employers Mutual Insurance Co. said it will pay wage-replacement benefits for any first responder or employee in the medical field who is quarantined because of direct exposure to a person diagnosed with COVID-19. The announcement follows a decision by the Washington State Department of Labor and Industries to pay wage-loss and medical treatment expenses for any health care worker or first responder who is quarantined because of coronavirus exposure. Washington operates a monopoly workers comp system, so that policy affects every employee covered by the state system.

It remains to be seen if other states will take the same measures relative to workers comp. For general health insurance, however, NCCI says at least 10 states have issued mandates to cover COVID-19. The mandates vary, but they include coverage for testing and visits to emergency rooms or urgent care facilities either in-network or out-of-network without deductibles or copays.

If expanded to more states, NCCI says, these mandates could limit workers comp claims in cases where only testing or quarantine are necessary.

Triple-I Webinar Covers COVID-19’s Economic and Health Implications

The Insurance Information Institute invited its members to a webinar titled “Covid-19’s Impact on Health, the Economy and Growth” on March 5 at 11:00 a.m. EST presented by Triple-I Vice President and Senior Economist Michel Léonard, PhD, CBE.

Dr. Lèonard will discuss the following key points:

• Economic impact likely to continue into Q3/Q4 2020 and 2021
• Could reduce global growth by as much as 1 percent and delay recovery by up to 12 months
• Fiscal and monetary policy, rates cuts, unlikely to be effective
• Insurance industry to see higher claims, reduced premium growth

He will also preview the Global Macro and Industry Outlook report before it is made available to the public.

To find out more about the benefits of Triple-I membership click here.