Category Archives: Health & Safety

Home Safety During the Holiday Season

By Max Dorfman, Research Writer, Triple-I

Holidays are usually occasions for celebration and family gatherings. But in this pandemic holiday season we remind you to please observe the social distancing rules and advisories in your area.

Triple-I also offers these tips to help make sure everyone is safe and injury-free this holiday season.  

Decorations

According to the U.S. Consumer Product Safety Commission (CPSC), there are approximately 200 decorating-related injuries each day during the holiday season, with about half involving falls. During the 2018 holiday season, 17,500 people were treated in emergency rooms due to holiday decorating-related injuries, with six deaths associated with holiday season decorations in 2019.

Our Tips: Choose the correct type of ladder for hanging lights, making sure they are indoor lights for indoors or outdoor lights for outdoors; do not nail, tack, or stress wiring when hanging lights; and keep plugs off the ground and removed from puddles and snow.

Fires

Christmas trees are involved in about 200 home fires per year, according to the National Fire Protection Association (NFPA). Home Christmas tree fires caused an average of six deaths, 16 injuries*, and $14.8 million in direct property damage annually from 2011 to 2015.

Electrical distribution or lighting equipment was involved in 40 percent of the home Christmas tree structure fires. About 26 percent occurred because some type of heat source was too close to the tree. Decorative lights were involved in 18 percent of these incidents.

Eight percent of home Christmas tree fires were started by candles, which are another major fire hazard. The top three days for home candle fires were Christmas, New Year’s Day and New Year’s Eve, according to the NFPA.

However, cooking fires remain the number one cause of residential fires, an average of 1,700 cooking fires occur on Thanksgiving Day each year. Christmas day and Christmas eve are also peak times for cooking related fires.

Our Tips: Do not leave cooking food unattended and keep children away from the cooking area; keep candles at least 12 inches away from anything that can burn; blow them out when you leave the room or go to bed; be careful if someone in the household is using oxygen; and keep candles away from children.

Gift Giving

Although giving toys as presents during this season should be celebrated, there are also risks associated with them. According to a CPSC study from 2019, there were approximately 162,700 toy-related, emergency department-treated injuries and 14 deaths of children under 15 years old, with most related to choking on small parts, like small balls and small toy parts and riding toys.

Our tips: Choose toys in the appropriate age range, with toys with small parts not given to children under three and toys that must be plugged into an electrical outlet not gifted for children under 10; and be aware of toy recalls. Non-motorized scooters in particular are associated with a high rate of accidents, though that has been declining.

Home Care

We also remind you to keep your home heated to at least 65 degrees, let hot and cold faucets drip to prevent freezing and to keep your fireplace flue closed when it is not being used.

*These do not include firefighter deaths and injuries which are recorded separately by the NFPA.

Making the home a safe place to work

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Work from home arrangements necessitated by the coronavirus pandemic are predicted to become permanent for some employees as companies like Google contemplate ‘hybrid models‘ with more flexible work options.

And though remote work is nothing new, an increase in the numbers of people working from home in the coming post-pandemic years is bound to lead to some thorny workers compensation questions. 

In a recent report called “Digital Business Accelerated,” which examines digital transformation trends that small and mid-sized businesses are pursuing, Chubb pointed out that makeshift home offices that don’t properly address ergonomic best practices may lead to an increase in long-term injuries.

Relaxed work habits and environmental inconsistencies in air quality and lighting can also affect the overall wellbeing and performance of employees. And the risk of slips and falls remains in the home, just as it does in the office, said the report.

An injury or illness that occurs while an employee is working at home will be considered work-related if it occurs while the employee is performing work for pay or compensation in the home, and the injury or illness is directly related to the performance of work rather than to the general home environment or setting, according to OSHA.

For example, OSHA goes on to say, if an employee drops a box of work documents and injures his or her foot, the case is considered work-related.  If an employee is injured because he or she trips on the family dog while rushing to answer a work phone call, the case is not considered work-related. If an employee working at home is electrocuted because of faulty home wiring, the injury is not considered work-related.

There’s a lot of ambiguity around such claims.

“It is much more difficult to prove that an injury was work-related because there is usually less evidence available in these home office scenarios,” said Gary L. Wickert, an insurance trial lawyer, in a Claims Journal article. “An accident at a business or job site may have witnesses or be caught on security footage. Work at home employees often are all by themselves while they work, so there is often no one present to corroborate a sudden injury or accident or to help determine the precise conditions of the injury.”

Holding a third party responsible (subrogation) for an accident also becomes more complicated in cases of at home injuries.

“When the employee is injured in their home, subrogation targets tend to shrivel up and blow away,” said Wickert. “If an employee is injured at home or while taking kids to the daycare prior to, during, or after the workday… A subrogated carrier cannot sue the employee in the name of the employee – neither can the employee,” he said.

Employers and workers also need to be aware of mental health issues which can develop. Though many tout the mental health benefits of working remotely, others find that remote work leads to anxiety, depression and burnout. The Center for Workplace Mental Health has suggestions for workers that include exercise and keeping a regular schedule, as well as for employers, which includes staying connected and recognizing the impact of isolation.

To reduce the changes for injuries in the home, of which poisoning and falls are the most common, check out the CDC’s Home and Recreational Safety page. For tips for setting up an ergonomically correct workstation read this Mayo Clinic article.

Travel Risk: It’s Not
All About COVID-19

Anticipation that a COVID-19 vaccine – combined with social distancing, mask wearing, and other protective measures – may soon lead to increased travel revives our need to think about travel insurance.

Even before COVID-19, travel insurance purchases were on the rise, but primarily for trip cancellation coverage – the very product that wound up disappointing many who had their holiday plans disrupted by the virus. Most policies exclude pandemics or fear of travel, which made them practically useless after the outbreak.

Pandemic risk wasn’t on many travelers’ radar screens before the coronavirus struck – any more than the many common illness, injuries, or causes of death that ought to have prompted them to add medical and medical evacuation to their travel coverage. A report by the U.S. Travel Insurance Association (USTIA) last year found Americans spent nearly 41 percent more on travel insurance in 2018 than in 2016.  However, trip cancellation/interruption coverage accounted for nearly 90 percent of the benefits purchased. Medical and medical evacuation accounted for just over 6 percent.

People don’t want to think about illness, injury, or death when planning a pleasure trip – still less pay to mitigate an improbable (at the time) threat like a global pandemic.

Travelers who wanted to cover all their bases could have purchased cancel for any reason (CFAR) coverage, which provides some reimbursement (usually 50 to 75 percent) if you cancel, no matter what reason. Before the pandemic, CFAR would have cost 40 to 60 percent more than a standard travel insurance policy. It may be even more expensive now.

Airlines offering COVID-19 coverage

Some airlines have begun offering COVID-19 coverage. This week, Cathay Pacific announced that  it is providing free coverage to all passengers.

“Customers who fly with Cathay Pacific from Dec. 7 to Feb. 28, 2021 will be covered for medical expenses related to a COVID-19 diagnosis incurred while overseas,” Insurance Journal reports. “The free cover will be automatically applied when customers book their flights.”

Air Canada recently announced that members of its Aeroplan affinity program making eligible new bookings originating in Canada will receive COVID-19 emergency medical and quarantine insurance.  Emirates introduced a similar program in July that it says is free of charge and covers all passengers flying to any destination in any aircraft. The airline recently announced that it has expanded the coverage, adding new features from December 1. 

It’s not surprising to see airlines incorporating a COVID-19 “value add” to help boost bookings by an anxious public, and it will be interesting to watch this new business scheme play out. But, lest eager travelers forget, more routine risks that you probably weren’t insuring against before pandemic remain.

Falls, crashes, and drownings

“Globally, an estimated 37 million unintentional falls requiring medical treatment occur each year” write researchers in the journal Injury Epidemiology, citing 2018 World Health Organization (WHO) data. And falls aren’t the most common cause of injury and death on vacation. Research indicates the top two causes of death are automobile accidents and drownings.

Out of the one billion tourists traveling globally each year, it is estimated that 30 to 50 percent are either injured or become ill while traveling abroad.

Don’t let yourself be blindsided by hazards that can be easily avoided or mitigated. Understand the risks your travel plans may entail and insure against them appropriately.  

SHOULD YOU BUY TRAVEL INSURANCE?

INFECTIOUS DISEASE: GOOD REASON TO BUY MEDICAL TRAVEL INSURANCE – BUT CHECK THE TERMS

TRIP COVERAGE: IT’S NOT JUST ABOUT CANCELLATIONS

TRAVEL COMPANY COLLAPSE OFFERS LESSONS IN RISK

Tribal Communities Disproportionately
Hurt by COVID-19

The COVID-19 pandemic has disproportionately affected minority communities across the United States. A less reported but no less significant part of that story has been the disease’s impact on tribal populations.

According to the Center for American Progress, the Navajo Nation has one of the highest infection rates in the country – and they’re not alone in their suffering.

“Native people make up only around one-tenth of New Mexico’s population but more than 55 percent of its coronavirus cases,” the center wrote back in June, when it said the Navajo infection rate was “greater than that of the worst-hit state, New York; it is even greater than that of Wuhan at the height of the outbreak in China.”

In Wyoming, American Indian/Alaskan Native (AI/AN) people are less than 3 percent of the population but make up more than one-third of the state’s cases, the center said.

Inequities exacerbated

Limited health services, insufficient infrastructure, and above-average rates of immunocompromising diseases all predate COVID-19 and contribute to the vulnerability of these populations. Many tribes also feel excessive pain from the pandemic-spurred economic downturn as their lifeblood enterprises in gaming and hospitality are shutttered. Casino closures in early March led to an estimated loss of more than $4.4 billion in economic activity and $997 million in lost wages, affecting 246 tribes with over 500 gaming facilities in 29 states.

The Chickasaw Nation in Oklahoma is among the entities that have filed lawsuits against insurers related to business interruption coverage claims. As hundreds of COVID-19-related lawsuits regarding business interruption coverage make their way through U.S. courts, judge after judge has found in favor of insurer defendants.

Meanwhile, Native American leaders are keeping close watch on the U.S. Supreme Court battle over whether to repeal all or parts of the Affordable Care Act – a move many say could devastate health care for AI/AN communities.

“In the context of what we’re all facing,” said Stacy Bohlen, chief executive officer of the National Indian Health Board, “this is not the time to add this extra burden and an additional crisis onto the Indian health system and onto Indian people.”

The Affordable Care Act, signed by President Obama in 2010, contains provisions specifically relevant to Native Americans, including permanent reauthorization of the Indian Health Care Improvement Act, which provides ongoing funding for Native health programs. It also expanded tribes’ authority to run their own health care programs, including behavioral health and youth suicide prevention programs.

“People talk about the Affordable Care Act like it’s all one thing,” said Sarah Somers, an attorney with the National Health Law Program, who specializes in litigation to help underserved communities access good health care. “But if you repeal it, then all of the codified statutes go away.

A political force

The number of people in the United States identifying as American Indian has climbed in recent years, with California, Arizona and Oklahoma accounting for the largest concentration of the nation’s AI/AN populations, according to a USAFacts analysis of Census Bureau data.

“The U.S. held 2.8 million people who self-identify solely as Native American in 2018, with another 2.9 million identifying as multiple races, including Native American,” according to U.S. News & World Report. “The country’s population that identifies as solely Native American expanded 13% between 2000 and 2018, while the number of individuals who identify as at least partially Native American ballooned 77%.”

In this year’s elections, Native American voters played an important role in some key battleground states, according to High Country News. In Arizona, indigenous people account for nearly 6% of the population — 424,955 people as of 2018 — and eligible voters in the Navajo Nation alone number around 67,000. Native support for Joe Biden — who has released a robust policy plan for tribal nations — may have helped him win that heavily contested state.

House Panel Discusses Approaches to Manage Future Pandemic Risk

That the insurance industry alone can’t be expected to cover future pandemic risk seemed to be a given at yesterday’s hearings by the House Finance Subcommittee on Housing, Community Development, and Insurance.

But, as is so often the case, the devil is in the details.

The session – Insuring Against a Pandemic: Challenges and Solutions for Policyholders and Insurers – was chaired by Rep. William Lacy Clay. In his opening statement, Clay said, “It is not realistic or practical to expect the insurance industry to shoulder the astronomical cost of a global pandemic. The American Property and Casualty Insurance Association has estimated that paying all [COVID-19-related] claims, regardless of exclusions, would amount to $1 trillion per month.”

With respect to business interruption coverage claims currently being adjudicated, Clay referenced both the virus exclusions in most commercial property policies and the lack of “direct physical damage or loss” in COVID-19-related cases.

John Doyle, president and CEO of global insurance broker Marsh, testified on the importance of a public-private partnership to address pandemic risk, as well as to the need to “act now” on a solution for future pandemics.

“Acting now on a public-private pandemic risk solution will accelerate the economic recovery by reducing uncertainty,” Doyle said. “Moving forward, capital markets will seek assurances that companies have protection against prospective pandemic risk. The pace of recovery will depend upon the nature and degree of confidence in the marketplace.”

Doyle said the credit and power of the U.S. government is essential – “at the same time, I believe the insurance industry has a role to play.”

The Pandemic Risk Insurance Act (PRIA), introduced by Rep. Carolyn B. Maloney of New York, provided the jumping-off point for the testimonies and discussions of alternative proposals. PRIA, patterned after the Terrorism Risk Insurance Act (TRIA) put in place after the 9/11 terrorist attacks, was generally recognized as a good start – but several other structures were proposed to address perceived weaknesses.

One is the Business Continuity Protection Program (BCCP), advanced by the National Association of Mutual Insurance Companies (NAMIC), the American Property Casualty Insurance Association (APCIA) and the Independent Insurance Agents & Brokers of America (Big “I”).

Brian Kuhlmann, chief corporate counsel for Shelter Insurance, speaking on behalf of NAMIC and APCIA, described BCCP as a program that “would provide straightforward revenue replacement for businesses and nonprofits of all sizes” using a parametric approach that wouldn’t require claims adjustment. Unlike traditional insurance, which pays for damage if it occurs, parametric insurance automatically pays when specific conditions are met – regardless of damage incurred.

Michelle Melendez McLaughlin, chief underwriting officer for the small commercial and middle market at Chubb, presented a “bifurcated” framework that would treat small businesses differently from mid-size to large corporations.

“Pandemics affect small and large businesses differently,” she said. The Chubb framework would cover small companies for up to three months of payroll and other expenses. Policyholders would be paid a pre-determined amount when the policy is triggered. “This provides policyholders with certainty that they will receive timely financial assistance after an event.”

For businesses with more than 500 employees, the Chubb proposal would create Pan Re – a federal reinsurance facility. “Private insurance companies that choose to sell coverage would write pandemic policies at market terms and retain some portion of the risk. The rest of the risk would be reinsured through Pan Re.”

R.J. Lehmann, senior fellow at the International Center for Law and Economics, agreed with other witnesses that the insurance industry isn’t equipped to handle pandemic risk alone. He went further to question whether insurance is the best structure for addressing this problem.

“Insurance is a system of risk transfer, not a system of economic relief,” Lehmann testified. “Even if private insurers could provide this coverage—on their own or with government support—it is not clear their incentives would align with public health goals or with the aims members of Congress likely have in mind.”

The best argument for a public-private partnership, he said, is that insurers can help policyholders mitigate risks. “But it’s important to ask, ‘Mitigate the risk of what’? The risk you’re trying to reduce is the risk that a business will shut down. But, in a pandemic, you want businesses to shut down. We want them to have a safety net so they can shut down and survive.”

Hartmann counseled legislators to take their time and get the solution right, drawing from all the options that exist.

“Let’s be humble about how little we know, even about the current pandemic,” he said. “Get help to the businesses, workers, and communities who need it now. Don’t legislate for the next pandemic while we’re in the midst of the current one.”

Utility Shutoffs Threaten to Worsen Pandemic Pain

I’ve been living and working at my father’s house since the onset of COVID-19, keeping him from having to venture out and risk infection. Late last week, his furnace died, and we were fortunate to have family nearby to move in with while we wait for it to be fixed.

I’ve been truly grateful and mindful of people – especially the elderly – who don’t have such options. Then, this morning, I read this National Journal article, which threw light on the subject from a different angle.

“Throughout the pandemic, states and cities have put in place moratoriums on utility shutoffs,” the Journal writes, “but many have expired and more will be lifted in the coming weeks.”

The pandemic’s economic dislocations have put many people in situations in which they may not be able to pay basic bills, like rent, electricity, heating, and water. Not only that – even people who can move in with family or friends may be putting themselves in danger of infection.

People can’t remain in a home safely without water, said Rianna Eckel, senior organizer for Food & Water Watch, which advocates on environmental and resources issues.

“You can’t do basic things like wash your hands, which is one of the top safety recommendations,” she said. “You can’t bathe or shower; you can’t flush your toilet; you can’t cook; you can’t really clean. That raises the risk for COVID transmissions because you’ll have families who are going to neighbors’ houses, going to friends’ houses, so that they can wash some clothes and cook or maybe take a shower.”

Similar concerns apply to electricity, gas, and steam utilities.

“Those are critical to the ability to heat your home, to cook, refrigeration to preserve foods or medication,” said Emily Benfer, a law professor at Wake Forest University. “You need electricity to use medical equipment. So all of these are necessary to sheltering in place and to maintaining health, let alone preventing the spread of the virus.”

Benfer added, “The COVID-19 pandemic and social-distancing requirements have created a situation in which utility shutoff is a life-threatening emergency for the majority of Americans.”

In our case, family members had all just been tested for COVID-19 out of concern about a possible exposure (we came up negative). This precaution, too, isn’t readily available to many people. Especially people who have to choose between paying for electricity or food.  

In November, 10 state moratoriums on utility shutoffs are slated to end, according to the National Energy Assistance Directors’ Association. Thirty-three states have expired moratoriums or did not put one in place.

Lawmakers and advocates have been pressing for a moratorium on water shutoffs, calling for the Centers for Disease Control and Prevention to use the same authority it exercised when the agency issued a stop to evictions. In a House-passed bill providing COVID-19 emergency funding, $1.5 billion was included to assist low-income households with water bills.

“It’s incumbent on utilities to figure out a way to make sure that people’s health is not put at risk by having widespread shutoffs, because that’s just going to make the pandemic all that much worse,” said Erik Olson, a health expert at the Natural Resources Defense Council. “The answer to this problem is not to be shutting off low-income people’s water all over the country.”

Beyond the clear humanitarian concerns, if these issues are not addressed effectively, they could lead to litigation and insurance claims to be resolved for some time to come.

Insurers Help Victims Find Freedom from Domestic Violence Through Financial Empowerment

COVID-19 Could Further Impact Intimate Partner Violence Survivors

By Loretta Worters, Vice President – Media Relations, Triple-I

Financial security and access to resources can make all the difference to domestic violence victims when deciding to leave an abusive relationship. And insurance is an important component of financial planning that can help survivors move forward.

Financial abuse is a common tactic used by abusers to gain power and control in a relationship. The forms of financial abuse may be subtle or explicit, but in in general, include tactics to conceal information, limit the victim’s access to assets, or reduce accessibility to the family finances. Financial abuse – along with emotional, physical, and sexual abuse – includes behaviors to intentionally manipulate, intimidate, and threaten the victim in order to entrap that person in the relationship. In some cases, financial abuse is present throughout the relationship and in other cases financial abuse becomes present when the survivor is attempting to leave or has left the relationship.

Repercussions from the pandemic – layoffs, loss of income, living with abusers due to stay-at-home orders, restricted travel and closures of key community resources – are likely to dramatically increase the incidence of domestic violence, which may further hamper a victim from leaving an abusive situation. 

Survivors struggling to get back on their feet may also be forced to return to their abuser.  That’s why it’s so important survivors understand how insurance works and what a critical role it can play in gaining financial freedom and economic self-sufficiency.

In support of Domestic Violence Awareness Month, the I.I.I. offers financial strategies to protect victims before and after leaving an abusive relationship. They include securing financial records, knowing where the victim stands financially, building a financial safety net, making necessary changes to their insurance policies and maintaining good credit. 

The National Coalition Against Domestic Violence (NCADV) reports that 10 million people are physically abused by an intimate partner each year, and 20,000 calls are placed to domestic violence hotlines each day. In addition, 85 percent of women who leave an abusive relationship return because of their economic dependence on their abusers. Furthermore, the degree of women’s economic dependence on an abuser is associated with the severity of the abuse they suffer.

“Home is often times a dangerous place for survivors of domestic violence, and COVID-19 exacerbates the circumstances, due to the abusers’ ability to further control,” said Ruth Glenn, president and CEO of the NCADV. “Tactics abusers use include ruining the credit of their victim as well as financial and digital abuse, such as stimulus funds being co-opted by abusers to an increase in domestic online harassment,” she said. 

Experts agree that domestic online harassment can come in many forms, from impersonating a victim by email in order to sabotage her work, to controlling the influx of information about the pandemic to make her more fearful and reliant on the abuser.

The Allstate Foundation’s domestic violence initiative has been committed to ending domestic violence through financial empowerment, providing survivors with the education and resources needed to achieve their potential again and equip young people with the information and confidence they need to help prevent unhealthy relationships before they start.  This year the Foundation contributed $500,000 to help the National Network to End Domestic Violence support more than 100 local domestic violence organizations. The Foundation also provided funding for the National Domestic Violence Hotline to enable remote-working technology and has worked with these organizations who are urging Congress to pass a COVID-19 relief package that addresses the housing, economic, physical and mental health needs of survivors of domestic and sexual violence and the advocates on the frontlines that need additional resources to ensure the safety of survivors and their staff.

“One of the most powerful methods of keeping a survivor trapped in an abusive relationship is not being able to support themselves financially,” Glenn explained. “That’s why insurance and financial education are so important,” she said.  “Education can save a life.”

Deaths Resulting from Louisiana Hurricanes Underscore Need for Personal Power Generator Safety Awareness

(Photo by Rob Foldy/Getty Images)

By James Ballot,  Senior Advisor, Strategic Communications, Triple-I

On October 1, Hurricane Delta hit Louisiana as a Cat. 2 storm, cutting power to almost 700,000 residents and causing further setbacks to people in that region who were still recovering from Hurricane Laura, the Cat. 4 storm that ravaged the region in late August.

Residents in hurricane-prone regions commonly rely on emergency power generators to aid in recovery from storms and other catastrophes. Nevertheless, many home and businessowners lack knowledge and training to safely run these devices: of the more than 30 lives lost to Laura and Delta nearly one-third  were caused by fires or carbon monoxide (CO) poisoning due to improper use of emergency power generators.

If you own a generator or are considering purchasing one as part of your emergency preparedness planning, the Triple-I encourages you to follow guidance put forth by the Center for Disease Control, State Farm, Travelers and other reliable sources, including:

William Davis, the Triple-I’s Georgia Media Relations Director adds, “Before a storm knocks out electricity, generator owners need to learn how to use them safely. Generators can be life savers in time of need, but they can also be killers!”

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.

New CDC Numbers Raise Concern for Health, Workers Comp Insurers

Between June and August, the CDC says, COVID-19 was most prevalent in people between the ages of 20 and 29.

The Centers for Disease Control and Prevention this week provided new data on the spread of COVID-19 that diverges sharply from past reports and is something health and workers  compensation insurance providers will want to incorporate into their claims projections.

In its Morbidity and Mortality Weekly Report, the CDC says that between June and August the virus was most prevalent in people between the ages of 20 and 29, accounting for more than 20 percent of all confirmed cases. It went on to say that “across the southern United States in June 2020, increases in percentage of positive [COVID-19] test results among adults aged 20-39 years preceded increases among those aged ≥60 years” by between four and 15 days.

Most of the workforce

“This has profound implications for claims made against health insurance and workers comp,” says Dr. Steven N. Weisbart, CLU, Triple-I’s senior vice president and chief economist. “Early in the pandemic, COVID-19 was most common among adults age 70 or older – people who are mostly retired. Now, the CDC says, more than 50 percent of confirmed cases during the referenced period were among people between 20 and 49. This is the segment of the population that makes up most of the workforce and tends to have health and life insurance.”

They also are the most mobile portion of the population, more likely than the elderly and infirm to spread the infection to co-workers, friends, and family before they know they have it.

Indicating how significant the shift has been, Weisbart points out that in May the most affected age group was still 80 and older, with a case incidence of 4.04 per 1,000 population. In August the most affected age group was 20-29 (case incidence: 4.17 per 1,000).

“By August,” Weisbart says, “the case incidence of the 80-plus group was down to 2.61 per 1,000.”

Expanded workers comp coverage

The ultimate impact of the pandemic on workers compensation is still not clear. It generally doesn’t cover illnesses like a cold or flu because they can’t be tied to the workplace. Before the pandemic, the National Council on Compensation Insurance (NCCI) says, at least 18 states had policies that presumed firefighters’ and other first responders’ chronic lung or respiratory illnesses are work-related and therefore covered.

Since the pandemic, some states have extended coverage to include health care workers and other essential employees. A common approach is to amend state policy so COVID-19 infections in certain workers are presumed to be work related. This puts the burden on the employer and insurer to prove the infection was not work-related, making it easier for workers to file successful claims.