Tag Archives: COVID-19 policyholder impact

California Reports $1.2 Billion in Premium Refunds in Response to COVID-19

Insurers refunded $1.2 billion to California policyholders as of June 26, according to actuarial firm Perr & Knight.

The California Department of Insurance (CDI) ordered the refunds to drivers and businesses in the state affected by the COVID-19 emergency. The companies were required to file reports outlining the details of their response to COVID-19.

CDI recently made these reports public, and Perr & Knight,  which specializes in rate filings, published an analysis. Here are some key takeaways:

  • California’s reports have information on the number and percentage of policyholders affected. If the state is a guide, EVERY person with a personal auto insurance policy got a break on premiums, as well as millions of other policyholders, according to James Lynch, Triple-I’s chief actuary.
  • Private auto insurance customers received the largest share of the refunds – a little over $1 billion. Commercial auto customers received about $33 million in refunds, and workers compensation customers received $82.7 million.
  • Commercial multi-peril clients received $11.2 million, commercial liability $7.2 million and medical malpractice $10.3 million.

The reports also have data on payment deferrals (grace periods), which is something that has been underrecognized, in part because it was so hard to quantify.

Business Interruption Coverage: Policy Language Rules

Whether business interruption coverage in property policies applies to COVID-19-related losses has become one of the dominant insurance debates during this pandemic. Lawsuits have been filed – some even before insurers have denied a claim – seeking to establish that policyholders are entitled to coverage for losses sustained during the current shutdowns. 

The debate often focuses on a simple phrase in the insurance policy: “direct physical loss or damage.” Business interruption coverage can apply to losses stemming from direct physical loss or damage. Losses that didn’t come from direct physical damages aren’t covered.

Michael Menapace, Esq.
Wiggin and Dana LLP

 “A property policy may, for example, pay to repair the damage caused by a fire and may cover the loss of business during the reconstruction period,” writes Michael Menapace, a professor of insurance law at Quinnipiac University School of Law and a Triple-I Non-Resident Scholar. “But here’s the rub.  Are the business interruptions related to COVID-19 caused by physical damage to property?”

Insurers say no, arguing that “damage to property” requires structural alteration like one would find in a typical claim, where, say, a fire destroyed the interior of a building or wind damaged windows and furniture.

The virus, on the other hand, leaves no visible imprint. Left alone, it can’t survive long and, after it has perished, whatever it was attached to is as good as before. Even if some remediation is needed – like cleaning metal surfaces – insurers might argue that this is no different from cleaning dirt off a surface. They cite cases in which judges have ruled there’s no physical damage from mold if the mold can be cleaned off.

Departing from common sense

Others depart from this common-sense, legally recognized definition. Some plaintiffs’ attorneys argue that if coronavirus is not direct physical damage then insurers would not have created an exclusion for viruses in the first place. Many insurers added exclusions for losses from viruses and communicable diseases after the SARS outbreak in 2003. 

Policy language, Menapace says, controls whether COVID-19 interruptions are covered. Some policies have standard terms and exclusions, some provide “all-risk” coverage – covering loss arising from any fortuitous cause except those specifically excluded – and others are variations on these types.

“The threshold issue will be whether the insureds can prove their business losses are caused by ‘physical damage to property’,” he writes. 

In past cases, where there is direct physical loss to property – such as contaminated food that couldn’t be sold or a building rendered useless by asbestos contamination – courts have found business interruption coverage was triggered. But when an earthquake caused a power loss in two factories, courts found the only injury was a shutdown of manufacturing operations that didn’t constitute “direct physical loss or damage.” 

What About Current Claims?

Are business interruptions related to COVID-19 the result of the government restrictions, or are they due to the physical loss to their property?  Menapace writes that many of the current claims would seem not to trigger the standard coverage in a commercial business interruption policy, but he cautions that this might not always be the case.

A true “all-risk policy,” he writes, “generally would not distinguish between business interruption losses due to government action or direct physical loss because all-risk policies cover all losses except those specifically excluded.”

But most commercial property policies aren’t true “all-risk policies”; instead, they typically cover business interruption losses “caused by direct physical damage to property” at or near the insured premises. 

“That will be difficult burden for policyholders to meet,” Menapace says.

Some policies exclude coverage for losses resulting from mold, fungi, or bacteria.  Because COVID-19 is a virus, that exclusion might not apply. Other policies exclude viruses, diseases, or pandemics. 

“If a policyholder believes it may have a claim,” Menapace advises, “it should provide prompt notice to its insurer(s) so it does not risk a denial based on late notice. Likewise, once the claim has been made, it is essential that the insured cooperate with the insurer, including providing timely proof of loss.”

Resources:

Business Income (Interruption): Key Facts

The True Cost of Rewriting Business Income (Interruption) Policies

Triple-I Briefing: Surplus Is Key to Insurers Keeping Policyholder PromisesISO Excluded Coronavirus Coverage 15 Years Ago

Triple-I Briefing: Surplus
Is Key to Insurers Keeping
Policyholder Promises

The insurance industry can meet its obligations to policyholders in the midst of the coronavirus pandemic – but government interventions being discussed threaten to unravel this safety net and could make it impossible for insurers to affordably provide essential coverage in the future.  

These are among the conclusions shared by Triple-I chief economist Steven Weisbart and senior economist Michel Léonard in a briefing today that explained how the industry already has been affected by the pandemic and subsequent recession; how policyholder surplus ensures funds are available to cover claims; and how any attempt to retroactively apply this pandemic to business interruption policies would cause irreparable harm to the financial stability of the property-casualty insurance industry. 

“Insurers price their policies for expected claims, with additional monies set aside for unexpected claims, such as those which are filed during exceptionally severe hurricane seasons,” Dr. Weisbart said. “The policyholders’ surplus backs up every line of insurance each insurer writes. It is calculated as assets, minus liabilities, and rises and falls due to changes in asset values.”   

Dr. Weisbart and Dr. Leonard explained in detail how surplus works and showed how – under a variety of plausible scenarios – retroactively rewriting insurance contracts could make it impossible for insurers to play their critical role as financial first responders

“If insurers nationwide had to pay business interruption policy claims for which they collected no premium, it could cost the industry each month anywhere from roughly $150 billion to nearly as high as $380 billion,” said Léonard, noting that the smaller amount accounted for the U.S.’s small and medium-size businesses that currently have business interruption coverage and the larger amount includes those who do not. “Pandemic-caused losses are excluded from standard business interruption policies because they impact all businesses, all at the same time.”   

If you missed the briefing, you can view the presentation.  

Related Links: 

Coronavirus: Issues and impacts  

Triple-I Fact Sheet: Insurers Are Engaged In the COVID-19 Crisis
Triple-I Publication: A Firm Foundation: How Insurance Supports the Economy

Triple-I Publication: A Firm Foundation: How Insurance Supports the Economy

 
Triple-I Blog

COVID-19: Learning From History 

COVID-19: A Teachable Moment for Thinking About Risk 

Putting Car Insurance Prices Into Perspective

As car insurers help their customers cope with the pandemic’s economic impact through premium refunds and other relief measures and some groups complain the efforts are insufficient and ask regulators to make insurers pay more, it’s worth noting that the cost of insuring motor vehicles  has grown more slowly than inflation over the past 12 months and well below prices for hospital services and car repairs – two key drivers of car insurance claims.

As the chart below shows, year-over-year increases in auto insurance prices have trailed growth in the Consumer Price Index, the most widely used measure of inflation. 

“Auto premiums are kept relatively low by competition among insurers,” explained Triple-I chief economist Steve Weisbart. “This has been happening even as two major contributors to claims have grown much faster. In the case of hospital services, prices have not just been rising – growth has been accelerating since last July.”

You read that right. Even as two of the biggest contributors to claims – the money insurers pay policyholders after accidents – have grown faster than inflation, the prices policyholders pay for coverage have grown more slowly than consumer prices generally.

Many factors come into play when an insurer determines an individual’s premium payment – age, driving record, where and how far one generally drives, and much more; and, let’s face it, no one likes to pay for insurance or to see their payments go up. 

But think about it: even though you might roll the dice if your state didn’t require you to have insurance, would that really be a wise move? Would you really want to be on the hook for the full cost of damage to your car or that of another driver? Or for the liability associated with someone’s injury or death?

That premium payment provides an awful lot of value in terms of peace of mind – IF you think about it.  And, if you think further about it, you have more control over how much you pay for car insurance than you do over other products and services.  You can shop around. You can change how much or what type of coverage you buy. You can bundle auto with other coverages. You can get fewer tickets and improve how you handle your credit.

And as usage-based insurance, powered by telematics, gains traction, your options will only increase.

Compare this with, say, cable and satellite TV. Your ability to shop around is quite limited (though improving with each new streaming opportunity that comes online). The products you really want come bundled with others you would never pay for if you had a choice.

And the prices of these services, as the chart below shows, continue to grow at rates well above both CPI and car insurance.

Insurers respond to COVID-19 with host of relief initiatives

Insurance companies are working to alleviate the impact of the COVID-19 crisis by supporting their employees and distribution partners, donating money to global relief efforts and easing the financial burden on their customers.

Triple-I has published a fact sheet, Insurers Offer Forward-Looking Solutions for COVID-19 Recovery, which outlines how the industry is easing its customers’ financial burdens, working with government to create a COVID-19 Recovery Fund, and making sure it has the resources to pay future claims from events such as hurricanes, tornadoes, and wildfires.

Here are a few examples of what individual companies are doing:

Allstate will automatically cover customers who use their personal vehicles to deliver food, medicine and other goods for a commercial purpose. Standard personal auto policies typically exclude such coverage. This change will allow customers to serve those who depend on their services and support.

Allstate also announced a special payment plan to provide customers financial relief. The plan gives auto and homeowners policyholders the choice to delay two consecutive premium payments with no penalty. In addition, Allstate is pausing policy cancellations due to nonpayment during the declared COVID-19 state of emergency. This includes Allstate Business Insurance policies. 

Ninety percent of Allstate’s global workforce is working remotely. Allstate will continue to pay employees (full or part time) who can’t work remotely and have shelter-in-place orders during their normal work hours. Well-being services like telemedicine, prescription home delivery, and emotional and financial support lines are available to Allstate’s U.S. employees.

American Family Insurance along with the American Family Insurance Dreams Foundation, announced more than $4 million in support for COVID-19 pandemic relief and other non-profit efforts. Additional support from the Steve Stricker American Family Insurance Foundation is expected to push the total support to more than $6.8 million.

“The pandemic has left many struggling to meet basic needs while at the same time adapting to a new and unsettling normal,” said Maggie Pascaly, American Family community investment manager. “We want to help meet short-term needs of individuals, families and communities, while also addressing longer-term effects.”


The company’s employees and agency owners can support local organizations of their choice by using a 2:1 foundation match offered during a six-week time period beginning March 31. The foundation will match donations totaling up to $250,000, for a maximum additional investment of $500,000. Organizations that provide pandemic relief will be suggested for consideration.

Chubb announced that it is committing $10 million to pandemic relief efforts globally.  The support will go to people and programs providing emergency frontline services and for assistance to the most financially vulnerable members of the community who have been impacted the hardest by the pandemic. 

The company also announced that it will not conduct any layoffs of its employees while in the midst of the COVID-19 pandemic health crisis, and has added employee benefits such as additional sick days.

“We are committed to supporting people, business and communities most impacted by this global crisis,” said Evan G. Greenberg, chairman and chief executive officer.  “Our $10 million commitment will add to the urgent efforts required to meet the immediate health and nutrition needs of those most affected. Concerning our no-layoff pledge, we want our 33,000 employees around the globe to be assured that their jobs are secure at this difficult time.”

Travelers has initiated a distribution support plan to accelerate more than $100 million in commission payments to eligible distribution partners.

“As so many are facing a significant financial burden due to the COVID-19 pandemic, we want to show our agent and broker partners, many of whom are small business owners, our support at this challenging time,” said Alan Schnitzer, chairman and chief executive officer of Travelers. “Independent agents and brokers not only provide invaluable counsel and care to our customers but also play a critical role in the U.S. economy, and we are committed to standing by them.”

Bob Rusbuldt, president and chief executive officer of the Independent Insurance Agents & Brokers of America, said: “Travelers has always been the premier supporter of independent agents and brokers, and the Travelers Distribution Support Plan takes that support to a whole new level. We want to thank Travelers for their continued industry leadership.”

The commissions being accelerated were accrued in the ordinary course of business during the quarter ended March 31, 2020, and accordingly, this program will not have a significant impact on the company’s results.

MAPFRE, an insurance company based in Spain, is allocating 54 million euros to support customers and suppliers. This is in addition to 5 million euros recently donated to accelerate COVID-19 research in Spain.

More than 90 percent of MAPFRE’s 34,000 employees worldwide are working remotely to reduce the risk of contagion and to guarantee service to customers, who in Spain are being offered a free advisory service to learn how they can take advantage of the support that is on offer.

Tell us how your company is contributing to the pandemic relief efforts: communications@iii.org.

Triple-I: Insurers Offer Solutions For COVID-19 Recovery

U.S. insurers are meeting the challenges faced by their customers, communities, and employees amid the COVID-19 crisis, according to a fact sheet released April 3 by the Insurance Information Institute (Triple-I).

“The nation’s insurers continue to work actively on immediate and forward-looking solutions that will assist its customers and communities in recovering from COVID-19,” said Sean Kevelighan, CEO, Triple-I.

The fact sheet, Insurers Offer Forward-Looking Solutions for COVID-19 Recovery, outlines how the industry is easing its customers’ financial burdens, working with government to create a COVID-19 Recovery Fund, and making sure it has the resources to pay future claims from events such as hurricanes, tornadoes, and wildfires.

Immediate Customer Solutions: Insurers are offering payment relief and extending coverage to customers who are in financial distress while at the same time keeping its employees on the job to serve these same customers, the Triple-I notes.

Government-Backed Solutions:  Trade groups representing insurers have voiced support for the proposed COVID-19 Business and Employee Continuity and Recovery Fund. It would be financed by the federal government and provide essential funds to impacted employers and employees.

Facing Challenges Head-On: Workers compensation insurers in multiple states are covering the healthcare workers and first responders who face exposure to COVID-19 while auto, home, and business insurers are setting aside the resources needed to pay the claims arising out of future natural disasters even as insurer investment portfolios have faced their own headwinds. A Triple-I non-resident scholar predicted yesterday the likelihood of an ‘above-normal’ Atlantic hurricane season

Insurers have also contributed financially to food banks and organizations providing medical supplies.

RELATED LINKS:

Triple-I Presentation:   The Impact of COVID-19 On P/C Insurance

Triple-I Publication:     A Firm Foundation: How Insurance Supports the Economy

Triple-I Blog:                COVID-19 coverage
 

Proper decontamination before and after coronavirus exposure is crucial

While insurance policies might not cover the mitigation or cleanup costs related to commercial facility exposure to the coronavirus, preserving a healthy and safe place of business remains a critical risk management issue.

As the coronavirus (COVID-19) continues to spread rapidly around the world, it’s important to know what to do if someone carrying the highly contagious virus comes in contact with any of your facilities or those of your customers. Even the potential of your business premises being exposed to COVID-19 can create a possible need to engage risk mitigation efforts. Understanding the importance of utilizing a professional, credentialed decontamination contractor both before and after facility exposure is crucial to protecting your business.

Larry Thomas

“COVID-19 has presented new challenges for businesses around the world, and it’s necessary to understand the importance of ensuring the safety of all employees and customers,” said Larry Thomas, global president of Crawford Specialty Solutions, a division of Crawford & Company that includes Contractor Connection. Contractor Connection, an industry leader in managed repair services, provides insurance carriers, brokers and consumers a global network of more than 6,000 contractors vetted and managed for performance in residential and commercial work, including specialists in technical areas like cleanup after a biological event.

“Experts have warned that we have just begun to feel the impact of the virus in the U.S., and it is expected to continue to affect lives for the foreseeable future.”

With that in mind, it’s essential you ensure you are utilizing a decontamination contractor who is rigorously vetted, held to the highest standards, and professionally equipped to restore affected sites through proper remediation and containment procedures. Here are some best practices for how to approach this critical work while reducing risk for you and your customers.

Prevention protects you, your customers and others

Prevention is the first step toward reducing exposure to the virus. Even before an incident occurs, a decontamination contractor can work with your business to provide cleaning and disinfecting services designed to reduce the opportunity for infection and keep facilities operating longer. When administered by a trusted, licensed and insured provider, preventative cleaning provides a cleaner, safer work environment and enhances employee and customer satisfaction.

Decontamination services limit business interruption

If you or your customers’ facilities are exposed to coronavirus, legitimate decontamination services using proper techniques, equipment and materials, and following CDC, state and local protocols should be employed to restore your places of business back to operation as quickly as possible, limiting business interruption. Time is critical, so you should engage with a service that provides 24/7 assignment processing and emergency response.

Lance Malcolm

“Providing access to a rapid-response decontamination service can help reduce the potential impact of contamination in the workplace and return the environment to full operational status as quickly as possible,” said Lance Malcolm, U.S. president of Contractor Connection. “The focus must be on helping companies limit business interruptions and ensure that the affected facilities are completely safe for those who use them.”

Safe biohazard waste disposal reduces future risk of exposure

As part of decontamination services, it’s also important to utilize contractors trained to handle and properly dispose of biohazard waste, safely removing any affected materials from the facility. Services that provide quality assurance review and project monitoring ensure speedy completion and provide peace of mind knowing exposure to the virus has been properly reduced or eliminated.

Insurers Are “Financial
First Responders”
in COVID-19 Crisis

U.S. insurers are covering employees and employers facing exposure to COVID-19 while easing the financial burdens of their customers and communities during an extraordinary time in the nation’s history, according to the Insurance Information Institute (Triple-I).

“These are challenging times for insurance customers, and the industry is doing all it can to be a financial first responder. Workers compensation insurers are providing coverage to health care workers and first responders in multiple states,” said Triple-I CEO Sean Kevelighan. “Business insurers are protecting financially the restaurants who now offer take-out and delivery services. Beyond that, insurers are extending coverage and payment relief to customers who are struggling financially.”

A Triple-I Fact Sheet, Insurers Are Engaged In the COVID-19 Crisis, outlines how the industry’s financial stability allows insurers to keep the promises made to policyholders in the event of tornadoes, hurricanes, or wildfires. The Fact Sheet also notes how insurers are contributing to COVID-19 related charities, such as food banks and medical supplies.

“Pandemics are an extraordinary catastrophe that can impact nearly every economy in the world, so it is hard to predict and manage the risk,” Kevelighan said. “Pandemic-caused losses are excluded from standard business interruption policies because they impact all businesses, all at the same time.”

Moreover, the exclusion for pandemic-caused losses has been incorporated into standard business interruption policies for years.

A standard business interruption policy typically covers a business when it incurs direct physical damage due to a covered loss, such as a windstorm or a fire. Covered business interruption policy losses—even from a hurricane or a terrorist attack—impact only a portion of the U.S. rather than the entire nation. 


RELATED LINKS:

Triple-I Presentation: The Impact of COVID-19 On P/C Insurance
Triple-I Publication: A Firm Foundation: How Insurance Supports the Economy


Triple-I Blog:

 COVID-19: Learning From History

COVID-19: A Teachable Moment for Thinking About Risk
 


The Triple-I has a full library of educational videos on its YouTube Channel. Information about Triple-I mobile apps can be found here.

States’ COVID-19 Experiences Vary
as Testing Takes Hold

Coronavirus cases in the United States surged past 55,000 on Wednesday, while the death toll has climbed past 800, with 354 recoveries, according to figures from Johns Hopkins University.

Nearly half of those cases are in New York, which had reported more than 260 deaths as of Wednesday.

All numbers are moving targets in this fast-changing situation, both because of the rate of spread and state-by-state differences in testing.

Coronavirus update: Global cases hit 451,355 with 20,499 deaths, and New York rate of infection is accelerating  
Apple and Facebook donate face masks stockpiled for their own workers during years of wildfires in California
MarketWatch.com
Published: March 25, 2020 at 3:05 p.m. ET

Louisiana reportedly has the third-highest case load of coronavirus in the United States on a per capita basis – after New York and Washington – and the fastest growth, according to a University of Louisiana at Lafayette analysis of global data.

New Orleans emerges as next coronavirus epicenter,threatening rest of South
March 25 (Reuters) - New Orleans is on track to become the next coronavirus epicenter in the United States, dimming hopes that less densely populated and warmer-climate cities would escape the worst of the pandemic, and that summer months could see it wane.

New Orleans is a center of coronavirus. Mardi Gras could be to blame, doctors say.
NBC News
March 24, 2020, 5:11 PM EDT

Some health experts say it’s no surprise New Orleans would be hard hit after over a million people flocked to the city to celebrate Carnival for more than a month, culminating in Mardi Gras at the end of February.

Gov. John Bel Edwards has requested a Major Disaster Declaration for the state, where at least 46 people have died.

“It is still impossible to know exactly how long the COVID-19 pandemic will impact Louisiana,” the governor said, “but what we do know is that we have more cases per capita than every state, except for New York and Washington.” On Sunday, he issued a stay-at-home order to slow the rapid rise.

While some parishes appear to be unaffected, Edwards said testing just hadn’t caught up. “We shouldn’t delude ourselves. It’s in every single parish,” he said.

In Florida, Gov. Ron DeSantis said New York’s order for people to stay home to curb the spread of the new coronavirus led some people to leave — and come to Florida. At a news conference, the governor said he’d spoken with President Trump about doing something about airline flights ferrying New Yorkers to Florida.

Airlines could completely shut down flights in the US as the coronavirus rages on
Business Insider
Mar 24, 2020, 11:50 AM

Nearly 80 airlines cut capacity by 100 percent over coronavirus
TheHill.com -
March 24, 2020 02:09 PM EDT

COVID-19 diagnoses continue to be made in Washington state every day, the Seattle Times reported — an indication of both the virus’ spread and of expanded testing capacity. The state Department of Health announced 248 newly confirmed cases Tuesday, bringing the state total to 2,469 cases, including 123 deaths. The bulk of Washington’s cases remain in King County, which has seen 1,277 people fall ill and 94 die.

Possibility of “ventilator triage”

Faced with more critically ill COVID-19 patients than equipment to treat them, hundreds of hospitals are mapping out how they can ration care and equipment in order to save the greatest number of patients possible.

Guidelines were provided this week to scores of hospitals around the country that include a point system that could – in extreme cases – end up determining what patients live or die.

“Priority is assigned to those most likely to be saved, and most likely to live longer,” said Dr. Scott Halpern, professor of medical ethics and health policy at the University of Pennsylvania.

Hospital Capacity Crosses Tipping Point in U.S. Coronavirus Hot Spots
Epicenters resort to patient transfers and a makeshift morgue to cope as coronavirus infections mount

The Wall Street Journal
Updated March 26, 2020 10:15 am ET

Potential employer liabilities

Decisions made in the fluid pandemic crisis could lead to liability issues in the future. Marsh & McLennan has advised employers that even well-intended actions can lead to liability claims. In particular, it advises them to keep in mind:

  • Employees who refuse to work due to a belief that their health could be in immediate danger could be considered to be engaged in protected activity under the Occupational Safety and Health Act. Employers should avoid subjecting those employees to adverse action.
  • A group of employees who refuse to work because of concerns about the virus could also be considered protected under the National Labor Relations Act. Disciplinary action or termination of these employees could thus lead to an unfair labor practice claim.
  • There are no federal requirements that nonexempt (hourly) employees be paid for time not working — for example, while under an employer-mandated quarantine — nor is there a federal paid leave of absence law. But employers must be cognizant of the myriad state and local laws that bear on these issues. 

Health insurer costs and profit pressure

Managed care companies in the U.S. are likely to see elevated cost trends and more significant pressure on their profits the longer the COVID-19 pandemic continues, according to S&P Global Ratings.

S&P said in a report that the impact will depend on how far and how quickly the coronavirus spreads, as well as how many hospitalizations it causes.

“If the outbreak is mild both in terms of the infection rate as well as morbidity, the impact will be limited,” the report reads. “However, an increased spread of the virus and higher morbidity from COVID-19 could result in higher-than-expected cost trends for insurers. The claims trend will be especially affected if more patients are treated in inpatient facilities compared to lower-cost outpatient settings.”

COVID-19 Spurs Jobs
For Robots, Drones,
Other Technologies


COVID-19 threatens to overwhelm the U.S. health system in coming weeks, creating a need for remote services.

Robots, drones, and other technologies are being deployed in the fight against COVID-19, introducing new opportunities, challenges, and risks.

From “tele-health” solutions that facilitate care from a distance to robots that disinfect facilities to  drones that help manage crowds, the pandemic is spurring novel uses of existing technologies and could lead to new ones as nations, companies, and communities try to be better prepared for the next outbreak.

Telemedicine

Use of video conferencing and other forms of remote health-care delivery was developed to serve communities with few medical facilities. Today’s extreme circumstances, however, highlight its broader value.

Medicare this week said it will expand coverage for telemedicine nationwide to help seniors with health problems stay home and avoid coronavirus exposure. The virus threatens to overwhelm the U.S. health system in coming weeks, creating a need for remote services.

However, a patchwork of state-by-state regulations is slowing the advance of telemedicine.

“Oregon just rejected us because we didn’t have a facility there, and they told us to get one before we reapplied,” said James Wantuck, chief medical officer at San Francisco-based telemedicine firm PlushCare. “North Carolina, we found out, is really targeting retired doctors who previously had a license in that state, while other states like Mississippi, Colorado and Florida are making it very easy for our doctors to get licensed there.”

Over the past week, increased demand has slammed facilities that are used to serving only a few patients a day and now face backlogs.

“You can get the technology to support these astounding volumes,” said Roy Schoenberg, CEO of Boston-based telemedicine company Amwell. “But you’re very quickly getting to a point where the supply of medical services isn’t there. We need to have enough clinicians to allow us to handle that incoming volume.”

Robots

At the Wuchang field hospital in Wuhan, China – epicenter of the first coronavirus outbreak – a ward was staffed with 5G-enabled robots to help contain the contagion and alleviate the strain on human personnel.

Doctors in the United States used robot-assisted telemedicine to treat the first person in the country admitted to hospital with 2019-nCoV. In a two-bed isolated area at Providence Regional Medical Center in Washington – set up five years ago to deal with Ebola but never used – a robot equipped with a camera, microphone, and stethoscope enabled the patient consult with clinicians without direct contact.

Robots also are being used for disinfection.  Xenex robots – manufactured in San Antonio, Texas – use pulsed xenon ultraviolet-C (UVC) light to destroy pathogens. The company says its devices are being used to clean hospital rooms where there have been suspected cases of the new coronavirus. The robot can clean a room in as little as five minutes.

Los Angeles-based Dimer UVC Innovations has developed a germ-killing robot to sanitize airplanes. The robot – called GermFalcon – is being used at the Los Angeles International Airport, San Francisco International Airport, and John F. Kennedy International Airport.

Drones

In Spain, police are using drones to warn people to stay at home. Spain has declared a state of emergency and ordered citizens to stay indoors, apart from necessary trips, after reporting a sharp rise in coronavirus cases. BBC footage shows deserted Madrid streets policed by drones. The drones are controlled by humans who relay warnings through them via radio.

Similarly, in China drones were deployed to observe crowds and help manage traffic. People not wearing masks in public could be identified, and the drones were able to broadcast information to larger areas than regular loudspeakers. They also used thermal imaging to identify people with elevated body temperatures and were used to spray disinfectant in public areas.

Longer-term implications

Expanded use of these technologies against COVID-19 is a logical continuation of their evolution, but such advances don’t occur in a vacuum. Concerns about machines replacing human workers – especially if this outbreak ushers in a new era of “social distancing” – and about normalizing surveillance and use of drones for crowd control almost certainly will be raised.

If telemedicine gains greater traction, will cost efficiency conflict with efficacy of care?

Will internet-enabled technologies create more channels for cybercriminals to exploit?

Will greater social acceptance of technological solutions result in decreased attention to low-cost approaches to containment, like hand washing and environmental cleanliness?

Policymakers, corporate decision makers, and communities will need to address these and many other questions after this virus has been suppressed.