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  #91  
Old 04-08-2020, 03:51 PM
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llcooljabe llcooljabe is offline
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Originally Posted by Arthur Itas View Post
I would guess the primary coverage is employers liability piece of WC.
Don't work WC. Sorry if dumb questions:

Are there pandemic exclusions in WC? In a non-pandemic situation, can a worker sue the employer because he can "trace" his, say, flu to a coworker? e.g. (maybe extreme) bc no sick time, sick people continue to come to work and someone catches the illness from the coworker?
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  #92  
Old 04-08-2020, 04:54 PM
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Quote:
Originally Posted by llcooljabe View Post
Don't work WC. Sorry if dumb questions:

Are there pandemic exclusions in WC? In a non-pandemic situation, can a worker sue the employer because he can "trace" his, say, flu to a coworker? e.g. (maybe extreme) bc no sick time, sick people continue to come to work and someone catches the illness from the coworker?
WC is a statutory coverage, which essentially means that you are obligated to pay the benefits laid out in state statutes/regulations.

There are no "exclusions" in the typical sense, just that the injury or occupational disease had to rise out of the course of employment.

So, rather than a pandemic exclusion, you have to show that your COVID arose from the ordinary course of your employment. Typically occupational disease has different triggers than "injuries."

So, what typically ends up happening as that an administrative law judge rules on compensability.

That said, many states have "presumption language" that puts the burden of proof on the employer to show that the injury or diseases was NOT caused by work, otherwise it's covered (the opposite of the normal situation in which the injured worker has the burden of proof).

This presumption language is typically related to occupational cancers (e.g. firefighters). But in the wake of this crisis, many states have expanded their presumption language to include COVID. Most often, it is for first responders only (others may be covered, but they have the burden of proving it was contracted on the job). States also have different definitions of first responders, both typically, and even moreso for COVID (e.g. firefighters, paramedics, etc. almost always are, but in some states all healthcare workers may be for this crisis, and in a smaller number of states even grocery store front line employees may be).

What will become interesting over time is so called "mental-mental" claims -- a mental injury with no physical component. PTSD after a shooting is mental-physical, but PTSD after being scared about COVID (but not contracting it yourself) would be mental-mental. Whether these are covered varies from state to state.

Also interesting is the question of what's covered under presumption language today. My state specifically includes lost time claims from people quarantined without a diagnosis. Other states may require an actual diagnosis.

Your Walmart example may have a small WC piece -- there is a statutory death benefit in most (all?) states, but it's typically pretty small (I've seen $5K in one state).

Employers liability is an add-on to WC (or included with a relatively low limit) that covers things beyond the scope of WC. Similar in some ways to fault (Er Liab) vs no-fault (WC). Er Liab is at least theoretically intended for cases of intentionality, versus accidents. Not providing safety equipment, violating OSHA standards, etc. could fall under er liab.

Lastly, Walmart is very likely self insured, albeit with some sort of external stop loss.

The issue with COVID is that most claims will be relatively small (e.g. two weeks of wages and minor medical), unless the worker needs ICU. There just could be A LOT of them all at once.
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  #93  
Old 04-08-2020, 05:21 PM
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Quote:
Originally Posted by Arroway View Post
Employers liability is an add-on to WC (or included with a relatively low limit) that covers things beyond the scope of WC. Similar in some ways to fault (Er Liab) vs no-fault (WC). Er Liab is at least theoretically intended for cases of intentionality, versus accidents. Not providing safety equipment, violating OSHA standards, etc. could fall under er liab.
Employers liability is the one that gives me the most pause. For example, consider retailers like Gamestop or Hobby Lobby. Both companies garnered a lot of media attention by refusing to close well after state governments ordered shutdowns of nonessential businesses. Neither company did anything to protect employees from the virus, with Gamestop specifically referring to their operations as "essential retail."

If an employee at one of those stores were to catch COVID-19 and suffer serious consequences, a lawsuit doesn't seem out of the question. These companies might argue that the employee could have caught the virus anywhere, but a plaintiff attorney could just as easily argue that the defendant company's response to governmental warnings was negligent, producing dramatically increased risk for the employee.

It'll be interesting to see how it all plays out. As we saw with asbestos litigation, costs could be enormous even if primarily driven by legal fees and settlements rather than trial verdicts.
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  #94  
Old 04-08-2020, 11:37 PM
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Quote:
Originally Posted by llcooljabe View Post
what LoB is this? Workers Comp? Employment practices liability? Something else?

https://www.insurancejournal.com/new.../08/563660.htm
comp isn't what they would want to sue under. that's a statutory benefit and the chance to claim the person was infected outside the normal course of their work is pretty easy in this case (unlike an ER nurse or a cruise ship worker - but on the seas it's a different thing too). So even while no fault, they would likely have to sue to try to get comp to cover it bc it's likely not contemplated in WC.

they would be claiming good old fashioned negligence. Walmart likely wouldn't need to declare what policy is being hit bc...they likely self insure and can pay it from cash or whatever. if they filter it through their insurance program formally it would likely be EPL in my opinion, if the argument is that through poor management they maintained an unsafe work environment

those are my guesses
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  #95  
Old 04-09-2020, 10:56 PM
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Posted in another thread, but worth repeating here. Sounds like Wimbledon organizers had the foresight and willingness to pay for separate pandemic cover. Reportedly they have paid $2m per year for pandemic cover for the last 17 years and payout this year is $141M
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  #96  
Old 04-10-2020, 09:18 AM
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Quote:
Originally Posted by Arthur Itas View Post
Posted in another thread, but worth repeating here. Sounds like Wimbledon organizers had the foresight and willingness to pay for separate pandemic cover. Reportedly they have paid $2m per year for pandemic cover for the last 17 years and payout this year is $141M
Found this article about Wimbledon. Within it, it mentioned "force majeure". How common are those on policies, as opposed to an outright exclusion, or a clause forcing physical damage to pay out?

Quote:
But most businesses in sports aren’t lucky enough to have taken out pandemic insurance, so many are relying on a very specific clause within contracts: “force majeure,” a French term that means “superior force.”

This clause is meant to cover unexpected acts of god or nature, and it could either absolve businesses from the terms of a contract or could help activate a payment from an insurer.
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  #97  
Old 04-10-2020, 09:26 AM
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Yeah, they aren't "lucky" enough to have insured against a known risk

Where was that from? I didn't see it in the USA Today link, although sounds like something they would write lol
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  #98  
Old 04-10-2020, 12:48 PM
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Unlike some of the other tourneys, they can't postpone or reschedule because the playing surface is grass. French Open rescheduled for the fall for example.
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  #99  
Old 04-10-2020, 01:32 PM
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Wimbledon is organised by the AELTC. The recently retired AELTC Chairman (for 9 years, before that Vice-Chairman, before that Treasurer) is an actuary. That might have had something to do with it.
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  #100  
Old 04-15-2020, 01:40 PM
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I'm not sure whether to post this here or in the political valence of the discussion...so I won't be offended if the mods move this.

Apparently the White House is coming out on the side of pressuring insurers to pay COVID-related business interruption losses.

https://www.insurancejournal.com/new.../14/564744.htm
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