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Do you or your business have a Pandemic Insurance Claim? What is a Pandemic Insurance Claim? What triggers a Pandemic Insurance Claim? Why are insurance companies denying Pandemic Insurance Claims? This article will attempt to answer some of these questions and give suggestions on how individuals and businesses can begin to move forward on a suspected Pandemic Insurance Claim, even if it has already been denied.
What is a Pandemic Insurance Claim?
According to the Center for Disease Control a pandemic is, “a global outbreak of disease. Pandemics happen when a new virus emerges to infect people and can spread between people sustainably. Because there is little to no pre-existing immunity against the new virus, it spreads worldwide.”1 In our current situation, the pandemic is related to COVID-19 or the “Coronavirus”. The COVID-19 abbreviation was coined because it is “coronavirus disease 2019”. While the public and the media have also addressed this virus as “corona” or the “coronavirus”, understand that coronaviruses are a family of viruses that can impact humans and animals (including cattle, cats, and bats). COVID-19 has been declared a pandemic across the globe. Accordingly, this declaration may trigger insurance coverages for certain losses.
A Pandemic Insurance Claim is a claim filed with an insurance company related to losses sustained as a result of the pandemic. Not all insurance policies provide specific coverage for loss caused by pandemics or a virus. On the contrary, many policies actually exclude losses caused by a virus or pandemics. The first step in determining whether you or your business may have a Pandemic Insurance Claim is to analyze if there has been an identifiable or quantifiable loss which can be associated with the pandemic. The World Health Organization declared COVID-19 a pandemic on March 11, 2020. In the United States, state and local governments began to take action to protect citizens against the pandemic. On Friday, March 20, 2020 New York Governor Andrew Cuomo announced a statewide lockdown of all nonessential business operations. On March 25, 2020, the Pinellas County Commission issued a “safer-at-home” order. This order requires businesses to practice strict compliance with CDC social distancing guidelines and ceased operations of nonessential business. These types of orders were implemented almost statewide. On April 1, 2020, Florida Governor, Ron DeSantis, issued a stay-at-home order which by and large mimicked various local governments’ stay-at-home orders. One of the most impactful requirements was the required closure of nonessential businesses.

It is fairly easy to correlate the timing of the closures with loss of business revenue. Once this correlation has been made, the next step is to examine your insurance policy. Most of these Pandemic Insurance Claims will be related to business interruption and the lost income that results. First, determine if there is coverage provided in the policy for losses caused by pandemic or virus. Be on the lookout for specific exclusionary language related to viruses and pandemics. If there appears to be coverage provided, business owners are encouraged to submit a claim for loss to their insurance company. Unfortunately, insurance companies have been attempting to find ways to deny Pandemic Insurance Claims, even when there is coverage. If your claim has been denied and there is specific coverage afforded, contact a law firm immediately to address this wrongful denial.
Do Insurance Companies Cover Pandemics?
It has been estimated that approximately 60-70% of commercial insurance policies offered by insurance companies specifically exclude coverage for lost revenue due to pandemic or virus. This leaves 30-40% of commercial policies which do not have this exclusion. In this case, the next question is to determine if the policy is an “all risks” policy or if the policy provides coverage for losses caused by actions by a civil authority – this is sometimes referred to as “Civil Authority” coverage. Generally speaking, an “all risks” insurance policy provides insured coverage for losses stemming from “all risks” or “all perils” but then limits the coverage by stating exclusions or excluded perils. If a peril is not excluded then the argument is that the peril must be included because the insurance policy insurers “all risks” and the damaging risk, in this case, pandemic or virus, was not specifically excluded.
Generally, Civil Authority coverage protects businesses in the event of loss caused by the actions of a civil authority. Applying this concept to the COVID-19 pandemic, when any “civil authority” whether it be local, state or national government, issues orders which in turn cause business interruption, this would trigger Civil Authority coverage. Some local authorities were urged during the passage of stay-at-home orders to include language that COVID-19 causes property damage due to the virus’s ability to attach to surfaces for long periods of time. Some local executive orders in Florida have included this suggested language. This type of property damage language would also trigger Civil Authority coverage and potentially other policy coverages for business owners.
The easiest examples of businesses that have clearly been impacted by the pandemic in Florida are bars and restaurants (and pretty much anything to do with tourism). Florida’s bars and restaurants have been gutted by the closures mandated by local, state, and national governments. Many of these businesses have submitted insurance claims already only to be coldly denied and left without any help from the insurance company which provides these businesses insurance coverage. So why are these insurance companies denying these claims? Some of the industry’s commentators believe that if insurance companies began to cover business interruptions claims related to the COVID-19 pandemic, this would be a catastrophic loss for the property and casualty companies, some of which would not be able to survive.
What Happens If My Pandemic Claim Is Denied?
I suspect the insurance industry is going to be forced to take a uniform stance of denying Pandemic Insurance Claims so as to avoid the opening of the flood gates. With that said, lawsuits have already been filed related to insurance companies denying Pandemic Insurance Claims and will continue to be filed. With hundreds of millions of dollars on the line, these lawsuits will be heavily litigated and eventually will drive policy decisions on how to resolve this issue. In order to preserve your business’s ability to pursue a Pandemic Insurance Claim, I recommend having an attorney review the subject policy of insurance or your already denied claim to advise whether your Pandemic Insurance Claim is able to be pursued in court.
If you believe your insurance company has underpaid, denied, or delayed your Pandemic Insurance Claim, contact my office immediately for a FREE CONSULTATION AND FREE INSURANCE POLICY REVIEW.
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