C

OVID-19 has exposed long-overlooked frailties in existing insurance and contract terms on costs and delays, provoking a needed conversation. The vulnerabilities came into view within the first months of the pandemic.

First, lawyers called for contractors to invoke the force majeure clauses in their contracts with owners to win grants of extra time—but that didn’t address the costs. About the same time, states, which set workers’ compensation terms, started passing laws or issuing orders that retroactively required insurers to pay virus medical claims for some types of workers under existing workers’ compensation policies.

然后，随着冠状病毒促使承包商和所有者谈判谁将支付额外的费用，电影院，餐馆，餐馆和各种专业服务公司，而英国则向其财产保险公司提起诉讼，以支付其业务中断支出。18luck.cubDesign-Giant Aecom上个月对保险公司苏黎世进行了自己的诉讼。

DPR Construction的保险和风险经理Amy Iannone说：“从我的角度来看，没有一个全面的价格来保护我们。”

当大流行带到经济的旅行，零售和娱乐部门时，建筑，在大多数城市和州都被归类为必不可少的，并以某些停顿为必不可少。尽管风险管理的世界处于动荡状态，但只能估计对建筑的最终影响。

获得工人的赔偿。自19世纪成立以来，它已经扩大了与工作场所相关的疾病，但它从未被用来涵盖大流行中的传染病。

立法者返回工人的赔偿

By the time 2020 ended, more than 30 states had amended or weighed amendments to their workers’ compensation statutes to retroactively include a presumption of coverage, according to a compilation by the National Council of Compensation Insurers, the major industry rate-setting organization. In many states, the presumption is only applicable to health care, first responders, teachers, and certain other categories of essential workers.

总部位于丹佛的经纪人IMA Inc.的工人薪酬专家Sonja Guenther表示，大流行使该行业在捕获统计数据以及对工资报告和经验修改评级的影响方面创新了。评级局同意将COVID-19的伤害代码为“猫损失”或灾难性损失索赔，从而使保险公司能够捕获影响，但阻止其成为精算评级或经验评级的因素。

Another innovation, Guenther says, was a temporary change in payroll rules made in early 2020 that allowed employers to shift payroll into less-expensive codes for employees working from home and to document payroll for employees being paid but not working during stay-at-home orders. “Unprecedented, really, in our industry,” Guenther says.

加利福尼亚是改变工人赔偿的州的一个例子。

它始于州长加文·纽瑟姆（Gavin Newsom）在春季的五月行政命令，要求雇主和保险公司认为一些测试正面的工人在工作或由于工作而对该病毒签约。9月，州立法者通过采用一项新法律，涵盖了卫生保健工作者，急救人员和工作场所，其中特定百分比的员工测试在爆发期间呈阳性。

“These presumptions fundamentally change one of the basic tenets of workers’ compensation, the burden of proof,” wrote Kimberly George and Mark Walls in a November essay on the website insurancethoughtleadership.com. George, a senior vice president at healthcare consultant Sedgwick, and Walls, a vice president at insurer Safety National, noted that typically, under workers’ compensation the affected employee would be responsible for proving an exposure.

但是，乔治和沃尔斯写道，最大的含义是，在未来全球大流行中，Covid-19为工人对所有传染病的赔偿打开了大门。

Thus far workers’ compensation has not seen losses that would drive up costs, says Michael Deemer, the claims team leader at Risk Strategies, a specialized insurance broker. “The COVID claims have been relatively modest in the amount paid compared to non-COVID claims and (in many cases) they just involve symptoms without hospital stays.”

他说：“我们没有看到残疾。”除非案件涉及医院重症监护。

某些非covid-118luck.cub9索赔的总成本越来越高，因为它们的开放时间更长。由于人们无法去看医生并因预防病毒限制而无法获得医生并获得身体上的索赔，例如滑倒和瀑布等常规伤害的索赔。另外，可能没有办公室可以回去。

Deemer建议，COVID-19的索赔将不如滑倒或摔倒或破碎的伤害，而调节器和医生对索赔的调查也将有所不同。索赔人不太可能或通过视频完成。

业务中断：谁会占上风？

For now, the multibillion-dollar conflict over property insurance and business interruption claims is more consequential.

According to the National Association of Insurance Commissioners, about 8 million commercial insurance policies include business interruption coverage, 90% cover businesses with fewer than 100 employees, 83% include an exclusion for viral contamination, virus, disease or pandemic, and 98% of all policies had a requirement of physical loss. The total premium was $44.2 billion, with 4.9% specifically for business interruption claims.

最初，许多诉讼中提出的问题似乎是一个开放的问题。尽管该物业索赔已经要求财产损失，但许多保险公司在SARS爆发之后于2006年左右开始了新修订的病毒排除。

然而，许多财务海峡的政策持有人都认为或希望这种中断涵盖。

他们已经在州法院填补了码头，诉讼认为该病毒实际上造成了财产损失，从而触发了业务中断的承保范围。尽管保险公司使用行业标准形式和排除措施，但基本保险协议中的语言因公司而异，一些政策显然缺乏排除。律师已搜索可能是索赔基础的空缺。

财产和人员伤亡保险公司因数十亿美元的危险而辩称，这些索赔将消除储备和中断保险市场。他们将一些责任归咎于积极的律师。

C

harles Chamness, chief executive of the National Association of Mutual Insurance Companies (NAMIC), portrayed the claims as part of an unethical strategy by lawyers that includes publicizing claims by famous chefs whose restaurants were hit hard by the pandemic. The publicity was to create favorable public opinion that would then “make everything easier in your legal cases,” Chamness said in a video addressed to association members on the NAMIC website. “It shouldn’t work that way, but it might.”

但是，在法院之外，一些州议员和州长试图通过利用保险公司来为未来的大流行经济紧急情况提供资金。

As of December, lawmakers had introduced bills in nine states that would require insurers to include pandemic clauses under business interruption policies. In Pennsylvania and Louisiana, the requirements would apply to all companies, and in the other states they would apply to small companies. Some of the proposed laws provide for insurer-created pools to fund claims.

纳米克（Namic）政府事务总顾问安德鲁·保利（Andrew Pauley）盘点诉讼和拟议法律。

在Namic网站上的白皮书中，他写道，一到两个月的索赔可以完全消除整个物业/伤亡保险业的储备能力。他将追溯改变业务中断和工人补偿的诉讼描述为“意外情况下，但实际上是轻率的 - 在大流行期间提供帮助”。

理解政策条款的代理商和经纪人可能会激励不鼓励客户的索赔。

“If your client comes to you and wants to submit a claim, submit the claim on their behalf” even if you tell them you don’t believe it will be paid, said Christopher J. Boggs, executive director for risk management and education for the Independent Insurance Agents and Brokers of America Virtual University, in a webinar hosted by Insurance Journal. Insurers, not brokers, deny claims.

Aecomv. Zurich Lawsuit

AECOM的主张将不得不在其“全风险”全球财产政策中克服语言，而苏黎世则不包括所有污染物，而不是由辐射引起的污染。AECOM声称苏黎世已删除了保险公司使用的病毒或大流行排斥，并且作为涵盖Aecom许多工作场所的“全风险”政策，苏黎世有义务支付义务。每种情况都取决于管辖权，事实和政策语言。

In the U.S. so far, the plaintiffs have by and large not prevailed in court.

And several sources report that insurers are armor-plating the language in pandemic exclusions for policies up for renewal. “Any carriers that have language in their contracts that wasn’t really clear are now being explicit. They are just really tightening them up,” said DPR’s Iannone.

但是，英格兰的原告在美国上个月在伦敦的上诉法院比其同行更能显示出来或被大流行与客户和收入隔绝。

w

hat does the future hold? Property and casualty insurers have proposed a government-backed plan similar to terrorism insurance. It has not gone far in Congress and could have many obstacles to overcome. The businesses likely to buy such policies are ones most likely to shut down in a pandemic, creating problems for spreading out losses that insurance relies on.

有一种与财产政策无关的大流行有关的独立专业保险。

Chad Wright, head of North American Alternative Risk Transfer for broker Marsh, says his company had launched an insurance policy called PathogenRX in 2018 with Munich Re and technology firm Metabiota. It was designed to help companies grappling with interrupted operations in a pandemic.

现在，与潜在客户的讨论集中在购买覆盖范围的未来大流行。赖特说：“大流行后，我们被询问淹没了。”现在，Marsh，Munich RE和Metabiota正在大修该产品，该产品最初是基于流行病，而不是大流行病。

根据病原体的原始计划，健康精算师将使用发病率和死亡表模型，这些事情可新利luck能不一定会杀死您，但可能会阻止您从一个地区到另一个地区旅行或可能关闭国际边界，例如Zika。最初的客户群可能与旅行或酒店有关。赖特说，这是根据一个地区的一定数量的死亡人数围绕情感得分的变化而结构的。

现在，正在重新考虑覆盖范围。

New potential triggers would involve declarations of a pandemic or a civil authority lockdown followed by evidence that a policyholder suffered a loss.

wright said there would be a limit as high as $50 million and as low as $500,000, with the annual premium in the range of 3% to 6% of the limit of the policy. Policy holders could use the claim to help with cash flow, delay costs or pay for personal protective equipment. Until the present pandemic abates, Wright acknowledges, customers may wonder if it makes sense to buy a new policy.

更大的问题也仍然存在。一种是保险是否可以为所有全球风险制定负担得起的政策，包括很少有人认为一生中会发生的事件。另一个是一个决定在需要覆盖范围的社会是否明确购买之后，无论如何都应该能够要求它。