Insurers are telling businesses their policies don’t cover coronavirus shutdown. John Morgan attorneys say they’re wrong.
As soon as
“My first question to her was, ‘Do I have the insurance that covers that?’" The other voice on the line delivered the solemn answer: No.
“She was so straightforward and blunt about it, that just tells me that’s the status quo of the entire industry,” said Moore, who with her business partner has owned the indie Austin’s Coffee, known for its open mic nights and collection of board games, for 17 years.
The issue has sparked a nationwide feud between business owners, who say their claims are being wrongfully denied, and insurance companies, who maintain that in most cases the situation is “uninsurable.”
Already, lawsuits have been filed in courts across the country, including in
Now,
During a recent conference call, attorney
“Why would they do that?" he asked. "Well, they would do that so you don’t bring your claim ... so you assume the answer is no.”
Policyholders, many of whom were unexpectedly shut down for weeks under mandatory stay-at-home orders or been forced to curtail operations, are frustrated and looking desperately to state and federal relief and insurance money to shore up business.
6 workers on furlough
Austin’s Coffee, a quaint staple of
She’s applied for a federal loan through the Paycheck Protection Program but hasn’t been approved. Fortunately, Moore said, the building’s landlord agreed to a cheaper monthly payment, but she’s gotten behind on the rent for her own home.
She hasn’t talked with her insurance agent again.
“This shouldn’t be how it’s handled,” Moore said. “I think the state should have stepped in and forced the insurance company’s hand.”
But insurers are adamant that such policies don’t usually include viruses, adding that many specifically exclude them, pointing to changes that were made nearly 20 years ago when many companies rewrote policies to keep business from submitting claims for disruptions caused by fungus, bacteria or viruses following the 2002 SARS outbreak in
“'We will not pay for loss or damage caused by or resulting from any virus,'" Schwarcz read aloud from an example of common policy language. "That’s very specific. If you have a virus exclusion, I don’t think you have a shot.”
Attorneys for Morgan & Morgan said the vast majority of business interruption claims from the COVID-19 outbreak should be covered and that many exclusions do not apply to the coronavirus situation. In dispute, they said, is how insurance companies are interpreting a common clause in business interruption coverage policies -- physical loss of or damage to property -- that insurers use to determine when coverage is triggered.
Insurance companies have argued that without any damage to the property, they aren’t required to pay.
"They’re wrong,” said
“There is coverage because these businesses have sustained a direct physical loss. They’ve lost the use of their property for its intended purpose. ... If you’ve lost the use and function of your building to operate for its intended purpose, that is a direct physical loss,” Nation said. "Insurance companies are ignoring that.”
Even that argument is tricky though, Schwarcz said.
“In most cases, businesses were shut down not because of the actual presence of the virus on the premises, but the risk of future virus in the air. And that’s different. And courts have traditionally distinguished between the risk of a future event and direct physical loss to the property,” Schwarcz said.
A business’ best bet for coverage, Schwarcz said, is if their business interruption policy includes something called “civil authority coverage," which would likely require insurers to cover losses of businesses forced to close under state executive orders.
Trump weighs in
In
“If that isn’t the cause of every single one of these closures, what is? Clearly, it’s triggered," Nation said.
“I’m very good at reading language, I did very well in these subjects, and I don’t see the word pandemic mentioned. Now in some cases it is, it’s an exclusion. But in a lot of cases, I don’t see it, I don’t see a reference and they don’t want to pay up,” Trump said. “I would like to see the insurance companies pay if they need to pay -- if it’s fair.''
Industry groups estimate that covering small-business losses from the coronavirus outbreak would cost between
"Lawyers and the trial bar will attempt to torture the language on standard industry forms and try to prove something exists that actually doesn’t exist and try to twist the intent when the intent is very clear,”
State insurance regulators have so far taken the side of insurers, with the
Schwarcz said lawsuits will likely have to be decided on a case-by-case basis depending on each business’s situation and written policies. But realistically, he said, most businesses will lose.
Email the reporter at [email protected] and follow her on Twitter @bycarolineglenn.
___
(c)2020 The Orlando Sentinel (Orlando, Fla.)
Visit The Orlando Sentinel (Orlando, Fla.) at www.OrlandoSentinel.com
Distributed by Tribune Content Agency, LLC.
Mercury General: 1Q Earnings Snapshot
CFP Board Postpones July Exam To September
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News