FC&S has been writing about COVID-19 and the coronavirus from the beginning and will continue to do so. The subscribers have also started sending in questions. So you can see what others are asking quickly and easily, here is a list of all questions received. The list will be updated as more come in.
QUESTION:
The COVID-19 pandemic is challenging the Insurance Industry in areas of coverage interpretation that were not a component of the Underwriting and Rating process.
Under a Residential Homeowner HO3 policy, how are the following scenarios responded to:
1.The home sustained a covered loss, prior to the COVID-19 pandemic outbreak, making the house uninhabitable and triggering ALE coverage for the Insured(s). Because of limitations in place, directly and indirectly related to the various Executive Stay-At-Home orders, contractor repair activity is taking longer than normal. This involves suspensions of service, and an extended repair time. Does the Additional Living Expense coverage under the policy respond to this delay, which increases the ALE cost of the claim?
2.The home sustains a covered loss, but the house remains inhabitable. The Insured(s) is seeking ALE coverage while the repairs are being made. Out of the fear of coming into contact with a potentially infected construction worker, even though the workers are taking the necessary precautions in compliance with CDC guidelines and social distancing, e.g.wearing masks, gloves and even protective clothing. Does the policy ALE respond?
3.The home sustained damage from a covered loss and became uninhabitable. The Insured(s) were placed in temporary housing and ALE coverage was provided. The repair to the house is now completed but the Insured(s) do not want to return to the house, since it is located in a 'hot-spot'. Does the policy ALE respond?
ANSWER:
- Yes, ALE should cover the extended time to repair the property since neither the homeowner nor the contractor have any control over state orders, and what businesses are or aren't essential. Even if the repair work falls under an essential business, supplies may be unavailable, workers may be sick, or there could be other issues. Some insurance departments have expressly stated that in such situations ALE should be provided. https://www.nuco.com/fcs/2020/04/06/pandemic-recap-and-updates/
- While I understand the insured's fear, if the contractors are adhering to all CDC recommendations, and the insured's can safely remain in different parts of the house from where the work is taking place, I don't see that it would be covered. However this is an unusual circumstance, and a carrier might be making an exception for such circumstances. I haven't seen anything on it, but it is possible.
- No. Once the home is repaired, the ALE coverage ends. If the insured remains quarantined, even if the area is a hotspot, the insured should be safe. There have been no indications that people quarantined in their homes have caught COVID-19. Coverage is provided only until the home is restored to pre loss conditions.
One of our insureds has asked "in the event someone came into the office with coronavirus and we had to hire a company to do extensive cleanup, will the cleanup expense be covered under our insurance policy.
ANSWER:
The commercial property policy provides coverage for direct physical loss or damage to covered property from a covered cause of loss. Since the property did not sustain direct physical loss or damage, then the extended cleanup would also not be covered. For coverage to apply, the extended cleanup would need to be a result of a direct damage covered loss.
QUESTION:
Under ISO Business Income Coverage form, my question is:
Considering closing of business due to an ordinance of law:
1-Would there be coverage under ORDINANCE OF LAW on Business Interruption.
ANSWER:
First of all, the ordinance or law must be due to a direct physical loss or damage to covered property. If there is no physical damage to covered property, then there is no business income for ordinance or law that has to do with something like the coronavirus that's going on right now.
Otherwise, if there is a direct physical loss, then as long as the ordinance or law is not related to the construction, repair, or tearing down of the insured property, then the business income will apply to that coverage. Under the ISO form, there is a provision for Resumption of Operations that states that if the insured does not resume operations, the policy will pay based on the time that the insured could have resumed operations as quickly as possible.
QUESTION:
Please help me understand if this policy would cover business interruption pertaining to the COVID-19. (Subscriber attached the Allianz CGL policy for this insured.)
ANSWER:
While there is no determining how a California court would view the coronavirus in view of bodily injury, we do not see any coverage for liability for the coronavirus under the CGL policy you attached. There is a total pollution exclusion endorsement on the policy which excludes contaminants or thermal irritants, as well as biological materials. Also there is a medical payments exclusion on the policy which would preclude coverage for any medical payments for any reason.
QUESTION:
In light of businesses shutting down as a result of the Virus (restaurants in NH have been ordered to close) and they continue to pay their employees but do not receive any services from the employee. At the time of audit will these payments be included in the auditable payroll?
ANSWER:
Unfortunately, we cannot answer this question as it has to do with NCCI guidelines for the state of New Hampshire, and is not a matter of insurance policy interpretation.
For your convenience, here is the contact information for NCCI. You can call them and pose your question to them.

