Government Mandates That Insurers Pay for Uncovered Coronavirus Claims
New Jersey has a bill that would force insurers to pay for business income losses even if their policies clearly don't cover the claims. It was thought that the bill was dead, but according to the articles below, it is alive and being voted on tomorrow:
- Update: New Jersey Legislature To Vote On Bill Requiring Insurers to Cover COVID-19 Business Interruption Losses
- COVID-19 and The New Jersey Assembly Bill 3844
According to the vague language of the bill, it appears that insurers who pay uncovered claims could apply for reimbursement from some sort of mechanism that would be shared by other insurers, presumably even if they don't even write that type of coverage. Again, the proposed bill is not clear on exactly how this confiscation of funds would go down.
At the federal level, on March 18, a number of members of Congress wrote the CEOs of four industry groups asking that they voluntarily pay business income claims involving the coronavirus, again presumably whether covered or not. Two of the groups are agent and broker associations which are not parties to these insurance contracts, nor do they have any financial resources that could be brought to bear. The fact that they were included indicates that Congress lacks a fundamental understanding of how the industry works.
I am not an attorney but my understanding is that many legal experts believe that confiscatory government orders or legislation violate Article 1, Section 10, Clause 1 of the U.S. Constitution. There is an interesting Wikipedia discussion of whether a state can effectively modify a private contract in the public interest. It indicates that three tests must be met according to the U.S. Supreme Court. Another article outlines the basis for review.
Most recently, in Sveen v. Melin, 138 S. Ct. 1815 (2018), the SCOTUS ruled that such laws are void if they “substantially impair” a contract. My guess is that insurers would assert that mandating that they pay for losses not covered by their contracts substantially impairs them.
If such laws are passed, expect the industry to challenge them in court. In the case of New Jersey, this may be difficult. In researching this article, I came across my instructor notes from an old agent E&O loss control seminar which cited this 1988 New Jersey court decision:
"The underlying public policy in this area is quite clear when the potential for damage to the environment is this great. Consequently, the health, safety and welfare of the people of this state must outweigh the express provisions of the insurance policy in question."
According to my notes, the court case is Summit Associates v. Liberty Mutual. As I recall, it was a claim involving a SuperFund site where the court admitted that the policy excluded pollution and cleanup, but cited "public policy" as the basis for overriding the language of the contract. I don’t recall if the case was appealed and, if so, what was the final disposition.
Confiscatory legislation targeting one industry is potentially far more dangerous to a republic than the virus itself.
Why single out the P&C insurance industry to pay for business closures or curtailments mandated by governmental entities? Why not confiscate funds from the life insurance industry? The health insurance industry?
Why not require contributions from policyholder attorneys as well? And accounting firms? And labor unions? And grocery stores? And toilet paper manufacturers? Or, for that matter, hit up any business that isn't adversely impacted and any individual who is still employed? It makes as much sense.
And what happens when P&C insurers who are forced into insolvency can't pay policyholders who have claims actually covered by their policies? Ah, we assess other insurers via guaranty funds...if there are any left to assess. And what about the hundreds of thousands of insurance agencies and staff members formerly employed by the industry? Who's going to compensate them?
This is largely not an insurance issue. It's not really a business issue. It's a societal issue and no single industry should be expected to solve it. Probably the greatest beneficiaries of these efforts are members of the trial bar who stand to profit unless the laws confiscate their earnings too.
What do you think?
Employment Experience
4 年Businesses have been given the option to apply for a loan that they will not have to pay back if they continue to pay their employees. They should be prepared to handle a short term loss in sales, that’s good business management. Law firms are already running ads to call them regarding your Covid-19 claims.
Owner - LaPorte Consulting LLC
4 年For those who understand the principals of insurance contracts, this is pretty scary stuff!
Claims Examiner
4 年However this all shakes out (and there will be losers on all sides of it), you can bet that going forward it will be nigh on impossible to get BI coverage for anything other than a very narrowly defined set of perils and there will be a lot of strongly and clearly worded exclusions, if not even signed acknowledgements by insureds up front. Not that some future court won't try to void those, too, but good luck to any insured out there looking for even reasonable BI coverage on renewal.
Underwriter III-Commercial Lines at EMC Insurance Companies
4 年Great thoughts from all those who have posted. It's a topic we've had around our separate "coffee tables" aka Zoom meetings as we work from home due to this virus. I understand we want to be there in an insured's time of need -- it's what we do and who we are. I have friends who are small business owners and are being literally crushed by the economic impact of this virus. At the same time, an insurance policy is a contract - a promise to pay for the things listed in the policy. We generally don't pay for things of a catastrophic nature because it could bankrupt our companies. This is worse than a storm or a hurricane because it's not limited to a certain geographic location -- it can be anywhere in our 50 states and beyond with no definite end in sight. There's got to be another remedy rather than legislation mandating insurer's throw out their policy language and pay for a coverage that is clearly excluded when a Bacteria or Virus exclusion exists on the policy.
Expert Witness, Independent Consultant
4 年These efforts will have a tough time withstanding legal challenge.