Families First Coronavirus Response Act
Coronavirus & Safety in the Workplace
Benefits Frequently Asked Questions
P&C Frequently Asked Questions
Benefits Frequently Asked Questions (3)
An employee is considered disabled when they meet the definition of disability outlined in their policy. Your carrier would assess the claim to determine eligibility for benefits based on the terms of your policy, the same as the carrier would for any illness.
Is an individual who is quarantined but not sick or diagnosed with the coronavirus considered disabled?
No, disability carriers do not consider quarantined workers to be disabled. Unless they have a medical condition that meets the policy’s definition of disability.
If an individual is diagnosed with coronavirus, ADA services would evaluate medical information to determine disability under ADA or any state equivalent laws. Individuals who are quarantined without a diagnosis and not sick, generally, would not be considered disabled. The EEOC has published guidance for employers on specific workplace practices and inquiries related to COVID-19.
P&C Frequently Asked Questions (2)
For obvious reasons this is a fluid situation and there have been no specific rulings to date. Insurance carriers, third party administrators and risk managers must rely upon precedent, similar cases and relevant fact patterns to develop case management strategies, to address the issues as they arise, and to develop reasonable prevention strategies. In addition to “injuries,” Workers’ Compensation Acts provide compensation for “diseases” that are occupational in nature.
Specific diseases that have been associated with workplace exposures include Black Lung, Asbestosis and Hepatitis. Diseases not specifically enumerated by state law may also be covered if the industry’s exposure is substantially higher than the general population. This is why we do not typically see seasonal influenza workplace “injuries.” We strongly recommend reaching out to someone on your team to discuss your specific scenario.
Policies are frequently tailored to the needs of individual companies, meaning exclusions and limits vary. Therefore we suggest you speaking with your service team with any questions you may have. There are a few general points worth mentioning …Contagious disease coverage for business interruption (BI) is not commonly available since the SARS outbreak in 2003, which shares many similarities with the Wuhan virus outbreak. Even if coverage is available, there is usually a sublimit or restrictive terms. Most policies trigger coverage for BI only after a direct physical loss.
Again, every policy is worded differently and therefore it is imperative you discuss your specific situation with your team at KMRD. Also keep in mind, it is your obligation to ultimately prove a true loss of income which cannot be recovered in subsequent months. We will be your advocate but your carrier will make the ultimate decision on whether they believe coverage can be triggered.