The COVID-19 (coronavirus) outbreak is significantly impacting the workplace and the global economy, raising many concerns for workers’ compensation insurers as the pandemic continues to evolve:

  • Is the virus itself compensable as an occupational disease?
  • What workplace safety considerations should be taken?
  • What is the role of virtual medical care (telemedicine) for workers’ compensation?
  • What are the ramifications of the massive work from home transition for employees?

Most state laws provide compensation for “occupational diseases” that arise from, or during, the course of employment, excluding “ordinary diseases of life” (the common cold or flu, for example). There is a strong legal argument to at least cover personnel in healthcare and high-risk occupations for coronavirus. Whether the disease is seen as generally compensable, though, is uncertain.

The State of Washington’s Department of Labor and Industries recently changed its policy on workers’ compensation coverage for healthcare workers and first responders. Benefits will be provided to workers while they are quarantined, if they were exposed in the workplace.

Mandates for coronavirus coverage by health insurers (coverage for testing, visits to emergency rooms without deductibles or co-pays) have been issued by at least ten states. “These measures, if expanded to more states, could have the impact of limiting claim activity in the workers’ compensation market in those cases where only testing or quarantine are necessary,” according to The National Council on Compensation Insurance (NCCI).

Workplace safety planning will most certainly expand to include infectious disease guidelines in the future. Employers must take increased measures to ensure the safety of their onsite workers. From cleaning/disinfecting measures to safe distance practices, new guidelines will need to be written and enforced. In the past, many insurers would incorporate safety and hygiene plans for high-risk occupations (first responders, etc.). Will this become the new norm for non-risk occupations as part of the “new business” insurance policy application process?

Telemedicine is also becoming a standard for providing medical care in a quick and safe manner. It allows healthcare providers to remotely interact with injured workers. Insurers will need to figure out how this service will be administered and compensated for workers’ compensation claims (they may need to adjust fee schedules accordingly) under each state model.

With insurers moving to work from home scenarios, the task of assimilating and managing employees needs to be addressed. Do employees have the technical tools and support they need to function efficiently? Can core insurance systems be accessed remotely and on multiple devices? Is VPN bandwidth large enough to accommodate the increased volume? If insurers were not prepared for a work for home scenario – and very few, if any, were likely prepared to transition almost their entire staff to WFH – they are certainly working their way through these issues now.

We are all in this together and Sapiens will continue to act as a trusted advisor to our clients and the industry. Please don’t hesitate to reach out if you need assistance or guidance. Sapiens will continue to monitor this situation as it evolves.

Please note that the U.S. Department of Labor offers a useful resource to help workers and employers cope with the COVID-19 virus.

  • corona
  • coronavirus
  • COVID-19
  • insurance
  • insurers
  • occupational disease
  • telemedicine
  • workers comp
  • workers' compensation
Michael Desrochers

Michael Desrochers Michael has over 30 years of insurance / information technology experience from a global perspective, specialty areas consisting of Product Management, Business Process Design, and Product Development. He has successfully led new technology evaluations, product development, and implementations of numerous insurance core software packages for Property & Casualty Insurance and Workers’ Compensation. Michael is currently VP Product Strategy and Alliances at Sapiens, responsible for cultivating new ecosystem partnerships, product strategy, product awareness and positioning for Sapiens Platform for Workers’ Compensation.