Question: Will health insurance policy cover the Coronavirus?
Yes. Congress has passed the Families First Coronavirus Response Act and the President signed it into law on 3/19/20. Among other things, this Act requires health insurance issuers to provide coverage (at no cost sharing or pre-authorization/ medical management requirements) for the testing and administration of FDA-approved COVID-19 tests. The same requirements would apply to related services, including an in-person or telehealth provider visit, urgent care center visit, and emergency room visits that results in an order for COVID-19 testing. The waiving of cost sharing and related requirements only applies to the services relating to COVID-19 evaluation and testing.
The above requirements apply to group and individual health insurance coverage, group health plans, and grandfathered health plans.
In addition, most of our health insurance issuers are providing further enhancements to increase access to care through telehealth (virtual visits or calls) and increasing access to early refills of prescription drugs. We have a dedicated web page, www.doi.sc.gov/coronavirus that provides complete details by carrier.
Excepted Benefits Lastly, excepted benefit policies, short-term, limited-duration health insurance coverage, and/or health care sharing ministries can have significant limitations on coverage and may not provide the same level of coverage. If you have a question about one of these types of insurance policies, we encourage you to contact your insurer.
Question: Will the Coronavirus have any impact on our life insurance coverage?
There are typically no pandemic exclusions for life insurance. If you have been truthful about your answers in your application for coverage, there should be coverage. However, accidental death and dismemberment policies don’t cover deaths caused by illness.
Question: Does business interruption coverage protect business owners from financial losses due to business closures related to the Coronavirus?
No. Most business interruption coverage specifically excludes coverage for pandemics, infectious or communicable diseases, bacteria and viruses. The Coronavirus would generally fall within that exclusion.
Question: Is the same true if the Governor orders the business closed?
Answer: Yes, the same exclusion would apply to civil authority coverage.
Question: Are there any circumstances where there would be coverage under a business interruption policy?
That is a difficult question. Generally, there is no coverage because it would be excluded by the terms and conditions of the policy. If there is no specific exclusion, the business owner should contact their agent/broker or insurer directly and consider whether it is in their own interest to file a claim.
Question: I have heard that there is legislation being proposed to require insurers to provide business interruption insurance coverage. Is that true?
I have heard rumors, but I don’t have any specific information about that. However, this Department does not have the authority to require insurers to issue or offer that coverage. We also do not have the authority to make insurers cover losses that are specifically excluded by the policy.
Question: In light of the Governor’s order requiring restaurants to close dining rooms and instead offer take- out and delivery services, are there any insurance issues that should be considered by business owners?
Yes. Businesses should ensure they have commercial automobile coverage if a business vehicle is being used for delivery. Additionally, if employees are using their personal vehicles, it is essential that the employee check with their insurer to make sure they are covered while driving their car for business purposes.
Business owners and employees need to consult their agents and insurers to make sure they are adequately covered.