Thomas Wade April 14, 2020
Executive Summary
·
In the wake of the
economic disruption caused by coronavirus many businesses are looking to make
insurance claims despite their policies specifically excluding losses due to
pandemics.
·
The president and senior
lawmakers have suggested that insurers should pay these claims, fundamentally
assaulting constitutional contract law and with the potential to topple the
insurance industry.
Introduction
Both the coronavirus and national quarantine
efforts to contain it have resulted in businesses shuttering across the United States. Many
of these firms hold business interruption insurance coverage, and despite the
fact that this insurance typically does not cover losses due to pandemics, some
are suing to force their insurers to pay their claims.
Policymakers are engaging in this fight, too: The president of the United States called for
insurers to pay out to businesses in distress, and some legislators have gone
even further, with multiple states proposing legislation that would
retroactively expand coverage and require insurers to pay business interruption
coverage claims, a development that undercuts the entirety of U.S. contract
law.
Business Interruption Coverage
Business interruption coverage is not typically
sold as a stand-alone insurance policy in the United States. Instead, it is
sold as an add-on to existing property and casualty contracts. A business
interruption policy will usually cover a wide range of business losses in the
event of a business interruption event, including profits, fixed costs, wages,
taxes, and loan payments. The larger the business, the more likely it is that
is has purchased some kind of business interruption coverage, with only 33 percent of small businesses having
some form of coverage.
As written into most insurance contracts, a
business interruption event is usually defined as physical loss
(perhaps destruction of merchandise) in response to a physical event
(natural disasters or theft). Even alone, this definition would exclude lost revenue
as a result of the coronavirus pandemic, which has not resulted in physical
loss. Most business interruption contracts go further, however, by including
“viral exclusion” clauses, specifically excluding from coverage losses due to
widespread disease such as a pandemic, a lesson learned from the SARS epidemic.
SARS and Coronavirus
The 2002-2003 SARS outbreak led to millions of
dollars paid by insurers in business interruption claims, including a claim
of $16 million to one hotel chain, the
Mandarin Oriental International. The fact that courts were prepared to construe
widely – or ignore entirely – the requirements for “physical” damage led
insurance companies nearly universally to implement the viral exclusion clause,
and did significant injury to the conception that a business interruption event
required physical damage. It is important to note, however, that these court
challenges, even the successful ones, each represented individual cases rather
than any broad reinterpretation of contract law. The strength of the
requirement for physical damage was significantly weakened and made subject to
legal challenge but not removed – insurers added the viral exclusion clause to
make their position even more clear.
The coronavirus pandemic has breathed new life
into this contentious issue. President Trump surprised many by addressing
business interruption coverage in his daily coronavirus briefing on Friday,
April 10. The president noted that he expected to see insurers pay business
interruption claims except where the contract explicitly contains a viral
exclusion clause, the much broader interpretation of business interruption
policies. That same day (and it is unclear which preceded the other), seven Republican senators wrote to
President Trump on behalf of insurers, pointing to the enormous legal and
economic challenges of anything other than business interruption as defined in
contract and agreed to by insurers and policyholders.
Seven states – New Jersey, Ohio, Massachusetts,
New York, Louisiana, Pennsylvania, and South Carolina – have introduced bills requiring
retroactive coverage of business interruption loans. Massachusetts, South
Carolina, and New York have included in their draft bills language expressly
targeting the viral exclusion clause, with the draft New York text noting:
Any clause or provision of a policy of insurance
insuring against loss or damage to property, which includes, but is not limited
to, the loss of use and occupancy and business interruption, which allows the
insurer to deny coverage based on a virus, bacterium, or other microorganism
that causes disease, illness, or physical distress or that is capable of
causing disease illness, or physical distress shall be null and void.
[emphasis added]
The Dangers of This Approach
The approach of these states poses several
dangers to the U.S. economy.
Contract law and a stable investment environment
Proposed legislation retroactively and
unilaterally altering existing contracts would appear to violate multiple provisions
of the U.S. Constitution, most notably the Contracts Clause. Not only would
this assault to the legal concept of a contract fundamentally destabilize
financial services (and all other industries) but such hasty and ill-conceived
lawmaking would make the U.S. fundamentally less attractive to investors in the
future.
Protracted litigation
If passed, these bills would face significant
legal challenge, and appropriately so, with the result that litigation could
take years – years in which the business interruption claims would not be paid.
The bills appear to be seeking to ensure that businesses receive financial
assistance, but small businesses would not receive any funds, however
appropriately, in anything like the time required to make a difference under
the current circumstances. As the seven Republican senators and others have
pointed out, there are more appropriate (and significantly faster) mechanisms
for small business relief, most obviously the Payment Protection Plan provided for
under the Coronavirus Aid, Relief, and Economic Security (or CARES) Act.
The presence of specific viral exclusion
clauses, should give insurers the strongest possible legal case against claims,
but there remains some room for court interpretation. Although viral exclusion
clauses do often specifically include “viruses,” the exclusion is often a
subset of exclusions relating to “contaminants” and “pollutants,” terms that
will be inspected closely in courtroom arguments.
Insurers faced a significant number of courtroom challenges in the wake of
Hurricane Katrina in 2005 when courts were asked to decide whether
damages were caused by “flooding” or “wind.” Similarly, policyholders will contend,
as they did in the SARS epidemic, that government-ordered closures constitute
“physical damage,” even where these conditions are covered by “civil authority” clauses. Caselaw from
the SARS epidemic suggests that courts will favor policyholders to the extent
possible.
The insurance business model
At a fundamental level, the insurance industry
is not designed to address such widespread problems as the coronavirus.
Insurance works by pooling risk. The fact that policies against fire damage are
so universal, combined with the fact that incidences of fire damage are
relatively rare, allows the insurance industry to provide fire insurance
payouts to those who need it at the cost of a low premium to the entire
population that pays for it. Here, neither of those factors are true. Pandemic
insurance is not widespread, but more crucially the impacts of the coronavirus
are not localized. It would not be possible to build an insurance industry that
might have to pay claims to the entire country at a single point in time. If,
however, epidemics or pandemics become more common, coverage will presumably
increase and the price of premiums would decrease. At this point viral
exclusion clauses would not be necessary and the public would have access to
insurance policies priced appropriately for the risks that they cover. A
remarkably similar conversation has emerged in the field of cyber insurance, asking whether business
disruption as a result of cyberattacks should qualify as a covered business interruption.
Some contend that the insurance industry is not
capable of responding to such widespread events, with the chair of the House
Financial Services Committee, Maxine Waters, and others calling for a governmental pandemic risk
insurance program much like the National Flood Insurance Program or the federal
backstop created by the Terrorism Risk Insurance Act. This is clearly only the
beginning of these conversations.
Economic stability
Were insurers to have to pay business
interruption claims, it is likely that this would bankrupt the industry. David
A Sampson, CEO of the American Property Casualty Insurance Association,
estimates that a hypothetical 30 million claims from small businesses would
result in losses of $220 – $383 billion per month, 10 times the amount in
claims ever handled by the industry in a year. For the insurance industry to
pay these claims would necessarily require insurers to liquidate their assets,
a firesale that would likely precipitate a market crash. Toppling an industry
at this time of economic instability would of course be ruinous and likely have
a recessionary domino effect, either imperiling financial safety and soundness
as a whole or drastically prolonging the necessary recovery time. Worse,
requiring insurers to so deeply tap their reserves would render them incapable
of responding to an emergency that they do explicitly cover, such as another
natural disaster. This financial blow seems particularly unfair given that
insurers do not price or risk their insurance policies to include pandemic risk
– if they did, the cost of insurance premiums would be such that few would pay for
them and we would lose insurance coverage completely.
Conclusions
If a business or market need exists, the
insurance industry will consider the risk and provide an insurance policy
priced to cover that risk. Insurance firm Lloyds of London, one of the world’s
first insurance markets, has insured a variety of unusual risks, from Keith
Richard’s hands, to Bruce Springsteen’s voice, to Tom Jones’ chest hair.
Insurers are willing to offer pandemic insurance, too: despite the difficulties
noted above, brokerage Marsh began providing pandemic business interruption
insurance in 2018 (although it did not sell a single policy). One rare
positive example is that of Wimbledon, the British tennis tournament, which
cancelled rather than postponed its 2020 tournament, allowing it to collect a
reported £250 million as a result of its pandemic
insurance coverage. Constructing a policy to cover the risk of pandemics is not
impossible, but it is simply not at this point financially feasible for the
majority.
It is undoubtable that the coronavirus poses a
significant and unique economic threat to U.S. and international businesses.
Many will require extensive emergency financial assistance. Providing and
facilitating this assistance is, however, the role of governments and
regulators, not insurers. Construing contracts that specifically exclude
pandemic coverage as allowing for coronavirus relief – or worse, enacting
legislation that retroactively amends these contracts – is clearly
unconstitutional. To to do so would endanger the safety and soundness of the
financial system, disincentivize the entire insurance industry, and not even
provide timely relief to companies that need it.
https://www.americanactionforum.org/insight/coronavirus-and-business-interruption-insurance-coverage/#ixzz6JzaFx4Rx
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