Questions regarding your insurance coverage related to COVID-19?
As the Covid-19 pandemic continues to evolve rapidly, Member Insurance Solutions is receiving many questions from concerned insureds regarding their business and health insurance coverages.
In general, it is possible property and casualty insurance policies may not treat pandemics such as the coronavirus as covered perils, while life, health and disability policies may provide some coverage depending on policy provisions and normal claims procedures. The only way to make a coverage determination is to file a claim with your carrier so they can review the incident and decide if it is payable under your policy.
Business overhead insurance
Business Overhead coverage serves to provide the business with cash flow if an owner (insured) becomes sick or is injured and unable to work. Each claim will be evaluated in accordance with the terms of the policy and use claim processes already in place for disability claims.
Business interruption insurance
Business interruption coverage replaces lost income at a covered location due to “direct physical loss or damage” caused by a covered peril, such as a fire or tornado. Because of the absence of direct physical loss or damage, business interruption would not likely apply to business closures due to COVID-19. The only way to make a coverage determination is to file a claim with your carrier so they can review the incident and decide if it is payable under your policy.
Workers’ compensation insurance
Workers’ compensation covers an employee who is injured at work. Determining how the employee was infected would be extremely difficult. The only way to be certain is to file a claim and let the insurance company decide if it is payable under the terms of the contract.
For group life insurance (Basic, Optional, Dependent, GUL and GVUL), there are no policy limitations that would limit a claim payment resulting from a COVID-19 death, provided the individual met all other certificate requirements.
Accidental Death and Dismemberment (AD&D)
AD&D policies provide coverage for accidents and dismemberment only; they do not cover diseases. Therefore, death due to COVID-19 is excluded, as are all deaths caused by disease.
Because COVID-19 is a viral infection it would be considered a sickness and the Sickness Hospital benefits (admission and confinement) would be payable provided the individual met all other certificate requirements.
The definition of an “accident” omits sickness and therefore COVID-19 is not covered under a standard accident plan. However, it would be covered if the accident plan included Sickness Hospital benefits (admission and confinement) and would be payable provided the individual met all other certificate requirements.
Critical Illness/Cancer Insurance
Because COVID-19 is not a listed “covered condition” it would not be covered under any of our Critical Illness product versions.
Disability insurance serves to provide the insured with cash flow in the event of a sick or injured following the waiting period elected by the insured. Each claim will be evaluated in accordance with the terms of the policy and use claim processes already in place for disability claims.
Medically necessary diagnostic testing for Covid-19 is provided at 100% of allowable charges with no member cost sharing applied for Blue Cross Blue Shield of Michigan group and individual plans and Medicare plans. To be eligible for no-cost testing, either of the following codes must be used for laboratory testing: U0001 or U0002. For specific questions about your health insurance, please see the contact information below: Frequently asked questions about coverage, rates and membership in light of COVID-19: CLICK HERE
- Blue Cross members 1-800-775-2583
- Blue Care Network members 1-855-624-5214
The Coronavirus National Emergency is a rapidly developing situation and information from the state and federal government is constantly changing and being updated. Staff at Member Insurance Solutions is diligently tracking all updates regarding the disease, legislation, travel restrictions and risk assessments from official sources.
Most Member Insurance Solutions employees are working from home until the COVID-19 emergency ends. Office phones have been forwarded to mobile telephones. During this time, we encourage you to call 800.878.6765 and access the company directory to be connected to your usual contacts. If you leave a message, we will make every effort to return your call in a timely manner. We ask for your patience and understanding as we navigate through unprecedented circumstances.