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Covid exclusions won’t prevent lawsuits for treatment delays or denials: CRC podcast

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Clauses that limit or exclude cover for Covid-related claims won’t prevent lawsuits that focus on adequate care failings, said Bob Allen, president of Pro-Praxis, a CRC company that provides specialty programs to healthcare firms.

Speaking on the CRC Group podcast “Placing your first insurance”, Allen gave an example of a man in Alabama who died from a stroke after being denied treatment at multiple facilities during the height of the pandemic.

“He was going from facility to facility; no one could take him in,” Allen said. “He eventually ended up in Mississippi, and I think that with the delay in care, he passed away.”

“All those places that might be sued for that delay in treatment, or that denial in treatment, I think there may be where law firms start to go, going forward,” he continued.

On the topic of senior living, a space which has been heavily hit by the pandemic, CRC broker Alex Gould said that the new mandate for facility staff to be vaccinated is raising concerns on potential negligence of care, as some members of the employee base refuse the vaccine.

CRC senior broker Rusty Hughes added that there is a “big battle” going on behind the scenes, between the employee point of view and the resident point of view.

“The majority of residents are vaccinated these days, [but] you still have an employee base, that may or may not accept the vaccine, and so you have that road going on. You have carriers still unwilling, for the most part to cover the exposure,” Hughes said.

Hughes also pointed out that concerns around the “second wave” of Covid remain, as its impact on claims is still unclear.

“What is the claim dump going to look like in six months, eight months?” Hughes questioned. “And how are the carriers going to respond to that now that there is more responsibility placed on these operators? Because they are supposed to know how to handle it now.”

Yet, Hughes noted [on senior living] that excess markets are now “much less erratic” than they were last year.

“Those markets have calmed down a bit,” Hughes said. “Not to say that the excess markets are still not difficult, they are just a bit more calm than this time a year ago.”

Speaking on the allied healthcare market – a sub-segment of medical liability that provides coverage for healthcare workers who are not physicians – Gould said that distress is found in pockets, and that it is now a “much healthier space, generally speaking”.

Earlier in May, an RPS report found that policy renewals in the allied healthcare liability market were sustaining rate increases of about 10% to 25%, with some carriers withdrawing entirely from mid-market accounts, or stopping to write niche market sub-segments such as correctional facilities’ medical clinics. 

Finally, Allen said that the sexual misconduct in the healthcare liability space is “almost getting uninsurable”.

“How do you underwrite humans?” Allen questioned. “There’s going to be some really bad people in the world, and there’s going to be some really horrific events, but I can’t tell you how to underwrite each and every individual, and each and every employee, and guarantee that I don’t have a bad apple there.”

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