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    By On 21 April 2020 In Be Smart Be Safe, Issues, State Tags , , ,

    Insurance & Covid-19 Claims – Update for Pandemic

    Be Smart – Be Safe

    April 13 – California Insurance Commissioner Ricardo Lara, ordered insurance companies to return insurance premiums to consumers and businesses and provide much-needed financial relief during the COVID-19 emergency. The Commissioner’s Bulletin covers premiums paid for at least the months of March and April — including the month of May if “shelter in place” restrictions continue — in at least six different insurance lines: private passenger automobile, commercial automobile, workers’ compensation, commercial multi-peril, commercial liability, medical malpractice, and any other insurance line where the risk of loss has fallen substantially as a result of the COVID-19 pandemic.

    Be sure to check with your insurance broker to determine whether these refunds apply to your situation.  Click here for more information.

    In addition – The Worker’s Compensation Insurance Rating Board (WCIRB) proposed changes in response to the COVID-19 pandemic.  The following brief summary, outlines the proposed regulatory changes.  WCIRB expects to submit this special regulatory filing for approval to the California Department of Insurance (CDI) the week of April 20th.  The CDI will schedule a public hearing to consider the filing, and once the Notice of Proposed Action and Notice of Public Hearing are issued, the WCIRB will post a copy in the Filings and Plans section of the WCIRB website. Source – WCIRB website:

    Workers’ Comp Governing Committee Approves Special Changes in Response to COVID-19

    In response to the impact of the coronavirus disease 2019 (COVID-19) pandemic on California employers and workers, the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) Governing Committee voted unanimously to make changes that would affect several key areas:

    Exclude COVID-19 Claims from Experience Rating

    Claims arising directly from a diagnosis of COVID-19 with an accident date on or after December 1, 2019, would be excluded from the experience rating calculations of individual employers. Since the occurrence or non-occurrence of COVID-19 workers’ compensation claims incurred by an employer is unlikely to be a strong predictor of that employer’s future workers’ compensation claim costs, the inclusion of such claims in an experience modification calculation would not meet the intended goal of experience rating.

    > Note:   It is important to note that the claim can’t just be a potential Covid claim; there must be a documented diagnosis of COVID-19. This will apply to any claims with an occurrence date on or after December 1, 2019.

    Exclude Payments to Employees Who Continue to Be Paid While Not Working

    Payments made to employees who are continuing to be paid while not engaged in any work activities would be excluded from reportable payroll. This exclusion would apply while California’s statewide stay-at-home order is in place and for up to 30 days thereafter if the employee continues not to work. Excluding this payroll recognizes the extraordinary circumstances resulting from the stay-at-home order and the fact that employees not engaged in work activities have virtually no work-related exposure.

    > Note: It will be important to document that the employee is not authorized to perform work of any kind for that period of time and that this is reflected in payroll records. Specific language is:   “Employers must maintain records that document the change in duties and that segregate such payments during this time.”

    Allow Assignment of Classification 8810 for Temporary Change in Duties

    The temporary assignment of Classification 8810, Clerical Office Employees, would be allowed for employees whose job duties meet the definition of a Clerical Office Employee. This provision would apply while California’s statewide stay-at-home order is in place and for up to 60 days thereafter if the employee continues to meet the definition of a Clerical Office Employee, but does not apply to the payroll of employees whose payroll is otherwise assignable to a standard classification that specifically includes Clerical Office Employees.

    > Note: Essentially, this means, for example, that employers will be allowed to reclassify someone who is normally not classified as a “Clerical employee” as a “Clerical employee” under Class Code 8810, for the time that employee is performing only duties that fit the Clerical Office class code 8810.  Again, maintain records establishing the work site/environment, duties, dates, etc.

    Some Comp Guidance in Response to COVID-19.

    1. Make sure to document now, showing that you are paying any employee who is not working, that they are not authorized to work. Keep clear records of that payroll, to be excluded from your audit.
    2. Document the physical site and work characteristics of an employee working remotely, to ensure they qualify for Clerical code 8810. Also consider ergonomic issues regarding their work stations.
    3. Make sure you are setting the work hours for remote employees, so Workers’ Compensation claims occurring while they are remote; will be occupational only.
    4. Make sure any claims that are investigated as potential COVID-19, or become actual COVID-19 claims; are coded properly by your claims adjuster to the WCIRB so they will not be counted against future Experience Modification calculations.
    5. Make sure your protocols are clear for responding to post-termination claims for any laid off employees.
    6. You may have previously injured employees who are afraid to go in for medical treatment, or may have problems trying to get treatment due to COVID-19 protocols by hospitals and clinics. The Division of Workers’ Compensation has made changes to telehealth rules, to help injured workers get treatment remotely. You may want to follow up with your injured workers to make sure they are getting the treatment they need.

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