How to know whether or not insurance covers a claim caused by the Covid-19? To answer this question, it is essential to analyze the contracted insurance policy in detail and in full, not only with respect to the general conditions, but also its particular conditions. Special relevance should be given to the clauses that refer to insurance coverage, as well as exclusions.
By Andrés Veszprémy Schilling
At the end of last year, the world was shocked by the information provided by the Chinese Government, regarding the outbreak of the coronavirus, “Covid-19”, in the city of Wuhan, which was causing the death of a large number of persons.
Rapidly, this virus was spreading in different countries, becoming a global pandemic, already exceeding 1.5 million infected people.
Governments around the world have had to react drastically, closing borders, banning gatherings of massive groups of people, closing schools, restaurants, cinemas, shopping malls and imposing mandatory total quarantines in localities, cities and even entire countries.
The above, together with the tragic deaths of nearly one hundred thousand people in the world, is giving rise to an economic crisis at a global level, affecting companies, workers, families, countries and the world in general.
In times of crisis, when the life and health of people is threatened, as well as the economic and labor continuity is interrupted, the contracted insurances take on special relevance, in order to try to reduce the serious economic and human consequences that are producing.
Therefore, it is important to determine whether the insurance policies contracted, especially with respect to life insurance, complementary health insurance, damage insurance, credit insurance and travel insurance, among others, cover the risks of pandemics, such as COVID-19.
In general, insurance companies worldwide exclude pandemic risks from the coverage of their policies. For their part, so-called “all-risk” policies generally cover business interruption if it is caused by physical damage to the assets or operations of a company, which is why Covid 19 may not be covered.
It should be noted that a bill originated by a parliamentary motion is currently being processed in the Congress of our country (Senate), which, among other matters, indicates that “in the event that a health insurance policy , health contract or others related to the delivery of health benefits, establish within its clauses the non-coverage, financing, payment or conditioning to an external event, for the delivery of any benefit or service due to an epidemic, pandemic or health alert by the competent authority, shall be understood as not written for all legal purposes. “
How to know if the contracted insurance covers or not a claim caused by COVID-19 or by some situation related to it?
To answer this question, it is essential to analyze the contracted insurance policy in full and in detail, not only with respect to the general conditions, but also its particular conditions. Special relevance should be given to those clauses that refer to insurance coverage, as well as exclusions.
Likewise, in those cases of business interruption in which there has been an act of authority that has impeded its normal development, such as cases of mandatory closings of businesses such as restaurants, cinemas, shopping malls, buildings, among others, or In those cases in which, due to the mandatory total quarantines of localities or cities, business continuity has not been possible, it is important to analyze not only if the policy covers said interruption due to pandemics or epidemics, but also due to acts of authority under these circumstances.
Finally, in the event that it is concluded that the insurance policy covers the claim, the insured must comply with the obligation to notify the insurance company, in due time and form, of the occurrence of the claim.