South Florida Hospital News
Thursday September 24, 2020

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September 2020 - Volume 17 - Issue 3


Ged Lawyers: Helping Local Business Owners with Complex Insurance Claims in Difficult Times

Does your healthcare business or hospital have business interruption insurance? No matter how secure your business seems, unexpected circumstances can derail your success instantly. Business interruption insurance helps replace any lost income and pay for additional expenses when your business is affected by a covered peril such as fires or hurricanes.

“This is generally added on via an endorsement, meaning you have to pay an extra premium for it,” says Marius J. Ged, a partner with Boca Raton, FL-based Ged Lawyers, LLP. “It provides coverage in the event of, for example, if you're a tenant in a building and the roof collapses due to hurricane. If you can't operate your business, your business interruption would cover you.”
Another example is if you're an owner of a freestanding office building and the windows are blown in because of a hurricane. If all of the computer servers become wet and your business is down for a couple of months as a result, your business interruption coverage pays your payroll expenses and extra expenses to cover you during that time of loss.
“In addition, there's something called civil authority, an additional coverage that you would purchase,” adds Ged. “It covers your business losses as a result of a government entity or an executive order shutting down your business, such as the governor of Florida and the different mayors and county commissioners for Broward and Palm Beach, who have shut down or made it impossible for certain people to operate their businesses during the current pandemic.”
With business interruption insurance, you can often extend the coverage for a year, while civil authority can typically extend for 90 days.
Your policies, whether it’s business interruption insurance or civil authority, should spell out when you can qualify for business interruption coverage. The loss of income must occur due to the physical loss of property that makes it necessary to suspend your operations, according to Ged.
However, many insurance companies have been rejecting business interruption claims as a result of COVID-19. This contradicts previous cases where claimants prevailed with claims based on bacterial contamination. In addition, Congress and numerous state legislatures are pushing to require insurers to include the COVID-19 as a qualified interrupting event. Despite these actions, insurers are routinely denying claims.
Ged stresses that if you have purchased business interruption coverage and have been losing income due to the coronavirus crisis or other covered perils, you should file a claim as soon as possible. In fact, you should file a claim even though you may be unclear how much income you have lost or will lose. That’s because if you fail to act now, you will have no basis to appeal a denial or file a lawsuit against your insurer if needed.
“We do these cases on a contingency, meaning the clients don't have to put up any money whatsoever upfront,” says Ged. “Only if we are successful or we win, are they responsible to pay us a fee.”
Ged’s advice is to read your policy carefully.
“There is what's called a virus exclusion, which is amazing that some of these coverages have included this,” he says. “They added this exclusion after the H1N1 virus back in 2003. The insurance industry recognized that there's potential exposure to them based on a pandemic or a virus. So it's extremely important to understand what the policy language contains and what exclusions may apply.”
Albert Johnson, a nationally known trial lawyer, who now works with Ged Lawyers, notes that business interruption insurance has particular significance now in the medical provider industry.
“Many of the medical providers, including imaging facilities, medical supply companies, and those who serve the needs of elective surgeries, have been shut down and have no income,” he says. "They depend upon these business interruption policies to a great extent, just to stay alive. Insurance companies are not in business to pay losses. They are in business to save money for their stockholders—not their policy holders, their stockholders. So they will do whatever they can to avoid paying losses.”
There are several reasons why insurance companies will not pay. One major reason is the lack of physical damage. They claim that if there's no physical damage, then there's no physical interruption of business and/or loss. An example would be a flood that washes away your building or even a fire that burns down inventory, forcing your business to shut down.
“However, there are Supreme Court cases, which have ruled years ago, that physical damage should be interpreted as meaning damaged from odors or escaping noxious fumes from one building to another,” says Johnson. “That kind of thing would particularly exclude any defense based upon lack of physical damage.”
No matter the reason for denial of coverage, Johnson’s advice is to call Ged Lawyers.
“Call good lawyers right away, number one,” he says. “And number two, send us your insurance policy so we can review the denial. We’ll let you know your legal rights.”

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