How Insurance Works

How to Get Insurance Companies to Pay Out Your Business Interruption Claim


– And I’m Mark Nation of Morgan & Morgan. And I’m here to chat about
business interruption, business income claims and that is the view okay at this point? – [Ned] You’re looking beautiful here. – Alright thank you so much. And I’m here at my home
office and kind of dressed up but the way we are handling
today’s webinar is exactly how we’re doing court hearings now. Through Zoom and we appear
in court just like this and a coat and tie and have hearings. I’ve been I guess four so far
subset of hearings this week on important issues for policyholders. And so I wanna say welcome, welcome and thanks for
everybody coming aboard. First of all I hope
everybody staying safe. and I know there is a lot going on with various business
people and the losses that they’ve sustained and continue to sustain due to COVID-19. And I didn’t wanna talk a little bit about what we can do to help and
a little bit about myself. I’ve been practicing over 30
years all I do, day in day out For 30 years is helping
policyholders with claims. Whether its individual or small businesses or large businesses that is all what I do. I don’t dabble in other things
I do this day in day out. I travel not only I’m located in Florida but I’m more admitted to
the bar in several states. And I practice throughout
the United States helping policyholders
and that’s what I do. I’ve handled hundreds and hundreds of business interruption
claims over the last 30 years. This is nothing new to us. This is something maybe we can’t anticipate a pandemic like this. But we certainly knew
something like this could come and how insurance policy
are supposed to deal with these types of situations. And what I have on here with me. I think you can see several of my lawyers. As a team in our insurance recovery group. We have 54 lawyers and they’ve scattered throughout the United States. And I have a COVID-19 task
force that I put together with some of my lawyers so that we can deal with these issues. But by no means are these all
the lawyers that are working with us at Morgan & Morgan on
this specific issue right now. And so I want to tell you at
the end of this when we’re done you’ll get an email and that
email is going to give you a little bit more information about us but also if you have
questions you can email us with your questions. And also we have an AI tool. We call it Jimmy the robot lawyer. And you can go on Jimmy
if you think you have a business interruption claim
then you can go on that tool go through a couple of questions and it will qualify you for
a claim if you’re qualified. And we can move forward on your claim. That’s the best way to get a hold of us regarding these claims
because as you imagine there’s so many of these
being presented right now. The states that we practiced in that we are handling the cases in. Florida, Georgia, South
Carolina, Mississippi, Texas, Kentucky, Pennsylvania,
Tennessee, in New York. We have referral partners in other states that we don’t have offices in and we work hand in hand with them. Our partners in New Jersey I spent hours yesterday
working on the case with them and we got partners
throughout the United States. So if your claim is
elsewhere or your friends are then we can probably help
you when it comes to that. Don’t hesitate to give us an email and we’ll put it to your friend or you in contact with
lawyers in other states. And so I’m going to go
through a few things and then I wanna open it up
to questions and answers. And that’s really going
to be the best part. But I want to go through
what we can do a couple of insurance policy terms
you might want to look for and then open it up for questions. And I can imagine or I
can’t imagine you’re sitting there going I don’t want to
hear about the terms I want to hear about what you can do. I’ll do that as I’m
progressing through this and at the end we begin
we’ll just open it up for questions and answers. So let me share my screen here first. That was the opening one when we started. And Ned is that screen share effective? – [Ned] Yes sir. – Alright thank you. A word of caution and that is I mentioned at the beginning this is
all we do day in and day out is help policyholders they’re
not gonna do it a long time. There are a lot of lawyers who don’t or have not had much
experience in policyholder work and they’re starting to advertise and ask for these types of claims. And so if you talk to a lawyer
and interview that lawyer then I think you should ask some questions and be wise about it. Look at their website
see if it’s something that they even have on their website or if it’s just a
conglomeration of things. My insurance recovery
group again 54 lawyers it’s all we do day in and day out. We do not dabble this
isn’t part of what we do it’s what we do, it’s who we are. So let’s move forward
here in these screens. First things and this is going to be one of the most important. A little bit of homework for you. If you called our office and hired us, we were happy to file
a claim on your behalf. Whether you call us or not I would recommend if you have
a business interruption claim that you file a claim immediately. There’s no problem filing a
claim you’ve got the losses and you would then ask the
insurance company is it covered? And so this letter is
all you would need to do. You date it, you send it
to your insurance company, you put the your name here, you put the insurance company’s name here, you’re name being your company name or if you’re sole proprietor you’re your name or the company name. This is all you need to do. To put them on notice of
what type of claim it is. And then you simply say I’m hereby presenting a claim
for all coverages available under my business policy or policies. You don’t need to sit there
and go through the policy and try to figure out what coverages are or are not applicable. When you, if you were to
say I am only submitting I’m submitting a business
interruption claim. They might write you back and say well you don’t have coverage
for business interruption. But you do and they won’t tell
you that you do have coverage for something called time
elements or civil authority or some other type of coverage. So it’s just better to say
all coverage is available under the policy or policies
because you may have more than one and for this loss
of income and extra expense. And the claim includes
but is not limited to and you’ll see the list
of various things there that you can prove. It’s just important to get that notice to the insurance company
as quick as possible. So far every insurance
company who is received and that we’ve seen
received a letter like this or a letter similar to
this reporting a claim. Every insurance company so far has denied except in one small area of practice and that is event cancellation. So that you’ve heard about that
Wetteland submitted a claim for event cancellation. Those types of claims although
they are being fought a lot are being paid some. When this claim is
submitted whether you do it or we do it and you get a
denial don’t be intimidated. The denial might come with
a long letter then 15 pages could be shorter and people
will read that letter and they’ll say well I
guess there’s nothing that you could do. That would be a mistake. We’re willing to look
at your denial for free. If the insurance company did the right thing I’ll tell you that. If they didn’t we’ll tell you that too and what we can do to help you. I can only tell you this, every single case I’ve ever
won they all started with no. They’ve all had no incoming. In fact I can’t win your case until the insurance company says no. So don’t be intimidated by the no. Let us look at the denial for free. Alright go to the next page
one of the main questions I get is, what am I entitled to recover? Policies are different
but generally you’re going to be entitled to these
two types of expenses. Your normal continuing expenses that you’re incurring right
now plus profit before taxes. And so that would be generally the business income portion that I’m using that term loosely because it can mean different
things in different contexts. And then the second thing
is extra expenses encouraged because of the suspension
of your operation. Let’s say you’ve had to hire
somebody to watch something we had to haul some things away, where you’ve incurred any type
of innumerable extra expenses because your operations were suspended. Those are the two general types of damages that you’re entitled to. Now this is the first
lawsuit that we filed and it was filed yesterday we’ve collected a lot of them and this one is for a dental office. I’m gonna give you some examples of the people were helping through it you’ll have an understanding that. This is a dental office
who does cosmetic surgery and is not allowed to
do those at this point. They’re not considered
inessential business and so they’ve suffered a
significant loss of revenues. This is for a brewery, that first one was in Florida. This one is in Kentucky. We’re filing another one
right now in Pennsylvania. In addition I’ve got a Pilates studios that has a number of studios and they’ve all been shut down as well as gymnasiums, restaurants and all types of recreational officers who’ve suffered a loss. Those are just an example
of the type of clients that we have and regardless
of your business. If you’re suffering a business income loss we’d like to look at that claim for you. Now what coverages are
you entitled to generally? And I’m not going to get in
the weeds on these coverages but people are surprised
when they find out their business interruption
or business income claim originates in their property coverage. It’s just a fluke and it’s
a way to rose over decades that this type of coverage was put into your property coverage. The same coverage that’s
there if it burns down. And so in that policy typically you’re gonna have your
business income policy. It may be called business interruption, it may be called time element, it may be called a number
of different things. You don’t need to be
digging through your policy we will do that for you. We know where to look and importantly in each one of our state. We know what the courts say about how they interpret certain laws. But I just want to show
you some of the coverages. Here is just your business income coverage and it defines it. Then we have the extra expense coverage that’s what we talked about. In addition to that this is the next page
of the same endorsement. We have civil authority coverage this is when the government
shuts down certain areas and there people are no
longer able to get to or utilize your business. All of these coverages are
implicated because of COVID-19. And I can tell you what
the insurance company is what they’re going to say
is that there is no coverage no coverage under your
policy and 99% of the time they’re gonna say it’s because there’s been no physical loss to your property. No physical loss to your property. Now the thing that they’re not telling you and they make quoted just like that is that’s not the trigger for coverage. The trigger for coverage typically is gonna be physical loss of or
damage to the insured property or if it’s a civil authority
coverages physical laws of or damaged to another property
not insured under the policy. Physical loss of or damage
those are two different things. You can have a physical loss,
if somebody steals your car. You’ve got a physical loss,
it’s not damaged at all. If you have a business that no longer functions as a business. That property no longer
functions as a business that is a physical loss
with no damage to it. That triggers coverage
the insurance company is ignoring that issue. They ignore the fact that they distinguish between get damaged and physical laws. When you’re shut down you can’t use your business as a business that no longer functions as the property no longer functions
for its intended purposes of business that is a physical loss. They’re ignoring that. To continue there’s
another source of coverage. They’re ignoring that, it
is not coming up anywhere in any of the letters saying hey we’ve evaluated that and that’s here. This says we will not pay
for the loss or damage caused by or resulting from any of the following. But and that’s an important but it is loss or damage here they have
date you see it again. They distinguish between the two. Loss are damaged by a
covered cause of loss result we will pay for resulting
damage loss or damage. And what if one of those
things that they promise that they’re going to pay for. Government acts an act a
indecision or failure to act or decide of any person
group or governmental entity. Well most everybody’s
business is shut down just because of that. And this policy says that is
exactly the type of things that they’re intended this false
it was intended to pay for. Now let’s talk about the exclusions. Everybody has heard about
the virus exclusion. I will promise you there
is not any single thing than a one identifiable thing
that is the virus exclusion. There are lots of different
types of exclusions. Some of which have
nothing to do with virus that the insurance companies
were trying to use. And then there are others that are seen to have the word virus
in it but they also have they’re not triggered
because of this type of loss. But I want to make this point first. Many, many, many policies do not have anything remotely like a virus exclusion. Many policies don’t have
that type of exclusion. And so we don’t need to worry
about it in a lot of cases. I’m gonna go over a couple
of them, I’ll be quick just so you can see if you
happen to get a letter see that there are ways around it. But a little background. So we had SARS in ’03. At that point the insurance
companies looked at that and said that could be a problem in ’03. And then they began working on it with ISO Insurance Services
Office, service offices. They’re a vendor for insurance companies. And they came out with a new endorsement for virus viruses included
and this was July of ’06. And in their introduction
they did talk about SARS, a virus, a type of COVID virus. And then they wrote this exclusion not this exclusion is not in every policy and some policies have no exclusion, some have a form of exclusion
that has the word virus in it, and some have something like this. So this is the one they wrote in ’06. Immediately companies like
Lloyds adopted this in ’06 but this one has gone by the wayside for the most part it may be in some policies but most of them if they have this type of exclusion is gonna have ’07 version and I will just briefly show you. This exclusion the
exclusion set forth in B applies to all coverage
in Section one property. This includes but is not limited
to forms and endorsements that cover property damage to buildings. And forms and endorsements that cover business income extra expense. It seems pretty strong and if
your insurance company sends that to you let us look at it. I will point out one thing. Again the trigger for coverage
is direct physical loss of or damage to property for this. And what does this particular
exclusion apply to? Damage. It applies to damage
to buildings or property, it does not say it applies to laws. And if this A isn’t triggered
B never comes into existence. And so they gotta show and
the burden of proof is on the insurance company
to show property damage. That’s not even our claim, our claim is not that
there’s property damage, ours is that there’s direct physical loss as a result of COVID-19 or more more accurately
as a result of closures. That wasn’t intended for
this type of exclusion. Here’s another one. Insurance companies might
try to use this one. It’s called a microorganism exclusion. It does not have the word
virus anywhere in it. If they intended to exclude viruses they would have been required to say so. The courts throughout the United States say these types of exclusions
must be interpreted narrowly for the benefit of the insured. Something like this I
am strongly confident is not going to apply to virus but the insurance company
is going to you trying to use it and say that it does. And a virus is not a microorganism. We’re almost done. Here’s another example, this is a limited
bacterial virus coverage. And coverage has to be
interpreted broadly, coverage is interpreted
broadly, limits narrowly. So let’s see what this one says. This one goes through and it
is talking about, lets see. The next page … is not a
little bit clear when I get here. I’ll get to that one. It’s only talking about when you have direct physical damage to property ’cause you’re they’re telling you we’re gonna provide you this coverage. As long as you save and preserve the property from further damage. That’s talking about mold or a virus or bacteria on the property itself. That’s not what we’re here about at all. This is nationwide and that’s contained in
this section of the policy in this one however this does
not apply to damage from fungi whether any virus bacterium
or other microorganism that induces or is capable of
inducing physical destruction. This is one that we’re
working through right now. There is not a court yet
that has ruled on this one. If your insurance company
sends this one to you let us look at it. Courts in various states are going to interpret these differently. I can tell you they’re
gonna be some exclusions, some of the virus exclusions that the courts are going to follow. But it needs to be tested in court, don’t take it lying down. Final cutting and I’ve been
getting this question a lot. Paycheck Protection Program if
I got money through that PPP, do I have to pay that back? And it’s gonna depend on the state and it’s gonna depend on
the law in that state. I will give you an example in Florida there is no offset through
payments like this. If there is by the people who give the money a right of recovery. So if there’s a right of recovery then there is no offset. And it doesn’t matter if the
people who gave the money or provided the benefit
exercise that right or that the law would say that that right may be forgiven
under certain circumstances. If there’s a right of
recovery there is no offset. Other states don’t allow these types of collateral sources
at all to be utilized by insurance companies
to reduce what they earn, what they earn. And so that is all I have and I’m excited to answer questions. Let’s see what we got here. Alright hey Ned do we have if and what you can do is put your hand up. You know how to do that? On your more the little more button and I’ve got a bunch of questions. I’m looking at my chat box right now. – [Ned] There’s a question
from the audience here, Mark. The initial letter you
showed in this presentation Do you file this letter
to your insurance agent or go directly with insurance company? – You I would recommend sending
it to the insurance company with a copy to your agent. The problem with only
sending it to the agent is and we’ve seen this routinely is the agent sometimes just holds on to it and says hey it’s not covered or they tell you it’s not covered. And that may be somebody you’ve developed a relationship with and
there’s a trust there and but the agent isn’t the one who legatees this thing that’s us. And so it don’t just give it the agent it could get shut down. Send it to the insurance company, you can give a copy to your agent. What else do we got? – [Ned] We have a question from Nancy. Nancy I’m gonna unmute you. – [ Nancy] Thank you. I got a letter from my
insurance companies asking me to answer two questions. Are you claiming direct physical damage or lost due to uncover real property? And the second question
is are you claiming loss of business income at
your cover premises due to direct physical damage or loss of physical caused by COVID-19? – So here is what there getting at is in what state are you in? – [Nancy] Florida. – Okay. What they want you to do
is answer that on your own and then they’re going to try to shove that down your throat later. So I’ll give you some
guidance on how to answer it but I would prefer that you have lawyer who handles these types of
cases, answer it for you. The first thing I would tell you is the answer ought to say. Please come and investigate this claim, putting the onus back on them. I don’t understand what those terms mean. You can say that, please help me. My business, what type of business is it? – [Nancy] Restaurant. – Alright, as you know my
business is not able to operate or you closed or it’s just a slowdown. How are you handling that? – [Nancy] We closed. – Okay, my business is
closed because of COVID-19. Did you have any employees
that were actually do you know who had coronavirus and we’re working in your
establishment at that time? – [Nancy] Actually I am, I got really sick and I closed and I stay sick for weeks and finally they found
that I have pneumonia and I’ve been treated
by pneumonia right now. – So the reason I’m asking that is for clients who have
had an employee or owner who’s diagnosed with COVID, we do put that in the
letter and say to answer and say they were there in the premises and as you know it can cause direct physical loss and damage. The virus itself direct physical loss and damage to the property. And in that way we would put the onus back on the insurance company. So I would like to sit down and write out the letter wordsmith it and
send him that letter back. Because they’re trying to get you to admit that there’s no direct
physical loss or damage. The direct physical loss as I explained, is the loss of use of the building and for its intended purposes. But if you can write that, that’s fine or if you want us to do that then we – [Nancy] No I would prefer
you could help me out with that that’s why I joined the meeting today. So I’ll stay here and
maybe you guys can take my phone after the call. – Well you’ll get an email
right after the webinar and just email back and
we’ll be able to contact you. That will be the best way. – [Nancy] Okay, thank you so much. – [Ned] Thanks Nancy. – Good question, what else do we have Ned? – [Ned] Next up we have
a question from Jacob. I’m unmuting you Jacob. (clears throat) – Hey Jacob how are you [Jacob] Hi (clears throat) – [Jacob] I’m well thank you. I hope everyone on the call is well, and thank you very much for hosting this. So I, our company owns a
commercial shopping centers retail, commercial shopping centers and in non COVID situations
on an annual basis when we see hurricanes and sometimes that our local power stations
fail or the parking lots that squander our building is affected and we do have a covered loss. That’s kind of like all that we’re trying to fit
ourselves into in this discussion. But in the ordinary sense
when we have a covered loss and we look to as a landlord
to our rent loss coverage or that I guess that’s somewhat analogous to attendance business
interruption insurance. Our rent loss coverage will pay a claim if in our leases it says with the tenant that hey in the event of a casualty and you can’t operate your
business, your rent is abated. If our lease says that your rent is abated in whole or part then we have a claim and our insurance company
would potentially pay. But if our lease doesn’t
grant an abatement and says no matter what,
you have to pay your rent then we don’t have a claim. So that’s what we see in
a normal case typically. In this scenario with COVID, we’re trying to see if the same
kind of analogy would occur. Except here tenants are
proactively reaching out to us say grant me a deferral or
grant me a rent abatement. So if we agree with a tenant now, you know we’ve heard from our insurance company go pawn and sell. And we agree with tenants. Look we’re gonna grant you a deferral. We’re gonna not take your April rent or your May rent your June rent you pay that back next year or whatever. Will that still rise? Like would we be precluded potentially. Should we slow down our
approach to settling you know to making our tenants
lives easier and slow down and better analyze whether
deferrals or abatements would be, would let
themselves better to a claim if we do have a claim under our insurance? So thank you that’s my question. I hope it was clear I’m
not an insurance expert but hopefully tried to kind
of communicate what it was and hopefully that was clear, thank you. – It was crystal clear but stay unmuted ’cause I will have a couple of questions. Does your, do your
leases all allow for them to have a rent abatement
in the event of a casualty? – [Jacob] It varies on
a case by case basis. International tenants will
negotiate certain things and locals others and our
own internal philosophy about it has changed. Where normally we would
say, look pay your rent no matter what in the lease. That might work for
tenants with deep pockets. But your local mom and farm tenant doesn’t matter what it
says they don’t have the funds to pay. So the strategy of saying
look we’re just gonna look to our tenants and their
leases say they got to pay. Today we see that is not panning out in
community neighborhood centers where you do have a few national anchors or maybe open and flourishing. But most of the tenants are closed due to governmental orders
closing their business making their premises not usable. So it varies on a case-by-case basis. – Understood. So there are three issues
that I want to talk about that I think will get us
to where you need to go. First is we would look at the policy and see if what the trigger is. I suspect the trigger for
your coverage is gonna be where I’d said direct physical loss of or damage to the insured premises. And you’ve got direct physical
loss that trigger is there. People can’t use those the operations and no longer functions
as a shopping center ’cause they’re not shopping. Then your tenants have closed. That is your direct physical loss trigger. Step one because nothing matters if you don’t trigger the coverage. Step two, is there an
exclusion in the policy that would eliminate the coverage. I gotta look at the policy and will see. Even if it has something that
they say is a virus exclusion I want to take a look at that. Anyway, third issue is all right. You’ve got coverage,
you there’s no exclusion then what is the
calculation of your damages. And then that becomes the issue really that your question is focused on what is the calculation of your damages? People I once had a fellow
who owed me some money. And I said oh you got pay and he said Mr. Nation you
can’t get blood out of a tulip and I looked at him I said you mean turnip and he goes, it don’t matter,
you ain’t get no money. And so your tenant don’t have the money. You have suffered a loss. Whether you’re being nice and telling them you don’t have to pay or
not really doesn’t matter, they ain’t paying. And so you suffered a loss. Now the question is if later they catch up and your insurance company pays, can you make a double recovery? This comes up sometimes
people’s car gets stolen and then six months later they didn’t get their car back what happens? Depends on the policy language. Same with you, if your tenant catches up do you have to give the money
back to the insurance company? I don’t know, I’d have to see the policy. But going back to, (Jacob mumbles) Go ahead. – [Jacob] No no I was gonna
say thank you, thank you. – Going back to your
other question sometimes the insurance companies tell you, hey if you have this rent
abatement thing in there then we’ll pay you… that
might not even be in the policy. They may just be saying that
and you just go along with I don’t know that that’s accurate what they’re saying in the policy. So all that decision – [Jacob] Yeah thank you very much. We’ll you know digest what
the rest of the dialogue and discussion is and
you know you’ve raised a lot of points I’ve already requested from our risk management department is they’ve just told me
no we don’t have coverage but this isn’t the first similar webinar that’s raised questions and so I’ve already requested
a copy of the actual policy and the exclusions just to see for myself and then just as a final just thought I’ll let the floor go. But in addition to rent abatements often these leases
complicate things further by saying that the abatement is secondary the primary source during
these issues will be the tenants business
interruption insurance. And once it’s exhausted if they you know, they may have six months of coverage, twelve months of coverage whatever. Once it’s exhausted then
the abatement kicks in. So that may complicate the
refund issue you just mentioned. May complicate the timing
of the payment of claims and may magnify exponentially the number of claims necessary to get to a result. – Correct but the insurance
company doesn’t get off the hook by saying well
something good might happen to our insurer later so
we don’t have to pay. And so I’ll leave you with this thought one thing you may want to do
is have your tenants forward the email to them so they
can go on to our AI tool and see if they have a claim also. If they do obviously that benefits you. Assuming that they cut the check to you or if you’re listed as
an additional insured under the tenants policy. – [Jacob] We would be
we always are typically and now we’ve outsourced all
of our insurance management to companies are very robust
making sure these certificates now more than ever it’s important to have you know them
updated at your fingertips. So thank you for your insight and for all the information
and thank you to the group for everyone else’s
questions as well, thank you. – Happily thanks thanks for attending. – What else we got Ned? – [Ned] So we have a
question from Jason Moore. I’m gonna unmute you Jason. – Hey Jason how are you? – [Jason] Hey Mr Nation good
thank you for doing this. I’m an attorney in Missouri in Kansas and I’m seeing some of these
cases filed as class actions. And I’ve also heard some
chatter about an MDL. – Correct. – [Jason] Can you talk about that one of the chances of it
getting thrown into a class and do you think this would
work an MDL before that. – Excellent question and I spend
a lot of time discussing it and thinking about it because
we do have a department. We could do that, we do a
lot of MDL and class cases. However when I think
about these types of cases we’ve got let’s say we’ve got hundreds of insurance companies and each right it’s a
little bit different policy and then we’ve also got
individual companies who might write four or
five different coverages under different names and
then we have insurance who buy a whole lot of different endorsements so there’s gonna be a lot of dissimilarity between the policies that are written the coverages and endorsements
that are purchased and then we throw on it this complication. Bottom line up front I don’t
think the MDL or class is the best way to go for this. And for folks who don’t know the MDL is Multidistrict Litigation where you’ve got all these cases there that are coalesce and then the judge will make
certain determinations. It may have an impact
on all of those cases. One court, one judge might
be thousands of cases and then you can opt out. You can do different things. Try your own case that type of thing but that’s generally one of the … But here are the complications that I see with MDL and
final certification. The coverage trigger first of all, states define direct physical loss they’re damaged differently. Different states do them differently. They interpret the exclusions differently. In different states one
party might have the burden of proving that it comes with
like the insured in Florida. All he had to prove is that they suffered direct
physical loss over damage to the property during the policy period. And then the burden of proof
shifts to the insurance company to prove it’s excluded
and then it shifts back it’s a shifting burden proof. Shifts back to the insurer to
prove the amount of damages. Other states the whole burden
of proof is on the insured to prove breaching contract including their causation and damages.` And so we have these
different burdens of proof. One, no that’s two. Next you’ve got different
tools of interpretation. So in one state you might have something called reasonable expectation test. Where the courts will look at the reasonable expectation of an insurer in interpreting the policies. Other states reject that in favor of reasonable interpretation. And then we get to various exclusions and then it involves how are we going to interpret concurrent causes. Different states interpret
concurrent causes differently. And the concurrent causes just two or more causes coming
together to produce a loss. For instance you’ve got a civil
authority issuing an order and you’ve got people staying
inside because of COVID. Those two things come together. Are those concurrent causes? States treat those differently for are those an efficient proximate cause meaning they’re dependent causes. Some states then allow something called an anti concurring
cause clause some don’t. All that to say I don’t think that’s the type of thing that it’s resolved well. And in any other classification. We have the option I filed
our suits as individual. – [Jason] Thank you. – So that makes sense to you? – [Jason] Yes thank you very much. – Alright, I hate to get
the weeds for everybody but if you can’t tell I’m kind of enthusiastic about this type of thing. We start talking about concurrent call as an efficient proximate
cause I get really excited. Alright, who else we got Ned? – [Ned] Hey, so Mark we’re gonna do the last call for questions here. We don’t have anyone
with their hand raised. So last call for questions everybody. Click the button to raise your hand if you’d like to ask Mark a question. Oh here we go we have Chris. One second, Chris you’re on. – [Chris] Hey thank you. Hey Mark how are you? – I’m good, how are you? – [Chris] Fantastic thank you, thank you for putting this on. Hey question? So like I knew with actual
property loss or wreath loss or something like that from a storm, insurance the proof or the
burden of proof is on the carrier to say well that didn’t
happen because of the storm. How does it work with these
business loss policies. Like when you gave her the example of hey please help me,
please investigate this. Where does that burden of
proof fall for these losses? Is it on the insurance company to say once the claims are made they have to prove that it didn’t happen? How does that work? – So the insurance company has
a duty to adjust the claim. They adjust every premium
dollar that’s paid. Part of that premium goes
towards the insurance company hiring people to perform an adjustment. An adjustment means that they are supposed to determine the cause of the loss, to determine if those losses are covered, determine if there’s an exclusion and if they’re covered
it with no exclusion, determine the amount of the loss. That’s what their job is, that’s
what they were paid to do. With those premium dollars, at least part of every
dollar goes towards efforts. So initially they have
that burden of proof. You don’t have to prove the losses cover, you got to prove you sustained loss. You present the claim and
you say I’ve got loss. They then go and determine whether or not it’s covered or excluded. Now really the next question is who has the particular burdens of proof in see this… you see me I realized I was looking
at the chat box here. Everyone is asking some
good questions here we go. So in court generally speaking the insured is gonna have
the burden of proving that there is a loss that comes that occurs during the policy period. And so that fight is gonna be on this direct physical loss of issue. The insurer they may have
the burden of proving that. That issue will probably get resolved by the court during summary judgment. Once we get past that then it would be the insurance company’s burden to prove its exclusion
otherwise it’s paid. And then the insurer that person has to prove the amount of their damages. Chris does that answer your question? – [Chris] Yes it does I
yeah again I appreciate it. – Alright, thank you. – [Ned] So Mark you
have one more question. This will be the last question from James. And here we go, James you’re on. – [James] Thank you and Mark, thank you very much for this meeting. We are in a network of contractors that does repair work
and restoration work, mainly for insurance
companies and other entities. We’re getting ready through the carrier’s, insurance companies are asking
us to do COVID-19 cleaning. And some of the other clients that we have like Race gas station, is asking us to come by
and do some cleaning. And of course there’s the, the
two types of cleaning would be obviously will be sanitizing and other will be also cleaning because someone may employ
may have had been diagnosed with COVID so they want
us to come in clean. You know their store to be sanitized. What type of danger are
we in if we are cleaning. Let’s say our national contract what RaceTrac gas station across the US. We’re cleaning it and they say an employee two weeks
later says they have COVID after our cleaning, what type of danger are we in? Because of something like
that could possibly happen. – That is a great question. I’ve talked to a lot of
people about this issue. And so there is an exposure. And so step one anytime
you have an exposure is to make sure you have
good insurance on that issue. And so here’s what the next
call you need to make tomorrow would be to your insurance agent. And you need to make sure that your liability coverage covers this. If somebody were to
bring a claim against you because they say you
didn’t clean it properly and somebody got sick or died. Does my liability insurance cover them? And get it in writing. Two are there any exclusions that apply? What if you had a think about this. What if your liability policy
has one of these exclusions that they’re saying is a virus excluded. And here you are your whole job is to go clean to make sure that the virus is destroyed eliminated, and then they say oh by the way that premium you’ve been
paying to us thank you for that but you there’s an
exclusion in your policy for the very thing that you do. So you need to get it in
writing from your agent that there is coverage for that and that there is no exclusion. And don’t let them waffle on it. Confirm it in an email, you have told me that there is coverage for this and that there is no exclusion. Put it an email. We as you know, we clean
buildings businesses and try to destroy and eliminate
COVID exposure to people. If one of those people
brings a claim against us you’ve told us that have
liability coverage for that and that there is no
exclusion for that, thank you. And you see what the email comes back. If they say hold on a minute
we didn’t tell you that. Then you need to go make sure
you get a different agent and make sure you have coverage. Does that make sense? – [James] Yes it does,
thank you very much. – Do your work well and stay safe. – [James] Thank you sir, same to you. – Alright Ned. – [Ned] Mark I think that’s it. – Alright everybody appreciate – [James] Hey Mark – Yeah. – [James] Mark can I ask
you a quick question? So I think it’s double-sided on what you were just talking about it because let’s say you
got the employee okay, so now you got a workers’ comp claim. So will the comp carrier cover you okay? And then if you have a client, then you have a liability claim. So it could cut both ways,
so just thinking about that I like your advice about
calling the carrier. Many of Murray said you
know no we don’t cover it. But everybody’s thinking about it because of you know concerns about that. The other thing was there’s been some talk about the feds Act stopping
the insurance carriers. So that claims like these for
a business interruption could now be covered, that would be huge. – Yeah, here’s my thoughts on
that we’ll see here’s what I, people routinely said to me well what if they do now what
they did after 9/11, and require that the insurance
companies pay these claims? We’ll stop right there
that’s not what happened. What happened in after 9/11
is the insurance companies were denying the claim
saying look this is an act of war we have an exclusion for any loss or injury resulting from
act of war no coverage. The government came out and
said it’s not an act of war it’s an act of terrorism by
the way that’s not excluded. What happened essentially the next day is insurance company said well find we now have terrorism exclusions in our policy. – [James] you got it right, right. – And so I don’t think that the government either state or federal is gonna come in and mandate that insurance
companies pay claims in violation of the
terms of their policies. If it’s excluded then the
government’s not gonna be able to come in and say hey
you’ve got to cover that. – [James Right. – Court might, the court might say that exclusion doesn’t apply but the government won’t be able to do that. And so that gets us to
the next question is will a state or federal legislature say, if you pay the claims we’ll backstop you when your claims reach a certain level. – [James] Mm-hmm. – Maybe, maybe. Now I
would parse those out and I would suspect any
legislation would say hey if there’s an exclusion
and you’re not paying based on the exclusion we’re
not gonna make you pay. – But if the payment is made
on a policy with no explosion, once you hit a certain level of claims based on your market
share and we’ll pay you X. I don’t know if that gets passed or not because I don’t know how they
would ever determine whether or not or the cost of that legislation. So you’ve always got
to turn in put forward this legislation is expected to cost us X. That’s gonna be a whole lot of money. – I don’t wanna think what that amount is. – Does that answer your question. – [James] it’s a big
number, it’s a big number. Yeah and so on the comp side,
you know we’ve talked to the drug testing agencies. They’re like oh yeah
we’ll test all your people before they go back to work. But it’s really useless to
spend $150 to get them tested because five minutes after
you’re done testing them they can go home and their
wife could give it to them or you know the next
person they come in contact you know with it at the
office could give it to them. So they’re saying the temperature thing is a better thing to do. I don’t know it’s nuts you know. There’s nobody knows what to do next. – Alright, how often would you test as the employ, I’m not sure. – [James] Everybody’s saying
give them temperature gun when they show up to work, none of you if it aint
that go home you know. But the cop is a question also though because you know you guys are
involved with that stuff too and we you know we, those are unchartered territories you know. – Fine. Then you’d have to
prove it’s a workplace entry and – [James] Right would and where do you where did you get it you know and – It can be done I mean
once you trace it back it can be done. – [James] Yeah. – I don’t know that that’s going to happen a lot though. – [James] Yeah. – Appreciate it. – [James] Great stuff though, thank you. – Thank you. Alright Ned,
anything else or we done? – [Ned] We’re good. Watch out for the email everybody. – Yep. Alright everybody thanks for attending we’ll have more of these. All develops and these things happen. We’re certainly going
to have more of these. and you will get the email. Look for the tool the we
call Jimmy the robot lawyer. And pass that out to
your friends, tenants, you know folks that you know who might be benefited from that and let’s see if we can help. Alright God bless
everybody, and thank you. – [Nancy] Thank you.


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