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MLB Teams Sue insurers Over Lost Revenue Major League Baseball and all 30 of its teams are suing their insurance providers, citing billions of dollars in losses during the 2020 season played almost entirely without fans due to the coronavirus pandemic. The suit identifies AIG, Factory Mutual and Interstate Fire and Casualty Company as having refused to pay claims despite the league’s all-risk policies. The league claims to have lost billions of dollars on unsold tickets, co...ncessions, parking, in-park merchandise sales, corporate sponsorships, local and national media losses, plus missed income for MLB Advanced Media. It says all of those losses should be covered by their policies. Over 1,400 lawsuits have been brought against insurance companies regarding business interruptions claims related to the pandemic. Insurers have insisted that financial losses caused by the coronavirus do not constitute physical loss or property damage. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Covid-19 Business Interruption Lawsuits There’s a multibillion-dollar fight over insurance coverage for pandemic-related business losses. While insurers are winning a large number of cases, there are some exceptions. Since the start of the COVID-19 pandemic and government-ordered shutdowns, judges have dismissed more than four times as many business-interruption lawsuits as they have allowed to proceed, but some plaintiffs are finding weaknesses in the industry’s legal defens...es. There’s a lot at stake for thousands of businesses with the pandemic causing an increase in bankruptcies. The pandemic is also squeezing insurers. According to a prediction by Lloyd’s of London, the industry could face at least $100 billion in total underwriting losses from the pandemic. While many insurers added virus waivers to policies over the past decade following the SARS outbreak in 2003, industry executives say pandemic-related losses may be their biggest ever, and business-interruption claims will likely be part of that. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Are More Workers' Comp COVID-19 Regulations Coming? Workers’ compensation managers already have new laws and regulations to follow and may face more changes in 2021. In addition to the new rules clarifying gaps in California’s COVID-19 presumption law, employers may have to deal with potential vaccine mandates once a treatment becomes available. Once a vaccine is ready, it is conceivable that employers could mandate their workers get vaccinated. There are some that expect Pre...sident Joe Biden’s administration to draft new federal employer guidelines for COVID-19, which could impact employers’ reporting obligations under recently passed state Assembly Bill 685. AB 685, which requires employers to notify workers when someone at a job site tests positive, goes into effect Jan. 1. The bill also requires employers to report outbreaks to local health agencies. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Laws for California Employers 2021 Part 2 Continued from yesterday’s post. SEXUAL HARASSMENT TRAINING - California passed legislation requiring that all employers of five or more employees provide one hour of sexual harassment and abusive conduct prevention training to nonsupervisory employees, and two hours of sexual harassment and abusive conduct prevention training to supervisory employees, once every two years.... AB 2257 substantially revises California’s recently enacted statutory test for classification of independent contractors (known as AB 5). AB 5 had a complicated list of exceptions which AB 2257 revises, expands and clarifies, largely thanks to aggressive lobbying efforts by certain industries. AB 2143 expands and clarifies the use of NO-REHIRE provisions in settlement agreements. An employer may not enter into an agreement restricting an aggrieved person from obtaining future employment with that employer or its affiliates. AB 979 requires publicly held domestic and foreign corporations with principal offices in California to include directors on their boards from underrepresented communities. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Laws for California Employers 2021 Part 1 In preparation for 2021, California employers have an abundance of new laws to decipher and comply with. AB 685 Employers are required to provide notice to employees exposed to COVID-19 at a worksite and provides CAL/OSHA with authority to control an imminent hazard related to COVID-19.... SB 1159 creates new COVID-19-related presumptions in the Workers’ Compensation Claims Process and creates a disputable presumption that illness or death resulting from COVID-19 is an occupational injury entitling certain employees to workers’ compensation benefits. SB 1383 creates new California Family Rights Act obligations for smaller employers and impose some significant changes for larger employers. SB 1383 expands the reach of CFRA to smaller employers and provides leave to care for a larger pool of family members. AB 1867 codifies COVID-19 supplemental paid sick leave for qualifying food sector workers under new Labor Code section 248. MINIMUM WAGE INCREASES - Effective January 1, 2021, employers with 25 or fewer employees must increase the minimum hourly wage to $13.00 (increased from $12.00 per hour), while employers with 26 or more employees must pay a minimum wage of $14.00 per hour (increased from $13.00 per hour). SB 973 requires private employers who (a) have 100 or more employees and (b) are required under federal law to file an annual Employer Information Report (an EEO-1 Report) to submit an annual pay data report to the California Department of Fair Employment and Housing (DFEH). Look for part 2 tomorrow. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

SB 1159 Is Law California’s COVID-19 presumption law is now law until 2023, meaning employers need to comply with what’s required of them. If employers aren’t diligent about the requirements of the new law, they could end up paying huge fines on top of having COVID-related workplace claims. SB 1159 created a rebuttable presumption that COVID-19 is compensable for police, firefighters and health care workers who test positive within 14 days of going in to work. A separate pres...umption covers others who test positive within 14 days of going to a workplace that experiences an outbreak. An outbreak exists when at least 4% of the people at a company with more than 100 workers test positive, or when four people test positive at a company with 100 or fewer workers. SB 1159 is retroactive to July 6 and covers the period from when Newsom’s presumption executive order expired to when he signed the bill into law. And the law applies to all pending and open COVID-19 workers’ compensation cases. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Over $100k in COVID Penalties for Kroger The Division of Occupational Safety and Health (Cal/OSHA) penalized five Southern California grocery stores owned by Kroger, a total of $104,380, for allegedly failing to take necessary steps to protect employees from COVID-19. The agency said one store failed to provide its employees with effective training on how to avoid infection; signs and symptoms of the disease; and how to safely use cleaners and disinfectants. The store also fa...iled to report a worker’s fatal COVID-19 illness, which the agency learned of seven days after the worker died. A fatality at another store wasn’t learned of until six days after. The same store also exposed employees to the virus by allowing too many customers to enter, which prevented workers from maintaining at least 6 feet of physical distance. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Pandemic and Workers' Comp Fraud Workers’ compensation fraud experts are pointing to the economic downturn caused by the COVID-19 pandemic and anticipating a new wave of scammers ready to exploit unsuspecting injured workers and abuse gaps in the system. Fortunately, anti-fraud efforts are starting to keep up with the scammers. There are several organizations working on the problem, including the State Compensation Insurance Fund, Workers' Compensation Insurance Rating Bureau..., and the Department of Insurance’s Fraud Assessment Commission. With millions of people out of work and injured employees pursuing care via telehealth, the system is potentially more vulnerable to fraud. There’s a legitimate reason for extending benefits to people who are suffering during the pandemic, but it's also a money-making opportunity for those who want to steal and commit fraud. Effective fraud investigations start with employers. As relationships among stakeholders continue to improve, it will be easier to share data and monitor trends, making red flags easier to see earlier on. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

COVID-19 Workers' Comp Claims on the Rise in California The number of California workers’ compensation claims for COVID-19 continues to climb, as data from the Division of Workers’ Compensation (DWC) show that as of August 10, there were 9,515 claims reported for the month of July, bringing the total for the year to 31,612 claims, or 10.2% of all California job injury claims reported for accident year (AY) 2020. Those claims include 140 deaths. The number of COVID-19 claims w...ith June injury dates more than doubled from 4,438 claims as of July 6 to 10,528 claims as of August 10. Health care workers continue to account for the largest share of claims, filing 38.7% of the claims recorded for the first 7 months of this year, followed by public safety/government workers who accounted for 15.8%. Rounding out the top 5 industries based on COVID-19 claim volume were retail trade (7.9%), manufacturing (7.0%), and transportation (4.7%). The updated data is included in the latest iteration of CWCI’s COVID-19 and Non-COVID-19 Interactive Claim Application, an online tool that integrates data from various sources and allows users to explore and analyze a list of variables. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

$116,000 in Citations for COVID Violations The California Division of Occupational Safety and Health (CalOSHA) cited 11 employers a total of more than $116,000 for not protecting workers from COVID-19 because they did not take steps to update their workplace safety plans to properly address hazards related to the virus. The inspections were opened after notification of serious illnesses, complaints of workplace hazards and after proactive joint enforcement efforts. Sutter Bay... Medical Foundation in Berkeley was cited $6,750 for failing to comply with the Aerosol Transmissible Disease standard requiring proper respiratory protection in health care settings when transporting patients suspected of having infectious diseases such as COVID-19. Others cited include: DL Poultry Inc. $51,190. Michel Labor Services Inc. in Dixon, $11,700. Serve Max Farm Labor Contractor in Vacaville, $11,250. Olson Meat Co. $9,000. Uni-Kool Partners $5,850. Planasa, LLC in Macdoel, $5,400. Duncan Family Farms in Tulelake, $5,060. Ruiz Farm Labor in Dixon, $4,500. Sierra-Cascade Nursery Inc. in Macdoel, $4,050. M&J Williams Inc., $2,025. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

CA DAs Ask Fraud Commission for More Funding Representatives from district attorneys' offices across California pleaded their case for more funding to help combat workers’ compensation fraud with the Department of Insurance’s Fraud Assessment Commission. Members of the commission said another increase on the assessment is going to be difficult because employers might not be able to afford a larger assessment due to the financial realities of the COVID-19 pandemic. Each year, ...the assessment forms the basis of a surcharge California employers pay to finance prosecutors who focus on workers’ comp fraud. The assessment for 2020 was $72.1 million, an increase over the $66.6 million collected in 2019. Layoffs and other post-employment issues in the wake of the COVID-19 pandemic have created an environment where workers’ comp fraud can thrive. Increased use of telemedicine has also opened the door to fraud relating to prescriptions, suspicious charges, and falsely billing patients. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

COVID Presumption Bill Passes Before the regular session ended, the California Legislature passed a bill that would create a rebuttable COVID-19 presumption for first responders, health care workers and other essential employees through 2022. Senate Bill 1159 is now in the hands of Gov. Gavin Newsom and he has until Sept. 30 to sign the bill, veto it or allow it to become law without his signature. SB 1159 would codify the governor's May 6 executive order, which created a reb...uttable COVID-19 presumption between March 19 and July 5. In addition to writing the governor’s presumption into statute, the final version of SB 1159 would create two sets of presumptions. The presumption for firefighters, peace officers and health care workers would apply for anyone who tests positive for COVID-19 within 14 days after a day that person performed labor at the employee’s place of business. The second presumption in SB 1159 for non-emergency workers would apply only when a person tests positive for COVID-19 within 14 days of going into work and the positive test occurred during a period of an outbreak at the specific workplace. Two other proposals that would have presumed the disease is occupational were not called for votes in the Senate. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Following COVID Rules to Avoid Third-Party Lawsuits According to insurance experts, employers need to implement and enforce recommended COVID-19 guidelines or risk potentially expensive litigation, including third-party claims. A recent webinar advised companies on how to keep their workplaces free of COVID-19 and how to defend themselves against claims and lawsuits if an employee claims to have gotten sick on the job. When employees fall ill, most individual cases are handle...d by workers’ compensation systems. With the COVID-19 pandemic, new third-party claims are arising that could circumvent the normal process and catch some companies unprepared, such as claims for wrongful death by families of COVID-infected employees and claims by family members of COVID-infected employees who catch the virus themselves, in each case claiming employers failed to keep their family members safe while at work. In each case, the claimant would have to show the employer was wanton and reckless in putting workers at risk, which is difficult to prove. For companies, it’s important to show that they exercise reasonable care. Companies failing to implement policies that conform to state directives and failing to provide appropriate safety equipment and adequate training resources are more vulnerable. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Competing COVID Presumption Bills What do lawmakers plan to do with competing proposals to presume COVID-19 is an occupational condition? The Assembly Appropriations Committee passed a bill that would create a rebuttable presumption for first responders and other frontline workers, and codify the presumption the governor enacted through executive order. The Senate Appropriations Committee passed a bill that would create a rebuttable presumption that COVID-19 is compensable fo...r safety and health care workers, as well as a bill that would create a conclusive presumption that the disease is compensable for all other essential workers. The Senate Appropriations Committee voted 5-2 to pass Assembly Bill 196, which declares COVID-19 is compensable for workers other than law enforcement, firefighters and health care employees. Another measure was passed, AB 664, which would create a rebuttable presumption that COVID-19 is compensable for the first responders who would be excluded from the presumption created in AB 196. And, SB 1159 would codify Gov. Gavin Newsom's executive order that created a rebuttable presumption for essential workers, which ended July 5. SB 1159 would create a long-term presumption for those essential workers, with an ending date of Jan. 1, 2024. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

New SIU Rules to Help Stop Fraud On October 1, insurance companies will have to face new rules for special investigative units that the California Department of Insurance adopted to address its concerns about insufficient efforts to stop fraud. The new rules require that SIU workers receive five hours of continuing anti-fraud training each year. In addition, companies will need to make a number of changes to improve the quality of fraud referrals that they are submitting. The... rules clarify deadlines for responding to a CDI request to provide documents to require a response within 30 days for all lines except workers’ compensation, where documents must be provided within 60 days. Other changes require that special investigative units’ analyses of claims take into account factors indicating fraud, identify which industry-recognized databases are used by the SIU, and mandating that SIU summaries answer specific questions related to fraud allegations. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Expanded Worker Protections No New Presumption? Governor Newsom said he is committed to working with lawmakers to expand employee protections during the COVID-19 pandemic, though his office stopped short of saying the governor planned to announce another presumption after his previous order expired in July. Expanded paid sick leave will provide workers financial security so they are able to stay home when sick. Similarly, workers’ compensation access helps ensure that front...line workers can quarantine and stay home from work when ill. One new program would provide temporary isolation spaces for agriculture and farmworkers who either tested positive for the virus or were exposed to it. The governor also announced increased outreach and education on mask use as well as how employers can work to minimize COVID exposure in their workplaces. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.

Three Presumption Bills California lawmakers passed three different bills that would create presumptions that the disease is compensable. The Senate Labor, Public Employment and Retirement Committee passed AB 196 and AB 664. AB 196 would create a conclusive presumption that COVID-19 is compensable for all essential workers other than cops, firefighters and health care workers. The presumption that COVID-19, which has an incubation period of under a month, is compensable would... apply for 90 days following termination. AB 664 would create a rebuttable presumption that COVID-19 is compensable for police, firefighters and health care workers. The Assembly Insurance Committee passed Senate Bill 1159. The bill would codify Gov. Gavin Newsom’s executive order, which created a rebuttable presumption for workers who contracted the virus during the course of work between March 19 and July 5. The bill also would extend coverage for first responders, health care workers and some other frontline employees through July 2024. SB 1159 now goes to the Assembly Appropriations Committee. https://costfirst.com/ Remember to Like and Follow us, and if this news sounds interesting, please share with your friends.