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California COVID presumption could cost up to $1.8B


California’s rebuttable presumption for COVID-19 acquisition for 16 categories of essential workers may likely cost the state $1 billion, but far less than earlier projections, according to a presentation of the California Workers Compensation Insurance Ratings Bureau’s actuarial committee on Tuesday.

Preliminary costs of covering COVID-19 acquisition for essential critical infrastructure workers in the state via a rebuttable presumption could range from $600 million to $1.8 billion, according got the committee, based on its estimate of 66 million compensable COVID claims including medical and indemnity benefits.

The Oakland, California-based WCIRB published a detailed outlook April 17 of what presumptive coverage of COVID-19 workers compensation claims made by first responders, health care and other workers could look like in the state. The report considered a wide range of possible costs for coverage based on average rates of acquisition and levels of severity and their related medical costs, estimating that conclusive presumptive coverage of COVID-19 could cost anywhere from $2 billion to $33 billion.

On May 6, Gov. Gavin Newsom issued an executive order to allow all essential critical infrastructure workers who acquire COVID-19 to assume that they contracted the virus at work. However, the order allows employers to rebut that assumption before accepting a claim. 

The actuarial committee’s new estimations for rebuttable presumption looked at mild, severe, critical and fatal cases of COVID-19 among essential workers in the state, predicting that most claims would be mild, not subject to permanent disability or death benefits and carrying medical costs that total about $20 million. Based on its estimate, the biggest expenses would be due to death benefits, at an estimated total cost of $210 million, and medical costs for severe, critical and fatal cases at an estimated $200 million, $120 million and $140 million, respectively.

The committee noted in its presentation that its estimates do not reflect potential increases in COVID-19 claims when stay-at-home orders are relaxed, and noted that the environment is “very fluid” and that cost estimates could be impacted based on a number of conditions, including the implementation and interpretation of the governor’s order, preexisting conditions of COVID sufferers or claims made by those not covered by the essential worker order. 

More insurance and workers compensation news on the coronavirus crisis here.







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