Be forewarned: If you injure yourself while participating in an insurrection against the government, don’t expect your health insurer to pay your medical expenses.
Very quietly, a number of healthcare insurance companies have added “insurrection” and “riots” to their list of excluded benefit payments, apparently in reaction to the Jan. 6, 2021 attack on the U.S. Capitol. It’s not known if any of the actual Jan. 6 insurrectionists filed injury or sickness claims but, in keeping with insurers’ strategies of limiting risk and exposure, the companies have sought to head off any future potential losses from political riots. Or, perhaps they’re expecting some political unrest in this election year.
The 2024 Cigna Health Care insurance policy excludes “treatments of an injury or sickness which is due to war, declared or undeclared, riot, or insurrection.” Aetna also excludes losses “caused directly or indirectly by invasion, insurrection, riot, civil strife, or civil commotion.”
Insurers have sometimes listed “war” as coverage exclusions in policies, but the addition of “insurrection” and “riots” seems new.
‘Insurrection’ inclusion now ‘more common’
“The inclusion of ‘insurrection’ along with other civil disturbances is becoming more common,” said Eliezer Zupnick, the founder of East Insurance Group, an independent commercial insurance company. “Insurers aim to clarify that damages from such politically driven events are excluded.”
Repeated attempts to contact insurers for comment on this new exclusion were unsuccessful. Zupnick noted that there’s a good deal of ambiguity around how broadly terms like “insurrection” will be applied, compared to a “riot” or “civil commotion,” which have more legal precedents.
Both a riot and a civil commotion involve a revolt by a gathering of people in a public place. A civil commotion is similar to a riot, but involves a greater number of people, say insurance regulators. Riot and civil commotion can be difficult to differentiate. The perils are often listed together in a policy. Ambiguity can arise when courts are asked to determine how to define an event for insurance purposes. The same event can be characterized in various ways. CNN calls the events of Jan. 6 an insurrection but Fox News labels it “capitol protests,” or a “capital riot.”
Uncertainty regarding restrictiveness
“The exact language in policies will determine coverage,” Zupnick said. “So, while ‘insurrection’ as a specified exclusion is increasingly standard across major health insurance providers entering 2024, there is uncertainty regarding how restrictive the term will be in practice. Insurers will likely argue for broad interpretations to limit uncovered losses.”
Last year’s health policies from United Healthcare said its network medical groups and hospitals would do their best to provide needed services “in the event of a major disaster, epidemic, war, riot, civil insurrection, or complete or partial destruction of facilities.”
But this year’s United policies say it will not cover for illness, treatment, or medical condition, due to “war declared or undeclared.” Maybe if you take part in an insurrection, you’ll be covered.
Most travel insurance policies exclude war, acts of war, and political unrest from trip cancellation, according to TravelInsurance.com, meaning most claims related to those events are denied. However, trip insurance policies are vague regarding the definition of war, resulting in each claim being handled individually.
Property damage caused by riot, civil commotion or vandalism is generally covered under standard auto, business, and homeowners insurance policies, according to the Insurance Information Institute. Several types of insurance products, depending on the property’s nature and function, can provide coverage to help with rebuilding or replacement. But some may be tightening up those exclusions in the wake of potentially increasing politically motivated demonstrations.
Doug Bailey is a journalist and freelance writer who lives outside of Boston. He can be reached at firstname.lastname@example.org.
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