Amid COVID-19, Georgia Lawyers and Insurers Should Expect 'More Chaos'
There is significant ambiguity as to which insurers will cover COVID-19 claims; the specific treatments that will be covered; and whether out-of-network treatment will be fully covered.
May 06, 2020 at 01:22 PM
5 minute read
The novel coronavirus, SARS-CoV-2, or COVID-19, has caused hundreds of thousands of hospitalizations, claimed thousands of lives and brought the world economy to its knees. The strength of medical and economic contingency plans has been thoroughly tested in places like New York City, Washington state, New Orleans and the state of Georgia.
Since the World Health Organization declared a global pandemic, governments have executed measures to slow the spread of the virus: mandatory quarantines, closure of schools and universities and implementation of social distancing policies. As a result of these measures, the global economy has come to a halt, leaving millions unemployed and causing financial strain across all sectors of the U.S. economy. Georgia has not been left "unmarked" by the virus: more than 25,000 Georgians have been diagnosed with COVID-19, and there have been more than 1,000 COVID-19-related deaths.
As with all business sectors, Georgia's legal community has been greatly affected by the virus and resulting lockdown: the number of personal injury filings has decreased; several law firms have cut employee compensation; and the court system has effectively been suspended since mid-March.
The most serious consequence of the pandemic on the Georgia legal community has been the indefinite suspension of jury trials. Understandably, court and health officials are concerned about forcing potential jurors into a courthouse in close quarters to one another. There is a real fear that convening juries will negate whatever success Georgia has had in slowing the rate of infection. While this delay certainly affects the efficient resolution of civil cases, the indefinite delay of criminal trials is of concern. Under the Sixth Amendment to the Constitution, criminal defendants have a right to a speedy trial. The longer criminal trials and grand juries are suspended, the greater the likelihood that we will see Georgia criminal defendants file civil rights actions alleging a violation of their Sixth Amendment rights. This will put more pressure on a court system already overburdened. Some legal analysts have proposed "Zoom" trials to alleviate this problem; such trials, however, raise serious concerns over potential violations of the Confrontation Clause of the Sixth Amendment.
Gov. Brian Kemp recently announced plans to reopen Georgia's economy, permitting certain businesses, stores and restaurants to reconvene operations in early May. As a result, legal analysts around the state predict a surge in both court filings and insurance claims over the coming weeks in several industries—especially in the travel, hospitality, health care and insurance sectors.
For example, thousands of Georgians have been treated for COVID-19. This treatment will lead to the submission of substantial health insurance claims. While certain politicians and private health insurers have promised that COVID-19 treatments will be covered at no additional cost to the insured, there currently is no statutory enforcement mechanism to hold private insurers accountable, should they fail to follow through on these promises.
Consequently, there is significant ambiguity as to which insurers will cover these claims; the specific treatments that will be covered; and whether out-of-network treatment will be fully covered. Given the sheer volume of benefit claims that will be made, this confusion will inevitably lead to hundreds, if not thousands, of lawsuits related to improperly denied benefits. Ambiguity only creates more risk for health insurance companies, and it would serve them well to follow through on the promises previously made.
In addition, there likely will be an increase in federal False Claims Act (whistleblower), kickback and bribery cases filed in Georgia. In March, the federal government passed the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, to flood the economy with $2 trillion of liquidity as quickly as possible. As with any large-scale government action undertaken in a crisis, there will be businesses that fraudulently siphon public money for their own gain (e.g., claims related to the 2008 Troubled Asset Relief Program). The health care industry will be under a microscope in this area, as other commentators have already raised concerns about these organizations wrongly obtaining grants through the CARES Act for improper purposes.
As society begins to reopen, only time will tell whether the emergency measures taken by the federal government and state of Georgia effectively reduced the spread of the virus. In the near term, however, we can expect only more chaos—especially in the legal profession.
Alan Holcomb is a trial lawyer who handles catastrophic injury cases. He is a partner at Turnbull, Cain & Holcomb, a partner of The Law Center, a national network of law firms which advocate for those who have suffered from personal injury, asbestos-related diseases, motor vehicle accidents and more.
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