Can a communicable disease exclusion block an ordinary neglect claim?

The common form excludes any claim arising out of, resulting from, caused by, or in any way related to any actual or alleged transmission of, exposure to, or fear of any communicable disease. Two features make it broad.

First, the absolute causation language, applying regardless of any other cause contributing concurrently. Second, and more consequentially, an extension to any failure to prevent such transmission, which reaches the facility own conduct rather than only the disease.

Infection control is a standard component of a neglect allegation. A plaintiff alleging chronic understaffing will routinely include counts about hygiene, hand washing, wound care and isolation practice, because those are the observable consequences of insufficient staffing.

A decline that also involves wounds, dehydration and falls frequently has an infection somewhere in the sequence. Where the exclusion reaches failure to prevent, an insurer can argue the whole claim, or a substantial part of it, is excluded even though nobody would describe the case as an infectious disease matter.

These exclusions spread after 2020 and are commonly assumed to address pandemic-scale events. In a congregate care setting the ordinary-year exposure is larger than that: influenza, norovirus and antibiotic-resistant infection outbreaks all produce claims.

A congregate setting with a medically vulnerable population, shared dining and staff moving between residents is exactly the occupancy these exclusions were drafted against, which is precisely why an operator needs to know whether one is attached.

Removal of the exclusion. Failing that, a carve-back so ordinary negligence allegations are not excluded merely because an infection is present in the facts. Failing that, at minimum a narrowing of the failure to prevent language so the exclusion reaches transmission claims rather than general care claims.

And confirm the wording across every layer of the tower, because excess layers frequently carry different exclusions from the primary and the difference is invisible on a proposal.

This is a term that changes between renewals without being flagged. It belongs on an annual reconciliation checklist alongside defense treatment, the abuse sublimit, the retroactive date and the aggregate basis.

While you are in that part of the policy, check what happens on the property and business income side in an outbreak. Interruption caused by an outbreak or an isolation order involves no physical damage, so standard business income will not respond either, which means the operational and financial consequences can sit outside both programs at once.