California Insurance Policies Can’t Deny Claims Using ‘Riot’ Clauses, Insurance Commissioner Confirms

Rumors that coverage could be denied for injuries sustained at protests had spread on social media
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With numerous protesters hospitalized or seeking treatment following recent demonstrations, social media lit up with activists advising one another to check their health insurance policies for language that might imply that “participation in a riot” could be grounds to deny a claim. In California, at least, it appears such clauses are not permitted and shouldn’t be a reason for anyone to avoid getting care.

An analysis by MarketWatch found policies issued by Aetna, UnitedHealthcare, and other corporations do include the clauses. Kaiser Health News found similar language in policies issued by Cigna and Florida Blue. In all cases, there is little in the way of guidance or documentation on how to determine when they apply.

“If you went to a peaceful protest and someone shot a rubber bullet and it hit you, you didn’t intend to go to a riot,” Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University’s McCourt School of Public Policy, told MarketWatch. “In this context, most individuals involved intended to go to peaceful protest. The fact that it became violent isn’t their intention.”

Only 18 states have laws on the books that regulate these types of clauses, and of those 18 some of them are rules that explicitly allow them. California is one of only a handful of states where these clauses are prohibited across the board.

“California required health insurance companies to remove coverage exclusions for riots from their policies after the passage of the Affordable Care Act,” Deputy Insurance Commissioner Michael Soller tells Los Angeles. “Anyone who is injured or believes they contracted COVID-19 as a result of participating in protests should seek medical attention.”

Soller recommends that California residents that do have questions or concerns about their coverage contact the state’s consumer hotline at 800-927-4357.

Mayor Eric Garcetti has been encouraging protesters to schedule COVID-19 tests and fully self-isolate for at least 14 days after participating. Saying at a recent briefing that, “As we’ve been focused on racial justice, we can’t lose sight of our personal responsibility to not spread COVID-19 further[…]”


RELATED: Fury, Exhaustion, Hope: Black Photographers Turn Their Lenses on the Protests


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