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Posted By IIAW Staff,
Tuesday, November 30, 2021
Updated: Wednesday, December 1, 2021
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By: Josh Johanningmeier, IIAW General Counsel The Paycheck Protection Program, or PPP, was one of the federal government’s earliest Covid-19 pandemic programs. The PPP loan program is administered by the U.S. Small Business Administration (SBA). According to the SBA, just under 11.5 million PPP loans were made, totaling about $792 billion. For many small businesses, including independent insurance agencies and countless agency clients, PPP loans were a lifeline during uncertain and disruptive economic times.
One of the key aspects of the PPP loan program was that, under certain circumstances, the loans would be forgiven. The process for seeking loan forgiveness has been underway for many months at this point, and nearly 8 million borrowers have filed forgiveness applications, with nearly 97% of the loans forgiven and repaid by the SBA. That is good news for those borrowers, but leaves thousands either unforgiven, or pending. Some of the pending PPP loan forgiveness applications will be granted, of course, but there will be no shortage of denials as well. It is important to understand that the SBA’s forgiveness decision is appealable, but borrowers must act quickly. In mid-September, the final rule covering Borrower Appeals of Final SBA Loan Review Decisions took effect, and it provides the framework for aggrieved borrowers to appeal to the SBA Office of Hearings and Appeals (OHA). Here are the key requirements to ensure an appeal is heard by OHA.
First, only the actual borrower on a loan, or its legal successor in interest, for which SBA has issued a final SBA loan review decision has standing to appeal the SBA loan review decision to OHA. This means that the lending bank cannot appeal on behalf of borrowers.
Second, SBA decisions are appealable only if SBA’s completed review of a PPP loan finds any of the following: • The borrower was ineligible for a PPP loan—this looks back at whether the loan should have been made in the first instance. A denial on this basis will mean that no portion of the loan is forgiven. • The borrower was ineligible for the PPP loan amount received or used the PPP loan proceeds for unauthorized uses. • The borrower is ineligible for PPP loan forgiveness in the amount determined by the lender (lenders processing forgiveness applications make recommendations for full or partial forgiveness amounts). In this situation, the SBA final loan review decision
will disagree with the lender, but remember—only the borrower can appeal, the lender cannot do so. • The borrower is ineligible for PPP loan forgiveness in any amount when the lender has issued a full denial decision to SBA. Here too the SBA final loan review decision will differ from the lender’s recommendation, but in a way that is favorable to the borrower.
Finally, the appeal must be filed with OHA within thirty (30) calendar days after the borrower’s receipt of the final SBA loan review decision. This timing is critical, and because most forgiveness applications were handled through the same lender that made the loan, the borrower will most likely receive the final SBA loan review decision from the lender.
Within that framework, borrowers will need to consider their appeal options in light of a very deferential standard of review by OHA—the final SBA forgiveness decision will be altered only where the OHA administrative judge determines that the SBA’s decision was based on a clear error of fact or law. That said, with the volume of forgiveness applications being reviewed by the SBA, and the complexities of the PPP loan program in terms of eligibility and use of loan proceeds, borrowers should be prepared to quickly evaluate their appeal options with counsel and file their appeal by the 30-day deadline.
It is also important to note that the loan deferment period is extended during the pendency of the appeal, so borrowers will not enter repayment until their appeal is decided. The timeframe for OHA to decide an appeal of an SBA loan review decision is laid out in the final rule and could be as fast as 90 days, though there is ample discretion for the judge to extend certain deadlines. Considering the anticipated volume of appeals, it is likely that 90 days will be the exception, rather than the norm.
If your agency, or a client, is facing a full or partial denial of forgiveness of a PPP loan, act quickly to evaluate a potential appeal and consult with competent counsel to assist.
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Posted By IIAW Staff,
Friday, January 29, 2021
Updated: Thursday, January 7, 2021
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By: Josh Johanningmeier | IIAW General Counsel
In addition to all of the other complications created by what has been a very complicated year, it’s likely that both you and your business clients have encountered the difficulties of coordinating a remote workforce at some point in 2020. From trouble with Zoom calls to remote notarizations, the problems associated with working from home can be frustrating. Unfortunately, with Covid cases on the rise, many workforces may again make the transition back to remote work environments. Many may have never transitioned back to the office at all. One issue that should not be forgotten as both your agencies and your clients prepare for a winter working from home is the possibility of workers’ compensation liability even when an employee is off company property. While ensuring employee safety from afar may seem impossible, there are steps that can be taken to reduce the risk.
Remote Workers’ Compensation Liability
Worker’s compensation laws vary by state, but under most state laws, including Wisconsin’s, employers are liable for employee injuries that arise both out of and during the course of employment. According to Wisconsin’s Department of Workforce Development, this liability extends to “[a]n injury occurring away from the company premises, but while the employee is still performing service for the employer and under the employer’s direction and control.” Moreover, an employee whose job requires travel is covered at all times during a business trip. While air travel and hotel stays may have seen a significant recent drop, many companies have likely seen their employees driving more for work. Importantly, traffic accidents occurring while on company time are compensable under Wisconsin’s workers’ compensation laws. All of this combines to mean that workers’ compensation liability can extend far beyond the brick and mortar.
Now What?
The prospect of ensuring a safe work environment for at-home workers can seem daunting for employers, but it can also get lost in the shuffle of the logistical issues currently facing businesses around the world. Reaching out to your clients with a list of best practices for protecting at-home employees will not only generate goodwill, it may also reduce the prospect of future liability.
Specifically, here are some recommended practices when engaging a remote workforce:
• Require express written authorization before an
employee can work remotely
• Update and maintain accurate employee job descriptions
and expectations, and confirm that employees
understand the specific responsibilities of their positions
when working from home
• Require employees to specifically define their home
office space and provide employees with information
and training about safe workstation set-ups, consistent
with your in-office practices
• Create and maintain a safety checklist for home offices
to ensure employees’ offices are free from any recognized
hazards
• Remind employees, in writing, of their obligation to
promptly report all work injuries consistent with your
worker’s compensation and safety policies, even if they
occur at the remote worksite
• Remind employees, in writing, of who should receive
any reports of injuries that occur in their home office
environment
• Require both non-exempt and exempt employees to
record and maintain a detailed record of actual time
worked, including a detailed record of meal breaks and
other personal breaks during the workday.
While a remote workforce can create innumerable complications, it is still important to ensure that employee safety does not get lost in the shuffle. Continue to follow updates from the IIAW and this column for more suggestions on how to best protect your agencies and serve your clients.
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Posted By IIAW Staff,
Friday, September 18, 2020
Updated: Monday, September 14, 2020
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By: Godfrey & Kahn Updates
This article was originally published in our September Wisconsin Independent Agent. Read more from our September issue here.
Insurers issuing auto coverage in Wisconsin may want to double check their policies after the court of appeals’ recent decision in Brey v. State Farm Mut. Auto Ins. Co., 2020 WL 3455880 (Wis. Ct. App. June 25, 2019). There, the court found that the
state’s omnibus insurance statute requires carriers offering underinsured motorist (UIM) coverage to provide that coverage even when their insureds have not suffered any bodily injury themselves.
The facts of Brey were relatively straightforward. A father died in an automobile accident. His son sued to recover UIM benefits from State Farm, which insured him under a policy issued to his mother. The father was not insured under that policy,
as he did not live with the son and his mother. State Farm denied coverage because the policy’s UIM provisions required an insured
to suffer “bodily
injury” and the son (who was not involved in the crash) had not suffered any such injury. The son acknowledged those policy terms but argued that they were void and unenforceable because
Wisconsin law does not allow for UIM provisions that require bodily injury of an insured. The trial court sided with State Farm and dismissed the son’s claim. On appeal, however, the appellate court reversed, concluding that State Farm’s UIM terms
were impermissible under applicable Wisconsin statutes.
The case turned on Wis. Stat. § 632.32, a state statute that identifies the minimum coverage that all policies issued in the state must provide. Section 632.32(2)(d) addresses UIM coverage and states:
“Underinsured motorist coverage” means
coverage for the protection of persons
insured under that coverage who are
legally entitled to recover damages for
bodily injury, death, sickness, or disease
from owners or operators of uninsured
motor vehicles.”
According to the court of appeals, this statement unambiguously establishes that UIM provisions in Wisconsin must protect any person who meets three requirements: “(1) the person who makes the UIM claim must be an insured under the UIM coverage of
the policy; (2) that person must be legally entitled to recover damages for bodily injury or death; and (3) that person must be legally entitled to recover from an owner or operator of an underinsured motor vehicle.” 2020 WL 3455880, at ¶ 22.
Because Wis. Stat. § 632.32(2)(d) says nothing about the insured having to sustain bodily injury or death to access UIM benefits, insurance policies issued in the state are not allowed to include that requirement. Id.
State Farm raised a host of other arguments,contending that: the son’s reading of the statute was absurd; that prior Wisconsin case law dictated a result in State Farm’s favor; and that decisions from other jurisdictions suggested State Farm was correct. The appellate court quickly rejected all these arguments, reiterating that the statutory language was unambiguous.
The decision is a good reminder to insurers that, at least in Wisconsin, unambiguous policy language is not always the end of the coverage inquiry.Wisconsin’s omnibus insurance statute always serves as a backdrop to any coverage dispute and can lead to a victory for the insured even when the terms of the policy clearly do not afford coverage. Insurers facing such arguments should seek
counsel experienced with the omnibus statute to help them avoid trouble.
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Posted By IIAW Staff,
Tuesday, August 11, 2020
Updated: Monday, August 10, 2020
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In the final days of its 2019-20 term, the Supreme Court issued a decision with potentially vast implications for religious organizations. In Our Lady of Guadalupe School v. Morrisey-Berru, the Court ruled that parochial school teachers do not, for the most part, enjoy protections under federal employment laws. This decision, and the potential for the Court to expand on it in the years
to come, could have a major impact on insured claims against religious institution employers.
The Our Lady of Guadalupe School Case and Decision
The Our Lady case is actually a combination of two employment
discrimination cases brought by Catholic school teachers in the Los Angeles area. In both cases, the teachers argued the schools terminated them for discriminatory
reasons. The first plaintiff, Agnes Morrisey-Berru, claimed her former employer fired her based on her age. The
second plaintiff, Kristen Biel, argued her former school terminated her because she had breast cancer.
Before delving into the Court’s opinion in Our Lady, however,
it is necessary to discuss a bit of background. In 2012, the Supreme Court considered a similar case in which a terminated parochial school teacher sued her former employer for discrimination under
the Americans with Disabilities Act. In that case, the Court recognized a “ministerial exception” to federal employment laws rooted in the First Amendment’s protection of the free exercise of religion.
Specifically, the Court dismissed the plaintiff’s suit, holding that the ministerial exception precluded her claim given that she had received extensive religious training, was considered a minister of her church, and her firing fell
into a category of decisions religious institutions make that are essential to their central mission.
Despite important differences between the two cases, the Court reached the same decision in Our Lady as it did in 2012. In the 2012 case, the Court ruled the ministerial exception barred the teacher’s ADA claims based on evidence
that the fired teacher had extensive religious training and was considered by her church to be a “minister.” The same could not be said for the Our Lady plaintiffs, as the two teacher plaintiffs in the case did not have any specific religious
education credentials, and one of them testified that she was not even a practicing Catholic. However, according to the Court’s majority opinion, whether
a teacher has religious training is
inconsequential to the ministerial exception analysis. What mattered in Our Lady was that the teachers taught religious curriculum, prayed with their students, and accompanied them to mass. Ultimately, in dismissing the teachers’ claims, the Court held that the schools had initially
made the determination that the teachers knew enough about Catholicism to teach the subject, and “judges have no
warrant to second-guess that judgment.”
Now What?
Despite the fact that both the Our Lady decision and the 2012 case involved teachers,
the rulings could have much broader implications. In her dissent, Justice Sotomayor criticized the majority, arguing it had destroyed the existing
standard of review for the ministerial exception and replaced it with a single consideration: “whether a church thinks its employees play an important religious role.” Not only could this “strip[]
thousands of schoolteachers of their legal protection,” according to Sotomayor, it could also extend to “countless coaches, camp counselors, nurses, social-service workers, in-house lawyers, media-relations personnel, and many others who work
for religious institutions.”
If you or your agency have religious institution clients, this decision, and its progeny, could have a considerable impact on the scope of potential employment-related claims and litigation. If lower
courts consistently (or even more
broadly) apply the holding from Our Lady, it could greatly reduce the amount (or
at least the success) of employment discrimination claims against religious institutions. Moreover, if Justice Sotomayor’s dissent proves prescient, the opinion could serve as the backbone for future decisions
dismissing discrimination claims brought by any employee of a religious organization, or even claims brought by parishioners involved in community outreach or charity work.
Conclusion
In Our Lady of Guadalupe School v. Morrisey-Berru, the Supreme Court expanded the ministerial exception to employment discrimination claims brought against religious institutions. While the case involved
teachers at parochial schools, the decision may impact claims brought by any employees of religious organizations. Keep an eye on this column and updates from the IIAW for related developments.
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Posted By IIAW Staff,
Tuesday, June 9, 2020
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By: Josh Johanningmeier | IIAW General Counsel
Not since the Thrilla in Manila has a third bout been as eagerly anticipated as the upcoming United States Supreme Court hearing of the latest challenge to Obamacare. Well, perhaps comparing the case to the 1975 finale of the Ali - Frazier rivalry is unfair (to Ali and Frazier), but the case does merit attention. Earlier this month, the Supreme Court agreed to again hear a case concerning the validity of the Affordable Care Act (“ACA”), President Obama’s signature healthcare legislation. If the Court takes this opportunity to overturn the law, the provision of health insurance in this country could fundamentally change. This change would be especially impactful for your business clients.
Case Background
In 2017, congressional Republicans began their efforts to repeal and replace the ACA. When those efforts failed, Republicans changed tactics and instead, chipped away at one of the act’s most well-known, and unpopular, provisions: the individual mandate. To be clear, Congress did not eliminate the individual mandate itself, but, rather, eliminated the tax penalty for failing to acquire health insurance. President Trump quickly signed this change into law.
Seeing an opportunity, a group of 20 states brought suit in the United States District Court for the Northern District of Texas, arguing that the entire ACA is invalid because of the changes to the law. In a previous challenge, the Supreme Court upheld the individual mandate as an exercise of Congress’ taxing power. The states challenging the ACA asserted that, with no tax penalty for violations, the individual mandate can no longer fall under Congress’ taxation powers and must be considered unconstitutional as a violation of individual liberty. Going further, the states argued that the individual mandate is a fundamental component of the ACA, and, as a result, the entire law must be overturned. In a December 2018 decision, District Judge Reed O’Connor agreed and ruled the ACA unconstitutional.
Shortly thereafter, several groups, including Democratic state attorneys general and the House of Representatives, under Democratic control at that point, appealed the decision to the Fifth Circuit Court of Appeals. Given a choice between finding the individual mandate constitutional and overturning the entire law, the Fifth Circuit chose a middle way. The court agreed with Judge O’Connor that the individual mandate is unconstitutional, but sent the case back to the lower court to reconsider if such a holding renders the entire act invalid. The House and the states led by Democratic attorneys general appealed that the decision to the United States Supreme Court, which agreed to hear the case. Based on standard timeframes, the Court will likely issue a decision in spring or summer of 2021.
Now What?
Importantly, it is not clear how the Supreme Court will rule on this case. The ACA has come before the Court on two previous occasions, and it has upheld the law both times. While the makeup of the Court has changed significantly in recent years, all five Justices making up the majority in both decisions remain on the Court. However, the law has now changed, and in ways relevant to the Court’s previous opinions. The takeaway: while it is entirely possible the law will be upheld, you and your agencies should be prepared for it to be overturned.
If the entire law is invalidated, a key impact will be the elimination of the “employer mandate.” As you are likely aware, currently, employers with 50 or more full-time employees, or full-time equivalents, must provide health insurance to 95% of those
full-time employees and their children that is both affordable and ensures minimum value. Coverage is considered “affordable” if employee contributions do not exceed a specified percentage of that employee’s household income (9.78% in 2020). A plan provides “minimum value” if it pays for at least 60% of covered services (including deductibles, copays and coinsurance). If employers violate their mandate, they face a monetary penalty.
If the ACA is overturned, however, there will be of course no employer mandate. This will likely result in many of your business clients evaluating changes to their employee health plans. It is critical that you and your agencies work with legal counsel so that you can make informed decisions when it comes time to design plans responsive to your clients’ needs.
Conclusion
While it is unclear if the Supreme Court will take this opportunity to overturn the ACA, it is crucial to be prepared in the event that it does. Keep an eye on this column and other IIAW publications for developments on this case, and make sure to work with legal counsel to ensure that you and your agencies are able to successfully navigate what could be a complex path forward.
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Posted By Administration,
Wednesday, April 29, 2020
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By: Josh Johanningmeier | IIAW General Counsel
* This article was featured in our April 2020 Wisconsin Independent Agent Magazine. Click here to read the full April 2020 issue.

Federal Court Rules Business owners Policy Covers Ransomware Attack Damages
In late January, the United States District Court for the District of Maryland, in National Ink & Stitch, LLC v. State Auto Property & Casualty Insurance Co., ruled that a business owners policy provided coverage for an embroidery and screen-printing business that had fallen victim to a ransomware attack. The court described its decision as a continuation of a nationwide trend of courts finding coverage for loss of data or systems functionality following a cyber-attack. Implicit in the court’s decision may have been a recognition of the increasing frequency and severity of ransomware attacks across the country. It is critical that you and your agencies also take note of these trends.
The National Ink & Stitch Case and Decision
In December 2016, National Ink & Stitch suffered a ransomware attack, which prevented it from accessing all art files and other data contained on its server along with most of its software. The attacker demanded payment in the form of bitcoin to release access to the software and data, which National Ink & Stitch paid. However, the attacker then requested further payment. At that point, National Ink & Stitch contracted with a security company to replace and reinstall its software. While the business’s computers functioned after the reinstall, the new protective software slowed the system. Further, National Ink & Stitch still does not have access to the lost data, meaning it has to reproduce all of the lost art files. Finally, computer experts found that it was likely there are still remnants of the virus on the business’s computers, which could ultimately “re-infect the entire system.”
Due to past and continuing damages resulting from the attack, National Ink & Stitch presented a claim to its insurer, State Auto, for the cost of replacing its computer system. The relevant business owners policy states that State Auto “will pay for direct physical loss of or damage to Covered Property…resulting from any Covered Cause of Loss.” The policy defines “Covered Property” to include “Electronic Media and Records (Including Software).” However, State Auto denied the claim, finding its insured did not experience “direct physical loss of or damage to” its computer system under the policy. National Ink & Stitch then sued to resolve the coverage dispute.
Ultimately, the court held that State Auto’s policy did provide coverage for National Ink & Stitch’s losses. The court began with the policy language, which explicitly includes “data” and “software” within the definitions of “Covered Property.” The court also construed the phrase “physical loss or damage” to include the inefficiency of National Ink & Stitch’s computer system following the installation of protective software, finding that a computer can “suffer ‘damage’ without becoming completely inoperable.” While the court came to its conclusions based on an analysis of Maryland state law, it noted that its interpretation tracks with holdings “reached by the majority of courts interpreting similar policies.”
Now What?
Before getting to the potential effects of this ruling on your agencies and clients, it is important to understand the basics. Ransomware is a computer virus that effectively holds a computer, or an entire system, hostage until a fee is paid. Ransomware attacks have become increasingly common in recent years. In the first four months of 2019 alone, there were more than 40 million ransomware detections. Experts predict that by 2021, a business will fall victim to a ransomware attack every 11 seconds. Further, the costs for businesses targeted with ransomware can be incredibly high. The total damages associated with ransomware in 2019 surpassed $11.5 billion, or an average of $141,000 per incident. In other words, this problem is common, it’s expensive, and it’s not going away any time soon.
So what does this all mean for your agency? To start, as reflected by the National Ink & Stitch decision, courts across the country have begun to construe business owners policies to cover damages arising from ransomware attacks. Given the severity and frequency of the problem, and its effects on organizations ranging from multi-national corporations to small towns, courts are unlikely to reverse this trend. As a result, it is critical that you and your agencies understand the policy language you are presenting to your clients and the coverage they are requesting. Further, it is increasingly important to have connections with consultants, lawyers or firms that have expertise in not only insurance law, but in the expanding field of data privacy and cybersecurity, so that evaluating response strategy, security planning and coverage can be accomplished.
Conclusion
Ransomware attacks may soon become a daily headache for your business clients. In order to recoup some of the costs associated with these attacks, those clients are likely to bring claims under their business owners policies. If past is prelude, courts may be sympathetic to those claims and you need to be prepared to handle coverage requests and claims arising from these attacks.
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