Encova Agrees to Accept Gravely Ill Firefighter's COVID Claim After New Reports

Tuesday, February 2, 2021 | 0

A West Virginia insurance carrier has agreed to accept a COVID-19 claim from a gravely ill firefighter after news reports indicated that the insurer had initially declined to accept the case as work-related.

“Upon review of the facts and circumstances of Lt. Ritchie’s claim, we have deemed his claim to be covered and will pay appropriate benefits,” reads a statement from Encova, one of the largest comp carriers in the state.

Encova, formerly known as Brickstreet Mutual, posted the statement after television news stations reported last week that firefighter Brian Ritchie, of Weirton, was on a ventilator in the hospital. Most of the firefighters on his shift also fell ill from the disease, and the city reported Ritchie's claim as resulting from occupational exposure.

But Encova, the city's comp insurance carrier, declined to open a claim, according to the news reports.

Ritchie's attorney, Teresa Toriseva, said last week that Encova was not complying with the state's compensation law. After the carrier said it would accept Ritchie's claim, Toriseva issued a statement.

“Lt. Ritchie’s family and Toriseva Law are relieved and grateful that this matter has been quickly resolved. Please continue to pray for Lt. Brian Ritchie,” Toriseva said.

West Virginia is not one of the 21 states that have adopted a COVID-19 presumption law or rule. But the state's insurance commissioner in January issued a bulletin reminding insurers that workers have a right to file occupational disease claims.

The notice from Commissioner James Dodrill stopped short of declaring that COVID claims are compensable, but he noted that the pandemic has raised new issues and that insurers should thoroughly investigate claims to determine if the exposure was work-related.