Do you need insurance for an active shooter incident?

Security and risk mitigation regarding a potential active shooter incident is not an issue limited to the physical space of your medical practice, which is important when practice leaders consider insurance coverage options.

Though workplace shootings are relatively rare when viewed through the lens of the many thousands of gun-related deaths that occur every year in the United States,¹ high-profile incidents in 2019 — including the Virginia Beach shooting in June — reignited the debate over how employers should best manage the risks of such a threat, both with active and passive physical security measures and asset protection.

Ongoing gun violence and heightened awareness of it have prompted insurance program developers to address this specific area of risk with unique, “named-peril” policies that address mass violence in the same fashion that other policies are tailored to terror attacks or kidnapping/ransom.²

While active shooter incidents can occur anywhere, healthcare or life science facilities barely ranked in the top 10 settings or locations for active shooter events in the United States, based on FBI and Advanced Law Enforcement Rapid Response Training (ALERRT) data from 2000 to 2016.³

When it comes to patient-related claims, those are normally covered under an existing professional liability policy; similarly, injury or death for a doctor, nonphysician provider or staff member normally would be a component of a workers’ compensation policy; and general liability coverage would presumably extend to non-patient claims, such as a family member of a patient.⁴

Since policies vary by carrier and locality, it is important for medical practice owners and leaders to examine existing general liability, workers’ compensation and professional liability plans to determine if there are specific limitations that might necessitate a named-peril policy for active shooter/active assailant risks.

For example, many existing policies for physical property may cover damage to the facility itself incurred during an active shooter incident, but not vehicles and other non-facility property that may be subject to claims.⁵

The role of “duty of care”

The Occupational Safety and Health Administration Act of 1970 includes employer obligation to the “duty of care” for worker safety. This standard of accountability has generally increased in terms of legal liability in recent years, encouraging more healthcare organizations to uphold various public safety measures.⁶

What’s covered?

Practice leaders’ biggest risk following an active shooter incident is the threat of litigation. Specific policies for active shooter risk also may include victim counseling, loss of revenue, property costs related to security upgrades or building closure, loss of attraction and even crisis management.⁷

In addition to coverage that offers services before and after an incident, some policies are more expansive and will cover a variety of locations beyond the physical clinic. Some carriers have designed policies that cover events such as offsite health fairs or other commercial real estate held by physician owners that is unrelated to the practice’s physical location.⁸

Some policies will package coverage for workplace violence, active shooter and/or stalking threats with varying amounts of liability amounts.

What’s not covered?

Given the proliferation of named-peril policies in the insurance world, it is likely that an active shooter/active assailant policy would have exclusions for acts of terror. The importance of such a distinction was a key point in the deliberation over the October 2017 shooting at Mandalay Bay in Las Vegas, in which authorities could not determine the shooter’s motive and declined to label it as a terrorist attack. The casino’s ownership used legal tactics in a bid to gain immunity under a 2002 federal statute related to adopting “anti-terrorism technology.”⁹

Other common exclusions within an active shooter policy include employees or visitors of a business.¹⁰ Some policies include a casualty threshold that must be met to qualify an incident as a “mass shooting” or “mass violence,” or there are exclusions related to certain types of weapons.¹¹

Conclusion

Outside of coverage for these areas of risk, the first and best policy for a healthcare organization to have regarding threats of violence is a clear understanding of how to prevent security risks before they occur and how providers and staff alike should react in the moment.

In the growing market for business security consulting, the experts often remind business owners that threat assessments should begin with the business itself, as “most workplace shooters are disgruntled current or former employees or someone in a turbulent relationship with an employee.”¹² This puts business leaders in prime position to recognize potential problems.

This work can mitigate any remaining risks after an active shooter event while also offering a degree of confidence to those who work in the practice that the leadership is actively working to ensure a safe workplace.

Learn more

• Download the MGMA Emergency Planning Checklist: mgma.com/emergency-checklist.
• Learn the principles of OSHA compliance via the MGMA OSHA Online Staffing Training.
• "Addressing workplace violence in healthcare settings" (MGMA Connection article)
• "Solving emergency department security challenges" (MGMA Connection article)

Notes:

1. Pane LM. “Mass shootings in the workplace are rare and puzzling.” Associated Press. June 6, 2019. Available from: bit.ly/2XkFikP.
2. Marshall P. “Insurance coverage for active shooter risks.” Risk Management. Sept. 4, 2018. Available from: bit.ly/2MrfRDR.
3. Marsh. “Protecting people and operations from active shooter threats.” December 2017. Available from: bit.ly/2ZXuuGe.
4. Ibid.
5. O’Connor A. “As active shooter incidents increase, industry addresses coverage ‘gray area.’” Insurance Journal. Aug. 11, 2016. Available from: bit.ly/2XKPu5u.
6. Moorcraft B. “What is active shooter insurance coverage?” Insurance Business. Dec. 14, 2018. Available from: bit.ly/2vwWOlQ.
7. Marshall.
8. Devji I. “Medical practice asset protection: Active shooter insurance.” Physicians Practice. May 14, 2019. Available from: bit.ly/2NoYtWg.
9. Feeley J, Blumberg P. “To limit liability, hotel sues Vegas mass shooting victims.” Claims Journal. July 18, 2018. Available from: bit.ly/2Xhf8e2.
10. Marshall.
11. Ibid.
12. Rosenberg J. “Shootings raise level of alarm at small businesses.” Associated Press. Aug. 21, 2019. Available from: bit.ly/2UeI06H.