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The Aviva logo stands outside the insurer's head office in the City of London on March 7, 2019.

Simon Dawson/Reuters

Aviva Insurance Co. of Canada has stalled payments on pandemic insurance claims for 1,800 dental practices in British Columbia, saying the provincial orders given by the B.C. government to shut down non-essential services remain unclear.

Last month, thousands of Canadian dentists – who had followed industry recommendations to shut down their practices because of the COVID-19 outbreak – were left in limbo when their claims for business-interruption coverage were not being processed, even though their policies covered closings caused by pandemics.

On April 1, Aviva Canada chief executive Jason Storah reassured Canada’s dental community that the company would “stand by" its pandemic coverage for dentists who followed provincial orders to close down their practices because of the outbreak.

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But a note sent out on Monday by the British Columbia Dental Association (BCDA) said Aviva is not currently accepting pandemic insurance claims in the province because the wording of the government’s order on March 23 did not meet its policy requirements because it did not require a complete closing of all offices.

In an e-mail on Tuesday, Mr. Storah said Aviva’s position has not changed in paying out pandemic claims, and along with financial services provider CDSPI Advisory Services Inc., the company is working to “seek clarity" on the position of the B.C. government and its health regulators.

Mr. Storah says the company is “committed to paying all dentists’ claims” where there is a “clear legal direction” that a government order to close has been initiated based on a pandemic.

"I’m hopeful that we will have this resolved in the next few days,” he said.

Aviva did not specify to The Globe and Mail what terminology or what legal wording is required for the claims to be processed.

The lag in insurance payouts for dentists follows a growing number of cases in the insurance industry in which the coronavirus is being declared as uninsurable for certain business interruption policies.

Last month, Andrea Johnstone, a periodontist in Toronto, began an online petition, along with her colleague Sue Chincholi, to fight the delay in processing business interruption policies, which can cost dentists more than $10,000 in premiums a year.

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The industry-wide policy – sold to dentists and dental specialists by CDSPI and underwritten by Aviva Canada – is called TripleGuardTM Insurance and covers policy holders for fire, theft, liability and practice interruption, including special circumstances such as earthquakes and pandemics.

The insurance policy says it is intended “to help offset” income loss during a pandemic outbreak. Automatically, policy holders have practice interruption coverage up to $1,000 a day after the first 24 hours (up to a $20,000 annual limit) when they are prohibited from entering their office by an order from a civil authority or public health official.

For an extra premium, policy holders can increase pandemic outbreak coverage up to $2,500 a day (up to an annual limit of $50,000) or up to $5,000 a day (up to an annual limit of $100,000).

The pandemic coverage is only activated when there is a provincial order in place by the government to shut down non-essential services. According to CDSPI, Aviva’s position is that the B.C. government’s current instructions – which did not demand a complete shutdown by the province’s dentists – are not sufficient to trigger pandemic coverage under the plan.

The absence of required wording puts B.C. dentists in a “completely unfair” position, CDSPI president Ed Dermit said in a note to members. “Please be assured that CDSPI is working very closely with the BCDA at the most senior levels of government to seek a swift resolution to the situation.”

The BCDA says Aviva has taken advantage of “the lack of an order” to deny B.C. dentists their pandemic coverage. It estimates the value of the pandemic insurance claims in B.C. to be at least $36-million.

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“These practices are caught in a dilemma: They cannot provide regular dental care due to the pandemic; and now many cannot access their insurance coverage which they have paid for to help tide them over until they can get back to work," the BCDA said.

"If the pandemic insurance coverage is not provided, there may be a dramatic contraction of available dental care for patients who have had to defer treatment.”

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