Managing liability for Legionella and Legionnaires’ disease

“A 32-year old woman from Washington State had a lifesaving heart transplant—only to contract Legionnaires’ disease.” This is a heartwrenching article for someone to read in their local newspaper. You may even say to yourself that this can’t be true. But in fact, this is an online article that was published on September 27, 2016, in The Seattle Times by JoNel Aleccia.

The background of this story is of a 32-year old woman who had been battling heart failure for more than a decade. She went to the University of Washington Medical Center (UWMC) to have a lifesaving transplant. After the transplant was completed, she contracted Legionnaires’ disease, a form of pneumonia, due to a deadly outbreak while she was recovering in the hospital.

An internal investigation by UWMC found that the bacteria were located in several sites around the hospital “including an ice machine and sinks in the hospital’s Cascade Tower and on heater-cooler units that regulate patients’ temperature during surgery.”

The outbreak at UWMC contributed to four and possibly five others being ill including two confirmed deaths.

Nursing homes are not immune from a Legionnaires’ outbreak either. According to WRGB CBS 6 News in Albany, New York, four people contracted Legionnaires’ disease from Wesley Health Care Center in Saratoga Springs, New York, in October 2016. The cause of the outbreak is unknown at this time.

This is an exposure that you should take seriously. According to a June 7, 2016, article in The Washington Post, Legionnaires’ outbreak has “quadrupled in the United States over the past 15 years.”

According to Russ Nassof JD, Executive Vice President of RiskNomics, experts predict Legionnaires’ cases will continue to increase across the globe, due to:

  • Deteriorating infrastructure
  • Green technology encourages lower temperatures conducive to Legionella growth
  • Hands-free devices in healthcare encourage proliferation of stagnant water
  • Increased surveillance/awareness on diagnosis
  • Improved public awareness/reporting
  • Improved laboratory processes for identification
  • Increasing aging population

Reported cases of Legionellosis, almost all of which are Legionnaires' disease: 2000-2014 (CDC), as reported by The Washington Post on June 7, 2016

Reported cases of Legionellis

Legionella pneumophila bacteria, which cause Legionnaires’ disease, are common in many areas but are most commonly found in healthcare and senior living facilities where they pose the greatest risk.

Those at the greatest risk for Legionnaires’ disease include people who:

  • Are immune-compromised
  • Have end-stage renal disease
  • Have diabetes mellitus
  • Have hematologic malignancies
  • Have chronic lung disease
  • Are tobacco smokers
  • Are over the age of 50
  • Have received recent organ transplants
  • Have non-hematologic malignancies

Legionnaires’ disease is found in less than 5% of healthy non-smokers and is rare in children.

As a producer, why should you care about this type of disease outbreak?

Legionnaires’ disease can lead to bodily injury and property damage claims. It can also cause negative publicity, relocation, remediation, legal costs, and business interruption costs.

How does Markel’s Healthcare Practice respond?

Our site pollution coverage is offered in conjunction with environmental impairment liability and is written on a claims-made basis. Coverage is tailored for each individual risk including a menu of coverages available. Limits for coverage will start at $500,000/$500,000 with a deductible of $5,000. Minimum premiums start at $2,500.

Coverage is offered on a non-admitted basis. Highlights include:

  • Sudden and abrupt
  • Single location or multiple locations
  • Bodily injury (broad definition) and property damage resulting from pollution conditions
  • Business interruption expense
  • On-site cleanup costs resulting from pollution conditions
  • Legal defense costs
  • Transportation pollution liability
  • Broadly defined natural resources
  • Available capacity – $25 million
  • Circumstance reporting provision
  • Toll-free, 24-hour number to report claims

See below for links to the full articles mentioned above.


Anthony (“AJ”) Pregony
Associate Underwriter