Carilion Clinic v. American Guarantee and Liability Insurance Company

CourtDistrict Court, W.D. Virginia
DecidedFebruary 4, 2022
Docket7:21-cv-00168
StatusUnknown

This text of Carilion Clinic v. American Guarantee and Liability Insurance Company (Carilion Clinic v. American Guarantee and Liability Insurance Company) is published on Counsel Stack Legal Research, covering District Court, W.D. Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carilion Clinic v. American Guarantee and Liability Insurance Company, (W.D. Va. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF VIRGINIA ROANOKE DIVISION CARILION CLINIC, et al, ) Plaintiffs, ) ) Case No. 7:21-cv-00168 v. )

AMERICAN GUARANTEE & ) LIABILITY INSURANCE CO.,, ) By: Michael F. Urbanski Defendant. ) Chief United States District Judge

MEMORANDUM OPINION This insurance coverage suit brought by Carilion Clinic and many of its affiliated entities (collectively “Carilion Clinic”) is before the court on defendant American Guarantee & Liability Company’s (““AGLIC”) Motion to Dismiss pursuant to Federal Rules of Civil Procedure 12(b)(6) and 12(b)(1). ECF No. 47. The issues have been fully briefed and a hearing was held in this matter on October 19, 2021. The court concludes that The Zurich EDGE Healthcare Policy (“Zurich EDGE Policy”) at issue does not provide property damage or time element (business interruption) coverage for Carilion Clinic’s claims arising out of the COVID-19 pandemic, and that a claim for property damage based on the SARS-CoV-2 virus is excluded under the unambiguous terms of the Zurich EDGE Policy. As such, AGLIC’s Motion to Dismiss will be GRANTED as to Carilion Clinic’s claims for property damage and time element coverage. At the same time, the court concludes that Carilion Clinic’s claim for Interruption By Communicable Disease coverage is ripe, and DENIES AGLIC’s Motion to Dismiss the claim for Interruption By Communicable Disease coverage. Accordingly, AGLIC’s Motion to Dismiss is GRANTED in PART and DENIED in PART.

I, Carilion Clinic, based in Roanoke, is the largest health system in Virginia’s Blue Ridge and Southwest regions. Carilion Clinic operates seven hospitals and employs over 13,000 people, including 1,000 physicians and over 300 acute care providers, providing care in over 80 specialties, at over 270 ambulatory cate and related healthcare facilities. First Am. Compl, ECF No. 43, at { 23. Carilion Clinic alleges physical loss of or damage to its covered property

_ as follows: The Coronavirus can be released into the air when infected persons breathe, talk, cough, sneeze or sing, and such releases can infiltrate ventilation systems, as well as myriad surfaces (ie., fornites') such as dermal contact surfaces (e.g. door handles, bedsheets, hospital gowns, bed railings, and medical equipment). The Cotonavirus has and continues to deposit, and therefore elevate contagion risks on, myriad dermal contact surfaces, which are transformed into disease-spreading fomites. These fomites can pose transmission risks for persons contacting those surfaces. First Am. Compl, ECF No. 43, at 912. The First Amended Complaint rejects the comparison of the coronavirus to dust, characterizing it as a “false pronouncement[ ] advanced by the insurance,industry.” [Ihe presence of the Coronavirus in Carilion Clinic’s property in the air and on surfaces was neither expected nor ordinary. Unlike dust, the Coronavirus cannot be removed easily from surfaces, eg., simply by routine cleaning of the surfaces. Attempting to remove the Coronavirus from surfaces requires specific protocols. These specific protocols require harsh and abrasive chemicals that are not routinely used and that themselves cause additional physical loss of or damage to property. Even assuming surface cleaning was 100% effective every time — it is not — that

1 The online Oxford English Dictionary defines fomite as “[s]omething that is capable of transferring a disease from one place or individual to another; spec. an object or substance that is contaminated with an infectious agent and capable of transmitting it by direct contact.” Fomite, Oxford English Dictionary, www.oed.com (last visited Feb. 3, 2022).

does not eliminate the Coronavirus from the air, which is the numbet one transmission vector. Id. at 16. The First Amended Complaint alleges that Carilion Clinic experienced direct physical loss of or damage to its property in at least fout ways: (1) positive COVID-19 tests for its employees and patients “demonstrate[ | both the certain or virtually certain presence of COVID-19 and/or the Coronavirus throughout its network of hospitals, primary and specialty physician practices and other complementaty services, and its Wellness Centers, in the air and

on surfaces (whether in droplet nuclei, aerosols, droplets or otherwise);” (2) governmental otdets caused the loss of normal use and function of its property (in either total or part); (3) modification of “physical behaviors through the use of social distancing, avoiding confined indoor spaces, and avoiding congtegating in the same physical area as others, in order to reduce

or minimize the potential for viral transmission;” and (4) the need to mitigate the threat or actual physical presence of the Coronavirus on “surfaces, in heating and air conditioning systems, and in or on any of the multitude of other places the Coronavirus has been or could be found.” Id. at 27. The First Amended Complaint alleges that the “presence of Coronavirus in the air and

on surfaces made Carilion Clinic’s Facilities uninhabitable, unsafe, and unfit for their normal and intended uses,” and “no amount of routine surface cleaning could remove the aerosolized Coronavirus suspended in the ait in Carilion Clinic’s Facilities, further rendering those Facilities unfit for their intended uses. As a result, the Carilion Clinic Facilities had to operate at a limited capacity or close entirely.” Id, at [{] 33-34. The First Amended Complaint alleges that Carilion Clinic suspended all elective medical procedures during March—May, 2020, closed

its Wellness Centers entirely during March—June, 2020, and incurred massive expenses associated with its “herculean” efforts to help minimize exposure risk and make its facilities as safe as possible. Id. at {| 35-37. Carilion Clinic alleges that “[t]o cushion the impact of the Coronavirus and COVID- 19, Carilion Clinic turned to its property insurer, AGLIC, to whom Carilion Clinic has paid neatly $1 million in premiums in exchange for $1.3 billion in property damage and time element (also known as business interruption) coverage for the June 1, 2019 to June 1, 2020 policy period alone.” Id. at 42. In its remaining 245 paragtaphs, the First Amended Complaint provides detailed support for Carilion Clinic’s claims with reference to medical studies, epidemiological data, and guidance published by the scientific community, including the Centers for Disease Control and Prevention (“CDC”) and World Health Organization (“WHO”). AGLIC has denied coverage under the all-risk policy? purchased by Carilion Clinic, assetting that Carilion Clinic’s business losses from the COVID-19 pandemic do not stem from “direct physical loss of or damage caused by a Covered Cause of Loss to Covered Property,” Zurich EDGE Policy, ECF No. 43-1, § 1.01., and that the policy excludes claims atising from “any condition of property due to the actual presence of any... virus... .” Id. § 7.09, AGLIC also contends that Carilion Clinic’s claim for coverage for Interruption By Communicable Disease, id. at § 5.02.35., is not ripe for adjudication as AGLIC is awaiting

2 The all-risk policy in this case provides “coverage for direct physical damage to or loss of property resulting from any cause that it not excluded by the Policy.” NIT’ Data Int] LLC v. Zurich Am. Ins. Co., No. 3:21- CV-890-S, 2022 WL 196533, at *5 (N-D. Tex. Jan. 21, 2022) (referencing same Zurich EDGE policy at issue here); Ins, Co. of N. Am. v. U.S. Gypsum Co., 678 F. Supp. 138, 139 (WD. Va. 1988) (stating that an all-risk policy “insures all risks of loss except for specifically excluded events. . .”).

claims data requested from Carilion Clinic. The court will address the thtee aspects of AGLIC’s motion—covetage, exclusion, and ripeness—in turn. II. A.

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Carilion Clinic v. American Guarantee and Liability Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carilion-clinic-v-american-guarantee-and-liability-insurance-company-vawd-2022.