Carilion Clinic v. American Guarantee and Liability Insurance Company

District Court, W.D. Virginia·Decided November 16, 2022·No. 7:21-cv-00168·Unknown

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 matter is before the court on the motion to reconsider filed on August 10, 2022, by plaintiff Carilion Clinic in its insurance coverage suit against American Guarantee & Liability Insurance Company (“AGLIC”). Mot. to Reconsider, ECF No. 122. More than six months after the court’s February 4, 2022, ruling on the motion to dismiss, Carilion Clinic asks the court to address certain arguments it suggests the court did not address in its earlier forty-page memorandum opinion. In that ruling, the court granted AGLIC’s motion to dismiss Carilion Clinic’s claim for insurance coverage under the Property Damage and Time Element provisions of the insurance policy, but denied AGLIC’s motion to dismiss as to the Interruption by Communicable Disease coverage.1 As to the Property Damage and Time Element coverage, the court concluded:

1 The limits of liability agreed to by Carilion Clinic and AGLIC for the Property Damage and Time Element coverage and the Communicable Disease coverage are dramatically different. Whereas the limit of liability for the Property Damage and Time Element coverage is $1.3 billion, the Interruption by Communicable Disease coverage is limited to a 30-day period not to exceed $1 million. Zurich EDGE Policy §§ 2.03.06, 2.03.08, ECF No. 43-1. On balance, the court is persuaded by the uniform holdings of federal courts of appeals around the country that losses due to business interruption caused by the SARS-CoV-2 virus are not “direct physical loss of or damage” under the Zurich EDGE Healthcare Policy issued by AGLIC to Carilion Clinic. While the virus and COVID-19 have undoubtedly caused Carilion Clinic to suffer losses in terms of facility shutdown, reduction of medical procedures, and increased costs, the losses are not direct physical losses covered under the property insurance policy. Mem. Op., ECF No. 104, at 28. As the court’s earlier ruling detailed, Carilion Clinic also purchased “Special Coverage that plainly applies to losses sustained as a result of the COVID-19 pandemic.” Id. at 37. The court denied AGLIC’s motion to dismiss as to this coverage, and understands that the parties have resolved their dispute as to this coverage. In asking the court to reconsider its prior ruling, Carilion Clinic selectively mentions the few cases in which motions to dismiss on COVID-19 coverage have been denied, and completely ignores the mountain of precedent from around the country denying coverage under similar policies. By and large, Carilion Clinic’s motion to reconsider sidesteps the uniform decisions of United States Courts of Appeals, including the published decision of the Fourth Circuit Court of Appeals in Uncork and Create, LLC v. Cincinnati Insurance Co., 27 F.4th 926 (4th Cir. 2022), denying property damage coverage for the COVID-19 pandemic. Instead, the motion to reconsider asks the court to reverse course based on the very few decisions that have favored the insured, without regard to salient differences in the policies involved in those cases. Carilion Clinic’s argument is not supported by the text of the Zurich EDGE Policy nor the vast majority of cases that have decided these issues. As such, the motion to reconsider will be DENIED. Carilion Clinic argues that the court did not address certain of its arguments in its February 4, 2022, memorandum opinion. In order to provide a comprehensive record to the court of appeals, the court supplements its prior memorandum opinion as follows.

I. Carilion Clinic asserts that the court did not address three aspects of its claim that its business interruption losses due to COVID-19 fell within the AGLIC’s policy’s coverage for direct physical loss of or damage to property. A. Carilion argues that the very presence of the Interruption for Communicable Disease

coverage demonstrates that COVID-19 may cause the type of physical loss of or damage to property that it alleges occurred. Carilion argues that because § 1.01 of the Zurich EDGE Policy, ECF No. 43-1, provides that “[t]his Policy Insures against direct physical loss of or damage caused by a Covered Loss to Covered Property at an Insured Location . . . , all subject to the terms, conditions and exclusions stated in this Policy,” that losses subject to the Special Coverage for Interruption by Communicable Disease necessarily fall within the direct physical

loss or damage umbrella. The Interruption by Communicable Disease Special Coverage is found in § 5.02.35. Unlike most of the Special Coverages in the Zurich EDGE Policy, the Interruption by Communicable Disease coverage does not contain language limiting it to losses stemming from direct physical loss or damage. Rather, it provides that AGLIC will pay for actual Gross Earnings lost resulting from a necessary suspension of the insured’s business “if the

Suspension is caused by an order of an authorized governmental agency enforcing any law or ordinance regulating communicable diseases and that such portions of the location are declared uninhabitable due to the threat of the spread of communicable disease, prohibiting access to those portions of the Location.” § 5.02.35. The fact that coverage under this section does not require direct physical loss or damage, unlike the majority of the Zurich EDGE Policy, is important to understanding this provision of the policy. This section of the policy does not require direct physical loss or damage, rather coverage is based on whether the insured’s business activities at an insured location are suspended by government order enforcing any law or ordinance regulating communicable diseases. As such, this Special Coverage is best understood as an exception to the overall policy requirement of direct physical loss or damage. Carilion Clinic’s argument is backwards, and despite clear language throughout the remainder of the policy that losses are limited to direct physical loss or damage, would require the court to find that the exception reflected in the Interruption by Communicable Disease Special Coverage swallows the rule. The language of the policy does not allow such a upside down reading. Further, the fact that the Special Coverage for Interruption by Communicable Disease is not available if loss or damage ts payable under any other provision of the policy supports the notion that the Special Coverage is just that—special—and does not apply if coverage is available elsewhere. The recent California state case cited by Carilion Clinic, Marina Pacific Hotel and Suites, LLC v. Fireman’s Fund, No. B316501, 296 Cal. Rptr. 3d 777, 2022 WL 2711886 (Cal. Ct. App. July 13, 2022), reaffirms, rather than undermines, this conclusion. Unlike the Zurich EDGE Policy in this case, in which the Special Coverage for Interruption for Communicable Disease is implicated in the case of a governmental suspension of the insured’s operations, the

language in the communicable disease coverage in the Fireman’s Fund policy at issue in Marina Pacific “states Fireman’s Fund will pay for ‘direct physical loss or damage’ to insured property ‘caused by or resulting from a covered communicable disease event,’ including necessary costs

to ‘[r]epair and rebuild [insured property] which has been damaged by the communicable disease.’” 296 Cal. Rptr. 3d at 790.

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

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