Ciena Healthcare Management, Inc v. Hartford Fire Insurance Company

CourtDistrict Court, N.D. Ohio
DecidedJune 6, 2023
Docket3:22-cv-00438
StatusUnknown

This text of Ciena Healthcare Management, Inc v. Hartford Fire Insurance Company (Ciena Healthcare Management, Inc v. Hartford Fire Insurance Company) is published on Counsel Stack Legal Research, covering District Court, N.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ciena Healthcare Management, Inc v. Hartford Fire Insurance Company, (N.D. Ohio 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF OHIO WESTERN DIVISION

Ciena Healthcare Management, Inc.; and Case No. 3:22-cv-00438-JGC Laurel Healthcare Holdings, Inc.,

Plaintiffs,

v. ORDER

Hartford Fire Insurance Company,

Defendant.

This is an action for breach of insurance contract and declaratory judgment. Plaintiffs operate and manage long-term rehabilitation and nursing care facilities in Ohio (Laurel Healthcare Holdings) and Michigan (Ciena Healthcare Management), among other states. Defendant Hartford Fire Insurance Company provided commercial property insurance policies covering Plaintiffs’ Michigan and Ohio facilities. Pending is Defendant’s Rule 12(b)(6) Motion to Dismiss (Doc. 21), Plaintiffs’ Response in Opposition (Doc. 22), Defendant’s Reply (Doc. 23), and Plaintiffs’ Surreply (Doc. 25). Plaintiffs seek coverage for business losses during their 2020 shutdown in compliance with COVID-19–related gubernatorial orders. Plaintiffs base their claims for coverage on provisions they contend are ambiguous and therefore should be construed in their favor. Defendant rejects that contention. For the reasons that follow, I deny Defendant’s motion. Background Plaintiffs’ facilities provided skilled healthcare for thousands of elderly and infirm residents who are partially or entirely incapable of caring for their own health. (Doc. 1, ¶¶ 10– 11). For the year beginning January 1, 2020, Plaintiffs each had insurance coverage under commercial property policies issued by Defendant.1 Plaintiff Ciena paid an advance premium of $567,450 for its annual policy (Doc. 1-1, Policy No. 33UFJAE2GS0). Plaintiff Laurel paid $645,050 for its annual policy (Doc. 1-2, Policy No. 33UFJZL7900).

The two policies and the coverage they provided were very similar. These policies covered, among other things, certain damages and loss resulting from communicable disease outbreaks and contaminations as well as the government orders directed at such events. In early 2020, a globe-spanning communicable disease outbreak happened. (Doc. 19, ¶ 24). The world was overtaken by a new, highly transmittable strain of coronavirus, COVID-19. The virus, through its often debilitating and sometimes fatal effects, caused major and sustained disruptions across the United States. The pandemic had an even harsher impact on Plaintiffs’ nursing care facilities. COVID- 19 infections and fatalities were more likely to occur in older or immunocompromised individuals. (Id. ¶¶ 25–26). And this was what happened at Plaintiffs’ facilities. Hundreds of

residents and employees contracted COVID-19 infections, resulting in severe sickness and, in some cases, death. (Id. ¶¶ 27–28). Plaintiffs, and the government entities that regulated them, were aware of these dangers and took steps to monitor and ameliorate the spread of COVID-19 in their facilities. (See Id. ¶ 29). The Centers for Medicaid and Medicare Services issued requirements to nursing care facilities that included (1) restrictions to ingress/egress; (2) limitations on groups and individuals

1 The policy effective dates are clear, but it is unclear when the agreement was formed. Presumably, the insurance agreement was negotiated and entered into at some point in the preceding year, 2019—before the nature and breadth of the COVID-19 pandemic became apparent. permitted access to the facilities; and (3) other impediments to the management and operation of the facilities. (Id. ¶¶ 29–30). More directly applicable to Plaintiffs claims here, in March 2020, the governors of Ohio and Michigan both issued executive orders declaring a state of emergency in their respective

states. (Id. ¶ 33). These orders were regularly revised based on cases and fatalities reported to the state governments, including those reported by Plaintiffs that occurred at Plaintiffs’ facilities. (Id. ¶ 34–35). The orders and their revisions included additional guidelines and protocols that Plaintiffs’ facilities needed to follow. (Id. ¶ 36). The guidelines and protocols increased Plaintiffs’ costs and expenses and impeded operation of their businesses, most significantly by restricting access to the facilities and by creating staffing shortages. Plaintiffs now seek to recover those costs and losses under their commercial insurance policies. Legal Standard

A motion to dismiss is properly granted if the plaintiff has “fail[ed] to state a claim upon which relief can be granted.” Fed R. Civ. P. 12(b)(6). To survive a motion to dismiss, the plaintiff must allege facts that are sufficient “to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). “Threadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice.” Id. But I must accept the well-pleaded factual allegations in the complaint as true and construe the complaint in the light most favorable to the plaintiff. Hill v. Blue Cross & Blue Shield of Mich., 409 F.3d 710, 716 (6th Cir. 2005). “[W]hen a document is referred to in the pleadings and is integral to the claims, it may be considered without converting a motion to dismiss into one for summary judgment.”

Commercial Money Ctr., Inc. v. Ill. Union Ins. Co., 508 F.3d 327, 335–36 (6th Cir. 2007). Here, the insurance policies and related documents attached to the Complaint are integral to Plaintiffs’ claims. Discussion Defendant’s Motion to Dismiss calls for interpretation of the insurance policies it issued to Plaintiffs, covering Ciena’s Michigan facilities and Laurel’s Ohio facilities. Thus, a potential threshold matter arises: which state’s law applies? As a federal court sitting in diversity, I apply the choice-of-law principles of the forum state, Ohio. See Klaxon Co. v. Stentor Elec. Mfg. Co., 313 U.S. 487, 496 (1941); see also Troy Stacy Enters. Inc. v. Cincinnati Ins. Co., 2022 WL 2062001, at *2 (6th Cir. June 8, 2022). Ohio,

in turn, analyzes conflicts of law issues under the “most significant relationship” test. Ohayon v. Safeco Ins. Co. of Ill., 747 N.E.2d 206, 209 (Ohio 2001) (citing Restatement (Second) of Conflicts § 188 (1972)). For there to be a conflicts analysis, however, there must first be a conflict. Glidden Co. v. Lumbermens Mut. Cas. Co., 861 N.E.2d 109, 115 (Ohio 2006) (“[A]n actual conflict between Ohio law and the law of another jurisdiction must exist for a choice-of-law analysis to be undertaken.”) (adopting Restatement (Second) of Conflicts § 1 cmt. b (1972)). The parties do not raise any conflict between Ohio and Michigan contract law that would be relevant to this case. As the Sixth Circuit has noted in a different COVID-19 insurance coverage case, “[b]ecause the states at issue employ the same principles of policy interpretation, there is no actual conflict that requires us to engage in a choice-of-law analysis.” Troy Stacy Enters., supra, 2022 WL 2062001, at *2. Therefore, I apply Ohio contract law. See id.

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