Danville Regional Medical Center, LLC v. American Guarantee and Liability Insurance Company

CourtDistrict Court, W.D. Virginia
DecidedFebruary 22, 2022
Docket4:21-cv-00012
StatusUnknown

This text of Danville Regional Medical Center, LLC v. American Guarantee and Liability Insurance Company (Danville Regional Medical Center, LLC 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
Danville Regional Medical Center, LLC v. American Guarantee and Liability Insurance Company, (W.D. Va. 2022).

Opinion

Al LARIWILLE, ww FILED FEB 22 2022 IN THE UNITED STATES DISTRICT COURT JULIA C. DUDLEY, CLERK POR THE WESTERN DISTRICT OF VIRGINIA BY: s/H. MCDONALD DANVILLE DIVISION DEPUTY CLERK DANVILLE REGIONAL MEDICAL _ ) CENTER, LLC and CLINCH VALLEY) MEDICAL CENTER, INC., ) ) Plaintiffs, ) Case No. 4:21-cv-00012 ) v. ) MEMORANDUM OPINION ) AMERICAN GUARANTEE AND ) By: | Hon. Thomas T. Cullen LIABILITY INSURANCE COMPANY, ) United States District Judge ) Defendant. )

When COVID-19 first arrived in the United States, local, state, and federal governments imposed far-reaching regulations to combat the novel threat to public health and safety. Although these regulations dramatically altered everyday life, most fervently hoped (and believed) that the COVID-19 pandemic, and these restrictions, would be ephemeral. Unfortunately, this did not turn out to be the case. Two years on, COVID-19 still poses a threat, albeit a reduced and much more manageable one, to the public. Besides the drastic changes to our sense of “normalcy,” the pandemic has wreaked havoc on the healthcare system. Doctors, nurses, support and custodial staff, and others have worked tirelessly to care for everyone who has faced illness during this pandemic—COVID-19 infections or otherwise. The pandemic has also upended many hospitals’ business models. In addition to increased patient loads, staffing shortages, and heightened cleaning protocols, state and local governments imposed various shutdowns and other requirements that resulted in the

cancellation of many elective procedures. At the same time their revenues dwindled, hospitals and other medical facilities were forced to bear increased costs related to the pandemic. These pressures severely affected hospitals’ profitability.

To offset these financial losses, hospitals (like Plaintiffs in this case) submitted claims under their various insurance policies. This case concerns whether one such policy covers the alleged losses sustained as a result of the COVID-19 pandemic. For the reasons discussed more fully below, the court finds that two of the three coverage provisions are not implicated by the facts alleged by Plaintiffs. The court will accordingly dismiss claims related to both the Biocontamination and Decontamination Costs provisions of the applicable insurance policy.

Because there is no independent argument to dismiss the claims related to the Interruption by Communicable Disease provision, Plaintiffs’ claim as to that provision will survive. I. The facts are taken from Plaintiffs’ complaint and, at this stage, are presumed to be true. See Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). While factual assertions are entitled to this assumption of truth, legal conclusions couched as factual assertions receive no deference. See

id.; Papasan v. Allain, 478 U.S. 265, 286 (1986) (stating that, on a motion to dismiss, courts “are not bound to accept as true a legal conclusion couched as a factual allegation”). Plaintiffs Danville Regional Medical Center, LLC (“DRMC”) and Clinch Valley Medical Center, Inc. (“CVMC”) (collectively “Plaintiffs”) operate medical centers in Virginia. (Compl. ¶¶ 4–5 [ECF No. 1].) DRMC operates “Sovah Health—Danville” and “Sovah Health—Martinsville” in southside Virginia, and CVMC is located in in Richlands, Virginia.

(Id.) Both DRMC and CVMC are subsidiaries of LifePoint Health, Inc. (“LifePoint”), “an organization of affiliated entities that own and operate hospitals and other healthcare providers in more than eighty communities across the United States” that is headquartered in Tennessee. (Id. ¶ 6.) Defendant American Guarantee and Liability Insurance Company (“Zurich” or

“Defendant”) is an insurance company that “sells policies of insurance, including property and business interruption insurance policies.” (Id. ¶ 8.) The parties agree that complete diversity exists and that this court has jurisdiction over this case under 28 U.S.C. § 1332. In December 2019, the COVID-19 outbreak began. COVID-19 is a highly transmissible disease that, to date, has infected over 400 million people worldwide and is responsible for the deaths of almost 6 million.1 The virus can spread through both

symptomatic and asymptomatic individuals, and one of the primary modes of transmission is through “respiratory droplets” that spread “when an infected person talks, sneezes, or coughs[.]” (Id. ¶ 18 (citing the Centers for Disease Control and the World Health Organization). Plaintiffs contend that, “[a]lthough these virus-containing droplets are very small, they are still physical objects that can travel and attach to other surfaces and cause harm, loss, and damage, and these droplets physically exist ubiquitously in the communities and

facilities in which Plaintiffs operated and continue to operate.” (Id. ¶ 21.) On March 11, 2020, the World Health Organization “declared the COVID-19 outbreak a worldwide pandemic.” (Id. ¶ 25.) On March 25, the Governor of Virginia and the Virginia Health Commissioner issued an Executive Order (“the Virginia Order”) prohibiting all inpatient and outpatient surgical hospitals licensed under 12 VAC 5-410, free-standing endoscopy centers, physicians’ offices, and dental, orthodontic, and endodontic

1 World Health Organization, Coronavirus disease (COVID-19), available at www.who.int/emergencies/ diseases/novel-coronavirus-2019 (last accessed Feb. 18, 2022). offices in the Commonwealth from providing procedures and surgeries that require PPE [personal protective equipment], which if delayed, are not anticipated to cause harm to the patient by negatively affecting the patient’s health outcomes, or leading to disability or death.

(Id. ¶ 27.) “The Virginia Order suspended or slowed down many of Plaintiffs’ business activities at their respective medical centers, including medical procedures and surgeries, and prohibited use of or access to significant portions of the properties for these and other business activities due to the threat of spread of COVID-19 . . . .” (Id. ¶ 28.) These prohibitions “generated substantial losses by reducing access to the medical centers for various procedures and surgeries, causing reduced revenue, EBITDA[2] and income at Plaintiffs’ respective medical centers.” (Id. ¶ 29.) From June 1, 2019, to June 1, 2020, LifePoint was covered under a $650 million Zurich insurance policy3 (“the Policy”) “[t]o protect against property damage, threats of imminent physical property loss, and interruptions to Plaintiffs’ businesses . . . .” (Id. ¶ 31.) Both DRMC and CVMC are “Named Insureds under the Policy, and the Policy insures all of Plaintiffs’ medical centers in Virginia as Insured Locations.” (Id. ¶ 33.) The Policy “insures against all risks of direct physical loss, damage or destruction occurring during the term of [the Policy] to the type of property insured.” (Id. ¶ 35; id. Ex. A p. 26 [ECF No. 1-1].)

2 Although not defined in Plaintiffs’ complaint, “EBITDA” is generally accepted to mean “earnings before interest, taxes, depreciation, and amortization.” See, e.g., In re: Triangle Cap. Corp. Sec. Litig., 988 F.3d 743, 747 n.3 (4th Cir. 2021).

3 The policy “was underwritten on a quota-share basis by [Zurich], Liberty Mutual Fire Insurance Company . . . , and Lexington Insurance Company . . . .” (Compl. ¶ 31.) This structure is not relevant to the court’s analysis. The Policy contained several express provisions that Plaintiffs contend were implicated by the COVID-19 pandemic and the Virginia Order. The first, the “Biocontamination Extension,” states:

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