ENT and Allergy Associates, LLC v. Continental Casualty Company

CourtDistrict Court, D. Connecticut
DecidedMarch 3, 2022
Docket3:21-cv-00289
StatusUnknown

This text of ENT and Allergy Associates, LLC v. Continental Casualty Company (ENT and Allergy Associates, LLC v. Continental Casualty Company) is published on Counsel Stack Legal Research, covering District Court, D. Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
ENT and Allergy Associates, LLC v. Continental Casualty Company, (D. Conn. 2022).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF CONNECTICUT

------------------------------x : ENT AND ALLERGY ASSOCIATES, : Civ. No. 3:21CV00289(SALM) LLC, LITCHFIELD HILLS : ORTHOPEDIC ASSOCIATES, LLC, : and LITCHFIELD HILLS SURGICAL : CENTER, LLP : : v. : : CONTINENTAL CASUALTY COMPANY : March 3, 2022 and CNA FINANCIAL CORPORATION : : ------------------------------x

RULING ON MOTION TO DISMISS [Doc. #29] Defendants have filed a motion pursuant to Federal Rule of Civil Procedure 12(b)(6) seeking to dismiss the Complaint in its entirety. [Doc. #29]. Plaintiffs have filed a memorandum in opposition to the motion to dismiss [Doc. #35], to which defendants have filed a reply [Doc. #40]. For the reasons stated herein, the Motion to Dismiss [Doc. #29] is GRANTED. I. Procedural Background Plaintiffs ENT and Allergy Associates, LLC (“ENT”), Litchfield Hills Orthopedic Associates, LLC (“Litchfield Hills Orthopedic”), and Litchfield Hills Surgical Center, LLP (“Litchfield Hills Surgical Center”), brought this action on March 5, 2021, against two named defendants: Continental Casualty Company (“Continental”) and CNA Financial Corporation (“CNAF”). See Doc. #1 at 1.1 Defendants filed a Motion to Dismiss, and plaintiffs filed

a Motion for Partial Summary Judgment, both on April 15, 2021. See Doc. #28, Doc. #29. This matter was transferred to the undersigned on October 21, 2021. See Doc. #70. Plaintiffs subsequently filed a Motion for Leave to File Amended Complaint on November 22, 2021. See Doc. #83. On February 1, 2022, after defendants’ Motion to Dismiss had been pending for nine and a half months, plaintiffs filed a Motion to Certify Questions of State Law to the Connecticut Supreme Court. See Doc. #93. II. Factual Background The Court accepts the following allegations as true, solely for purposes of this Motion to Dismiss. “For many years, Plaintiffs have operated medical

practices” in the state of Connecticut. Doc. #1 at 2. “Defendants issued Policy No. B 6011680724 to ENT and Allergy Associates, LLC for a policy period of September 1, 2019 to September 1, 2020.” Id. at 6. Similarly, “Defendants issued Policy No. B 6011179848 to Litchfield Hills Orthopedic Associates, LLP for a policy period of January 1, 2020 to

1 Throughout this Ruling, the Court cites to the page numbers reflected in each document’s ECF header, rather than any numbering applied by the filing party. January 1, 2021. Litchfield Hills Surgical Center, LLP is an additional insured under that Policy.” Id.2 In March 2020, the State of Connecticut issued a series of

orders that directed “all residents in Connecticut to stay at home, impos[ed] social distancing rules, limited occupancy of buildings, and reiterated that any entity that does not employ individuals to perform essential worker functions ... shall adhere to limitations on social gatherings and social distancing set forth in the Order.” Id. at 13. As a result of these orders, plaintiffs allege that they were forced to “cease and/or significantly reduce operations at the premises described in the Policies and to incur Extra Expenses.” Id. at 15. Plaintiffs further contend: “The existence of SARS-CoV-2 caused direct physical loss of or damage to the covered property or ‘premises’ under the Plaintiffs’ Policies, by denying use of

and damaging the covered property, and by causing a necessary suspension (in whole or in part) of operations during a period of restoration and requiring prevention, repair and restoration measures.” Id. Specifically, plaintiffs allege that: 101. Plaintiffs’ suffered direct physical loss of or damage to Covered Property and resulting in loss of Business Income due to:

2 Plaintiffs’ policies are referred to collectively throughout this Ruling as the “Policies.” a. The actual presence of SARS-CoV-2 at the Covered Properties and resulting contamination or other damage;

b. The imminent risk of contamination and other damages and damages caused by SARS-CoV-2; and

c. Both the voluntary and government mandated suspension and cessation of Plaintiffs’ business operations in response to the presence and imminent risk posed by SARS-CoV-2.

Id. at 21 (sic).

The Policies, by their terms, provide coverage “for direct physical loss of or damage to Covered Property ... caused by or resulting from a Covered Cause Of Loss.” Doc. #29-2 at 15 (ENT policy); see also Doc. #29-3 at 19 (Litchfield Hills Orthopedic policy). The Policies cover “Business Income” losses as follows: “We will pay for the actual loss of Business Income you sustain due to the necessary ‘suspension’ of your ‘operations’ during the ‘period of restoration.’ The ‘suspension’ must be caused by direct physical loss of or damage to property at the described premises.” Doc. #29-2 at 37; see also #29-3 at 41. As to “Extra Expense” coverage, the Policies provide that defendants will pay for “reasonable and necessary expenses you incur during the ‘period of restoration’ that you would not have incurred if there had been no direct physical loss of or damage to property caused by or resulting from a Covered Cause of Loss.” Doc. #29-2 at 38; see also Doc. #29-3 at 42. Finally, as to “Civil Authority” coverage, the Policies provide: When the Declarations show that you have coverage for Business Income and Extra Expense, you may extend that insurance to apply to the actual loss of Business Income you sustain and reasonable and necessary Extra Expense you incur caused by action of civil authority that prohibits access to the described premises. The civil authority action must be due to direct physical loss of or damage to property at locations, other than described premises, caused by or resulting from a Covered Cause of Loss.

Doc. #29-2 at 63; see also Doc. #29-3 at 67.

“Plaintiffs submitted notices of loss to Defendants due to the probable presence of SARS-CoV-2 and the COVID-19 Pandemic. The Defendants denied ENT and Allergy Associates, LLC’s claim and has not responded to Litchfield Hills Orthopedic Associates, LLP and Litchfield Hills Surgical Center, LLP’s claim.” Doc. #1 at 17 (sic). Defendants rejected ENT’s claim for coverage on several grounds. While plaintiffs do not pursue Business Personal Property coverage in this case, defendants’ denial of ENT’s claim under that provision is informative: The Property Coverage provides that CCC “will pay for direct physical loss of or damage to the Covered Property at the premises described in the Declarations caused by or resulting from a Covered Cause of Loss.” EAA has not reported any “direct physical loss or damage” to its business personal property. Rather, the claim reported is limited to an interruption to EAA’s business caused not by any physical loss or damage to Covered Property, but by the aforementioned reluctance of your patients due to the fear of COVID-19 to come to your office to be seen. The Business Personal Property coverage therefore does not apply.

Doc. #1-4 at 3.

Defendants also found that ENT was not entitled to Business Income and Extra Expense coverage, stating: [Business Income and Extra Expense coverage] is conditioned on “direct physical loss of or damage to property at the described premises[.]” You have not claimed, however, and our investigation revealed no evidence that EAA’s operations were suspended because of any direct physical loss of or damage to property at that location.

Id. at 4.

Defendants further asserted in the denial letter that certain exclusions in ENT’s policy might preclude coverage: Even if there had been direct physical loss of or damage to property at the described premises or at locations other than the described premises, as required under the Policy provisions, the Policy also contains exclusions that might bar coverage for your claim.

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ENT and Allergy Associates, LLC v. Continental Casualty Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ent-and-allergy-associates-llc-v-continental-casualty-company-ctd-2022.