Essentia Health v. ACE American Insurance Company

CourtDistrict Court, D. Minnesota
DecidedMay 25, 2021
Docket0:21-cv-00207
StatusUnknown

This text of Essentia Health v. ACE American Insurance Company (Essentia Health v. ACE American Insurance Company) is published on Counsel Stack Legal Research, covering District Court, D. Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Essentia Health v. ACE American Insurance Company, (mnd 2021).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA

Essentia Health, File No. 21-cv-207 (ECT/LIB)

Plaintiff,

v. OPINION AND ORDER ACE American Insurance Company,

Defendant.

Rikke A. Dierssen-Morice, Judah Druck, and Bryan R. Freeman, Maslon LLP, Minneapolis, MN, for Plaintiff Essentia Health.

Kevin M. Haas, Clyde & Co. US LLP, Florham Park, NJ; Alexandra L. Zabinski, Cheryl A. Hood Langel, and Robert L. McCollum, McCollum Crowley Moschet Miller & Laak, Ltd., Minneapolis, MN, for Defendant ACE American Insurance Company.

At the beginning of the COVID-19 pandemic, Minnesota Governor Tim Walz issued an executive order requiring health-care providers to suspend elective medical procedures at their facilities. That suspension caused Plaintiff Essentia Health to lose a substantial amount of revenue. After unsuccessfully trying to recover some of those losses from its insurer, ACE American Insurance Company, Essentia filed this lawsuit, alleging that COVID-19 is a “pollution condition” that had caused it to suffer covered business interruption loss. ACE has moved to dismiss the Complaint for failure to state a claim. ACE’s motion will be granted. The term “pollution condition,” when read in conjunction with other provisions of the policy in this case, cannot reasonably be understood to include a virus. Because Essentia has only sought coverage on the ground that COVID-19 is a “pollution condition,” this conclusion dooms its claim as a matter of law. The Complaint will therefore be dismissed with prejudice. I1

COVID-19 is a “communicable disease caused by a virulent strain of coronavirus called SARS-CoV2[.]” Compl. ¶ 19 [ECF No. 1]. The virus “often spreads from person to person, through respiratory droplets produced when an infected person coughs, sneezes, or talks,” and transmission is accordingly “more likely when people are in close contact with one another.” Id. ¶ 21. But it can also spread via “airborne transmission,” which

involves “aerosols” that “can linger in the air for minutes to hours[.]” Id. ¶ 22. The virus has caused millions of confirmed COVID-19 cases and hundreds of thousands of deaths in the United States. Id. ¶ 26; see id. ¶ 20. Government officials have taken significant steps to combat the spread of the virus. See id. ¶¶ 24–25. Relevant to this case, Minnesota Governor Tim Walz issued an executive

order on March 19, 2020, that “required the indefinite postponement of all non-essential or elective surgeries and procedures that utilize [personal protective equipment] or ventilators.” Id. ¶¶ 31–32; see id., Ex. B [ECF No. 1-2]. That order was in effect until May 5, 2020, when a new executive order lifted the moratorium on elective procedures but required health-care facilities to “establish[] criteria for determining whether a procedure

should proceed during the COVID-19 pandemic, for prioritizing procedures, and for

1 In accordance with the standards governing a motion under Rule 12(b)(6), the facts are drawn entirely from the Complaint and documents necessarily embraced by it. See Gorog v. Best Buy Co., 760 F.3d 787, 792 (8th Cir. 2014). ensuring a safe environment for staff, patients, and visitors.” Id. ¶ 36; see id., Ex. C [ECF No. 1-3]. COVID-19 and the resulting elective-procedure restriction have had a major impact

on Essentia, “an integrated healthcare system” that operates hospitals, clinics, and other health-care facilities in Minnesota and elsewhere. Id. ¶¶ 27–29. Numerous patients and Essentia employees have tested positive for the virus, and Essentia believes that the virus has been present at all of its locations since March 2020. Id. ¶¶ 39–42. In April 2020, while the elective-procedure moratorium was in effect, “Essentia’s Minnesota operations

at all of its locations were partially or completely suspended.” Id. ¶ 37. The company estimates that, just that month, it lost more than $59 million as a result of these disruptions. Id. ¶ 38. To recover some of this lost revenue, Essentia sought coverage under a “Premises Pollution Liability Portfolio Insurance Policy” (“the Policy”) issued by ACE. Id. ¶ 43; see

id., Ex. A [ECF No. 1-1]. Relevant here, under an insuring agreement entitled “First-Party Remediation Costs Coverage,” the Policy covers “‘loss’. . . resulting from: . . . ‘First-party claims’ arising out of . . . 1) a ‘pollution condition’ on, at, under or migrating from a ‘covered location’; [or] 2) an ‘indoor environmental condition’ at a ‘covered location[.]’” Policy at 5.

This insuring agreement contains two key categories of terms with cascading definitions that must be carefully picked apart.2 The first category is the type of loss

2 There is no dispute that Essentia’s locations are “covered location[s]” and that COVID-19 gave rise to a “[f]irst-party claim,” so no more will be said about those terms. covered. “[L]oss” in this context includes both “[f]irst-party remediation costs,” which Essentia does not seek, and “business interruption loss,” which it does. Id. at 11. “First- party remediation costs” are, essentially, expenses that an insured incurs to “investigate”

and remedy “indoor environmental conditions” and “pollution conditions.” Id. at 10, 13. “Business interruption loss” means, as relevant here, “[b]usiness income.”3 Id. at 8. “[B]usiness income” in turn includes “[n]et profit or loss, before income taxes, . . . that would have been realized had there been no ‘business interruption.’” Id. And a “[b]usiness interruption” is “the necessary partial or complete suspension of the ‘insured’s’ operations

at a ‘covered location’ for a period of time, which is directly attributable to a ‘pollution condition’ or ‘indoor environmental condition[.]’” Id. The covered period of business interruption “extend[s] from the date that the operations are necessarily suspended and end[s] when such ‘pollution condition’ or ‘indoor environmental condition’ has been remediated to the point at which the ‘insured’s’ normal operations could reasonably be

restored.” Id. The second category consists of the covered causes of loss. The Policy defines “pollution condition” as [t]he discharge, dispersal, release, escape, migration, or seepage of any solid, liquid, gaseous or thermal irritant, contaminant, or pollutant, including soil, silt, sedimentation, smoke, soot, vapors, fumes, acids, alkalis, chemicals, electromagnetic fields (EMFs), hazardous substances, hazardous materials, waste materials, “low-level radioactive waste”, “mixed waste” and medical, red bag, infectious or

3 “Business interruption loss” also includes “[e]xtra expense” and “[d]elay expense,” but no Party argues that either of these kinds of loss is relevant here. Policy at 8. pathological wastes, on, in, into, or upon land and structures thereupon, the atmosphere, surface water, or groundwater.

Id. at 12–13.4 Through a “Healthcare Amendatory Endorsement,” the Policy defines “indoor environmental condition” to include “the discharge, dispersal, release, escape, migration or seepage of bacteria . . . or viruses in a building or structure, or the ambient air within such building or structure,” but only if, among other things, the insured seeks “remediation costs” and the bacteria or viruses involved “are not the result of communicability through human-to-human or bodily fluid contact.” Id. at 29. Essentia alleges that COVID-19 is a “pollution condition” under the Policy and that it suffered covered “business interruption loss” during the moratorium on elective procedures. Compl. ¶¶ 46–47. To support this conclusion, it argues that the Sars-CoV2

virus is an “irritant” or a “contaminant” that fits within the plain meaning of the Policy’s definition of “pollution condition.” Id. ¶¶ 48–51.

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