Gilreath Family & Cosmetic Dentistry, Inc. v. The Cincinnati Insurance Company

CourtDistrict Court, N.D. Georgia
DecidedMarch 1, 2021
Docket1:20-cv-02248
StatusUnknown

This text of Gilreath Family & Cosmetic Dentistry, Inc. v. The Cincinnati Insurance Company (Gilreath Family & Cosmetic Dentistry, Inc. v. The Cincinnati Insurance Company) is published on Counsel Stack Legal Research, covering District Court, N.D. Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gilreath Family & Cosmetic Dentistry, Inc. v. The Cincinnati Insurance Company, (N.D. Ga. 2021).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF GEORGIA ATLANTA DIVISION

GILREATH FAMILY & COSMETIC DENTISTRY, INC. d/b/a GILREATH DENTAL ASSOCIATES, on behalf of itself and others similarly situated, Plaintiff, v. CIVIL ACTION NO. 1:20-cv-02248-JPB THE CINCINNATI INSURANCE COMPANY, Defendant. ORDER Before the Court is Defendant The Cincinnati Insurance Company’s (“Cincinnati”) Motion to Dismiss Plaintiff’s Amended Complaint (“Motion”). ECF No. 14. Having reviewed and fully considered the papers filed therewith, the Court finds as follows: I. BACKGROUND Plaintiff Gilreath Family & Cosmetic Dentistry, Inc. d/b/a Gilreath Dental Associates (“Gilreath”) filed a complaint against Cincinnati in connection with Cincinnati’s denial of insurance coverage for losses Gilreath sustained as a result of the COVID-19 pandemic. As alleged in the Amended Complaint, Gilreath is a dental practice in Marietta, Georgia (Cobb County) insured under a Cincinnati policy that was in effect from October 2017 through October 2020 (the “Policy”).1 As relevant here, the Policy provided Business Income, Civil Authority and Extra Expense coverage.

The Policy defined those coverages as follows: Business Income We will pay for the actual loss of “Business Income” and “Rental Value” you sustain due to the necessary “suspension” of your “operations” during the “period of restoration[.”] The “suspension” must be caused by direct “loss” to property at a “premises” caused by or resulting from any Covered Cause of Loss. ECF No. 11-1 at 40 (emphasis added). Extra Expense We will pay Extra Expense you sustain during the “period of restoration[.”] Extra Expense means necessary expenses you sustain (as described in Paragraphs (2)(b), (c) and (d)) during the “period of restoration” that you would not have sustained if there had been no direct “loss” to property caused by or resulting from a Covered Cause of Loss. Id. at 41 (emphasis added).

1 The Court may consider the Policy and other exhibits attached to the Amended Complaint in ruling on Cincinnati’s Motion. See Fed. R. Civ. P. 10(c) (“A copy of a written instrument that is an exhibit to a pleading is a part of the pleading for all purposes.”); Griffin Indus., Inc. v. Irvin, 496 F.3d 1189, 1205 (11th Cir. 2007) (“Under the Federal Rules of Civil Procedure, . . . exhibits are part of the pleading ‘for all purposes.’”). Civil Authority When a Covered Cause of Loss causes damage to property other than Covered Property at a “premises[,”] we will pay for the actual loss of “Business Income” and necessary Extra Expense you sustain caused by action of civil authority that prohibits access to the “premises[,”] provided that both of [the specified conditions] apply. Id. (emphasis added). As highlighted above, each coverage is contingent on a “Covered Cause[] of Loss.” The policy defines “Covered Cause[] of Loss” as a “direct ‘loss.’” Id. at 27. “‘Loss’ means accidental physical loss or accidental physical damage.” Id. at 60. Therefore, Covered Cause of Loss means direct accidental physical loss or damage. The Policy does not specifically exclude losses caused by the spread of viruses or communicable diseases. As alleged in the Amended Complaint, the World Health Organization

declared the COVID-19 virus a global pandemic in March 2020, and the Governor of Georgia thereafter issued a shelter-in-place order that required certain businesses to cease in-person operations temporarily. As Gilreath acknowledges, dental practices were not required to close. The Centers for Medicare and

Medicaid Services and other pertinent health organizations recommended that dental practices delay all elective surgeries and non-essential procedures. Gilreath asserts that as a result of the various orders and recommendations, it was forced to “suspend or reduce” its operations. It explains that emergency dental procedures constitute an insignificant part of its business and that a substantial portion of its business is derived from routine and elective procedures.

Gilreath therefore submitted a request to Cincinnati for Business Income, Extra Expense and Civil Authority coverage. Cincinnati denied Gilreath’s request on May 20, 2020, on several grounds, including that the Policy required direct

physical loss or damage for coverage to apply. At the time of the denial, Cobb County had reported 2,584 COVID-19 cases and 134 deaths linked to the virus. Gilreath alleges that “[t]he presence of virus or disease can constitute physical damage to property” and claims the virus physically impacted its property

because its business is “highly susceptible to rapid person-to-property transmission of the virus.” As such, the virus “render[ed] [its property] unsafe, uninhabitable, or otherwise unfit for its intended use, which constitute[d] direct physical loss.”

Gilreath concludes that even if the virus did not impact its business, the various orders and recommendations made it “impossible” for its business to operate. Gilreath’s Amended Complaint asserts claims for breach of contract (Counts I-III), declaratory judgment (Count IV) and expenses of litigation (Count V). The

claims all relate to Cincinnati’s May 20, 2020 denial of coverage. Cincinnati seeks to dismiss the Amended Complaint on the grounds that Gilreath did not sustain “direct physical loss” of its premises, which is an express requirement for coverage. Cincinnati argues that when the conclusory allegations in the Amended Complaint are set aside, the remaining factual allegations fail to

show damage to the physical structure of the building. Cincinnati also explains that direct physical loss contemplates an actual change to the property causing it to become unsatisfactory or requiring repairs for future use. It emphasizes that no

Georgia case has found that the effects of a virus constitute direct physical loss to a property. Rather, Gilreath contends it is well-settled that “‘losses that are intangible or incorporeal’” are not considered direct physical loss, and claims of merely “‘detrimental economic impact unaccompanied by a distinct, demonstrable,

physical alteration of the property’” are precluded under the definition. Further, Cincinnati argues that Civil Authority coverage is not applicable because in addition to Gilreath failing to show any direct physical loss to its

property, it cannot show that the various orders and recommendations prohibited it from accessing its premises. Cincinnati points out that Gilreath was permitted to perform emergency dental procedures. Gilreath counters that because the Policy does not define what constitutes a

direct physical loss, and the phrase is ambiguous, it must be construed in its favor. It further contends that physical loss does not require a visible or physical alteration to the property and that the mere presence of COVID-19 constitutes physical damage to the property sufficient to require coverage under the Policy. Additionally, Gilreath argues that Civil Authority coverage is required here

because the COVID-19 pandemic and the accompanying orders and recommendations prevented it and numerous businesses in the area from operating and accessing their premises.

II. DISCUSSION A. Legal Standard In evaluating a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), the court “accept[s] the allegations in the complaint as true and

constru[es] them in the light most favorable to the plaintiff.” Traylor v. P’ship Title Co., LLC, 491 F. App’x 988, 989 (11th Cir. 2012).

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