Hudson Valley Bone & Joint Surgeons, LLP v. CNA Financial Corporation

CourtDistrict Court, S.D. New York
DecidedSeptember 23, 2021
Docket7:20-cv-06073
StatusUnknown

This text of Hudson Valley Bone & Joint Surgeons, LLP v. CNA Financial Corporation (Hudson Valley Bone & Joint Surgeons, LLP v. CNA Financial Corporation) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hudson Valley Bone & Joint Surgeons, LLP v. CNA Financial Corporation, (S.D.N.Y. 2021).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK --------------------------------------------------------------x HUDSON VALLEY BONE AND JOINT : SURGEONS, LLP, : Plaintiff, : : v. : OPINION AND ORDER : CNA FINANCIAL CORPORATION and : 20 CV 6073 (VB) NATIONAL FIRE INSURANCE COMPANY : OF HARTFORD, : Defendants. : --------------------------------------------------------------x Briccetti, J.: Plaintiff Hudson Valley Bone and Joint Surgeons, LLP (“Hudson Valley”), brings this action against defendants CNA Financial Corporation (“CNA”) and National Fire Insurance Company of Hartford (“NFICH”), alleging breach of contract and breach of the implied covenant of good faith and fair dealing with respect to defendants’ denial of insurance coverage for losses plaintiff allegedly sustained as a result of government restrictions on essential businesses during the COVID-19 pandemic. Now pending is defendants’ motion to dismiss the first amended complaint (“FAC”) pursuant to Rule 12(b)(6) for failure to state a claim. (Doc. #21). For the reasons set forth below, the motion is GRANTED. The Court has subject matter jurisdiction under 28 U.S.C. § 1332(a).

BACKGROUND For the purpose of ruling on the motion to dismiss, the Court accepts as true all well- pleaded allegations in the FAC and draws all reasonable inferences in plaintiff’s favor, as summarized below. Plaintiff alleges it is a medical group comprised of orthopedic surgeons and specialists who treat patients at two insured premises: 24 Saw Mill River Road, in Hawthorne, New York, and 819 Yonkers Avenue, in Yonkers, New York (the “insured premises” or the “Covered Property”). According to plaintiff, CNA is an insurance underwriter, and NFICH is a wholly

owned subsidiary of CNA that sells insurance on CNA’s behalf. I. The Insurance Policy Plaintiff alleges it purchased an “all risk” commercial property insurance policy from defendants, which provided coverage from August 1, 2019, through August 1, 2020 (the “Policy”). The Policy states: “We will pay for direct physical loss of or damage to Covered Property. . . caused by or resulting from a Covered Cause Of Loss.” (Doc. #20-1 (the “Policy”) at ECF 19).1 “Covered Causes of Loss” are defined as “risks of direct physical loss unless the loss is” excluded or limited by the Policy. (Id. at ECF 20–21). The Policy contains a “Business Income” provision, which provides coverage for the loss of certain business income:

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. The loss or damage must be caused by or result from a Covered Cause of Loss. (Policy at ECF 41). “Suspension” is defined in the Policy as “[t]he partial or complete cessation of your business activities; or that a part or all of the described premises is rendered untenantable.” (Id. at ECF 38).

1 “ECF _” refers to page numbers automatically assigned by the Court’s Electronic Case Filing system.

In considering a motion to dismiss, “a district court may consider the facts alleged in the complaint, documents attached to the complaint as exhibits, and documents incorporated by reference in the complaint.” DiFolco v. MSNBC Cable L.L.C., 622 F.3d 104, 111 (2d Cir. 2010). Plaintiff attached a copy of the Policy and claim denial letter to the FAC. In addition, the Policy’s “Extra Expense” provision allows recovery of “[r]easonable 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.” (Policy at ECF 42).

The Policy also includes a section entitled “Duties In The Event Of Loss Or Damage,” which provides steps the insured must take in “the event of loss or damage to the Covered Property,” including steps to mitigate damages. (Policy at ECF 27). Finally, the Policy’s “Civil Authority” provision provides: 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.

(Policy at ECF 63).

II. COVID-19 and Government Action Plaintiff alleges that in accordance with orders issued by state and local authorities, which limited operations for both non-essential and essential businesses during the COVID-19 pandemic, plaintiff closed the Hawthorne location from March 16 to April 13, 2020, and the Yonkers location from March 16 to an unspecified date in May 2020. Plaintiff and defendants agree plaintiff’s business is an essential business under the relevant government orders and therefore was not required to close at any time during the pandemic. Plaintiff alleges that on April 24, 2020, plaintiff made a claim for insurance coverage under the Policy for its “property and business interruption losses as well as extra expenses incurred as a direct result of the statewide disaster emergency orders.” (Doc. #20 (“FAC”) at ECF 1). According to plaintiff, defendants denied its claim because it did not report any direct physical loss or damage to the insured premises. DISCUSSION

I. Standard of Review In deciding a Rule 12(b)(6) motion, the Court evaluates the sufficiency of the operative complaint under the “two-pronged approach” articulated by the Supreme Court in Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009).2 First, a plaintiff’s legal conclusions and “[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements,” are not entitled to the assumption of truth and are thus not sufficient to withstand a motion to dismiss. Id. at 678; Hayden v. Paterson, 594 F.3d 150, 161 (2d Cir. 2010). Second, “[w]hen there are well-pleaded factual allegations, a court should assume their veracity and then determine whether they plausibly give rise to an entitlement to relief.” Ashcroft v. Iqbal, 556 U.S. at 679. To survive a Rule 12(b)(6) motion, the allegations in the complaint must meet a standard

of “plausibility.” Ashcroft v. Iqbal, 556 U.S. at 678; Bell Atl. Corp. v. Twombly, 550 U.S. 544, 564 (2007). A claim is facially plausible “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. at 678. “The plausibility standard is not akin to a ‘probability requirement,’ but it asks for more than a sheer possibility that a defendant has acted unlawfully.” Id. (quoting Bell Atl. Corp. v. Twombly, 550 U.S. at 556).

2 Unless otherwise indicated, case quotations omit all internal citations, quotations, footnotes, and alterations. II. Breach of Contract Claim Plaintiff’s breach of contract claim is based on defendants’ alleged failure to provide (i) business income coverage, (ii) extra expense coverage, (ii) civil authority coverage, and (iv) sue and labor coverage. Defendants argue plaintiff fails plausibly to allege that it suffered a covered

loss under the Policy. A.

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Hudson Valley Bone & Joint Surgeons, LLP v. CNA Financial Corporation, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hudson-valley-bone-joint-surgeons-llp-v-cna-financial-corporation-nysd-2021.