Legal Sea Foods, LLC v. Strathmore Ins. Co.

36 F.4th 29
Court of Appeals for the First Circuit·Decided June 3, 2022·No. 21-1202P·Published·Cited by 53 cases

Opinion

United States Court of Appeals For the First Circuit

No. 21-1202 LEGAL SEA FOODS, LLC,

Plaintiff, Appellant,

v.

STRATHMORE INSURANCE CO., Defendant, Appellee.

APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MASSACHUSETTS

[Hon. Nathaniel M. Gorton, U.S. District Judge]

Before

Barron, Chief Judge,

Howard, Circuit Judge,

and Singal, District Judge.*

Michael S. Levine, with whom Christopher M. Pardo, Nicholas D. Stellakis, Harry L. Manion III, and Hunton Andrews Kurth LLP were on brief, for appellant.

Gregory P. Varga, with whom Jonathan E. Small, Linda L.

Morkan, and Robinson & Cole LLP were on brief, for appellee.

John N. Ellison, Luke E. Debevec, and Reed Smith LLP on brief for amicus curiae United Policyholders.

Wm. Gerald McElroy, Jr. and Zelle LLP on brief for amici curiae American Property Casualty Insurance Association and National Association of Mutual Insurance Companies.

* Of the District of Maine, sitting by designation.

June 3, 2022

BARRON, Chief Judge. This appeal concerns a suit that Legal Sea Foods ("Legal") brought under Massachusetts law against Strathmore Insurance Co. ("Strathmore") following Strathmore's denial of Legal's request for coverage for losses that it claimed to have suffered during the COVID-19 pandemic. Legal filed the suit in the United States District Court for the District of Massachusetts. The District Court granted Strathmore's motion to dismiss Legal's claims under Federal Rule of Civil Procedure 12(b)(6). After we heard argument in this case, the Massachusetts Supreme Judicial Court (the "SJC") decided Verveine Corp. v. Strathmore Insurance Co., 184 N.E.3d 1266 (Mass. 2022), which addressed similar claims to those that Legal brings. Based on the reasoning in Verveine, we affirm.

I.

We draw the facts from the operative complaint, accepting them as true for purposes of reviewing the District Court's dismissal of the complaint under Rule 12(b)(6). Barchock v. CVS Health Corp., 886 F.3d 43, 48 (1st Cir. 2018). Legal owns and operates thirty-four seafood restaurants in five states and the District of Columbia. It purchased a commercial property insurance policy from Strathmore effective March 1, 2020 to March 1, 2021 (the "Policy").

Strathmore labeled the Policy "Protecto-Guard" and marketed it as an "enhanced property coverage endorsement for

restaurants." The Policy includes three types of coverage that this appeal implicates.

The first type is "Building and Personal Property Coverage." Strathmore "will pay" under this type of coverage "for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss." The Policy defines "Covered Property" to include, in relevant part, the buildings housing Legal's restaurants and permanently installed machinery and equipment. It defines "Covered Cause of Loss" to mean "Risks of Direct Physical Loss."

The second type is "Business Income Coverage."

Strathmore "will pay" under this type of coverage "for the actual loss of Business Income [Legal] sustain[s] due to the necessary 'suspension' of [its] 'operations' during the 'period of restoration,'" provided that the "suspension" is "caused by direct physical loss of or damage to property." The Policy defines "operations" to mean "business activities occurring at the described premises." It defines the "period of restoration" to begin 24 hours "after the time of direct physical loss or damage for Business Income Coverage" and last until "[t]he date when the property at the described premises should be repaired, rebuilt or replaced with reasonable speed and similar quality; or . . . when business is resumed at a new permanent location."

The third type is "Extra Expense Coverage." Such coverage is provided only if Legal is entitled to "Business Income Coverage" for that restaurant. Like the first two types of coverage, this type kicks in only if Legal suffers "direct physical loss or damage to property."

The Policy also provides a fourth type of coverage --

"Civil Authority Coverage" -- that is not at issue on appeal. To be eligible for "Civil Authority Coverage," Legal would need to show, among other requirements, that "a Covered Cause of Loss cause[d] damage to property other than property at" Legal's restaurants, and that "[a]ccess to the area immediately surrounding the damaged property is prohibited by civil authority as a result of the damage, and the described premises are within that area but are not more than one mile from the damaged property."

The Policy includes two relevant exclusions. Under the "Ordinance or Law" exclusion, Strathmore "will not pay for any loss or damage caused directly or indirectly by . . . [t]he enforcement of any ordinance or law . . . [r]egulating the construction, use or repair of any property." Under the "Acts or [D]ecisions" exclusion, Strathmore "will not pay for loss or damages caused by or resulting from . . . [a]cts or decisions, including the failure to act or decide, of any person, group, organization, or governmental body," unless those acts or

decisions "result[] in a Covered Cause of Loss," in which case Strathmore "will pay for the loss or damage caused by that Covered Cause of Loss."

The Policy does not expressly exclude or limit losses caused by viruses or pandemics. Nor does it include a typical "Virus Exclusion," a stock policy provision for which Strathmore's parent company had previously sought regulatory approval in New York to use in certain policies.1 On March 11, 2020, the World Health Organization declared that the global outbreak of COVID-19 was a pandemic. The first case of COVID-19 among Legal's employees and guests of which Legal is aware developed that same day.

The mechanisms of transmission of the virus that causes COVID-19, SARS-CoV-2 -- respiratory droplets from infected individuals that "attach to surfaces" or "carry through" and "linger in the air" -- made the virus "ubiquitous on surfaces and in the air." That virus also "attach[ed] to surfaces on and within . . . insured property and [hung] in the air."

1 That parent company, in its regulatory filings, had expressed that the application of the exclusion would be to "some isolated risks," and anticipated that "exposure [to these risks] is minimal." It saw the Virus Exclusion as "appropriate on occasion," and only for restaurants where "the risk presented with claim history indicative of recent incident and loss control with little remediation," accompanied by "concerns of an on-going nature (cavalier attitude of management regarding implementation of hand washing procedures by food handling staff)."

Between March 13 and March 24, the governors of the five states where Legal owns and operates restaurants and the mayor of the District of Columbia each ordered in response to the pandemic the suspension of restaurant table service, restricting restaurant operations to take-out and delivery only. These and subsequent orders required Legal either to close its dining rooms or impose atypically strict capacity limits. They also required Legal to install protective barriers and partitions before reopening.

Following the discovery of COVID-19 cases at Legal's restaurants and the issuance of the orders, Legal submitted a claim under the Policy to Strathmore for coverage for alleged losses. After a phone call with Legal, Strathmore denied the claim, apparently without further investigation. Strathmore concluded that Legal had not shown that it had suffered "direct physical loss of or damage to property," which each of the types of coverage discussed above required it to show. Strathmore also cited the "acts or decisions" exclusion in the Policy.

Strathmore thereafter denied by letter Legal's request to reconsider the denial of coverage. The letter both restated Strathmore's earlier reasons for the denial and cited the "ordinance or law" exclusion as an additional ground for denying Legal's claim for coverage.

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Legal Sea Foods, LLC v. Strathmore Ins. Co., 36 F.4th 29 (1st Cir. 2022).

36 F.4th 29 (Legal Sea Foods, LLC v. Strathmore Ins. Co.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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