The Oregon Clinic, Pc v. Fireman's Fund Ins. Co.

75 F.4th 1064
Court of Appeals for the Ninth Circuit·Decided July 31, 2023·No. 22-35047·Published·Cited by 22 cases

Opinion

FOR PUBLICATION

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

THE OREGON CLINIC, PC, an No. 22-35047 Oregon professional corporation, D.C. No. 3:21-cv-

Plaintiff-Appellant, 00778-SB

v.

OPINION

FIREMAN’S FUND INSURANCE COMPANY, a California corporation,

Defendant-Appellee.

Appeal from the United States District Court for the District of Oregon Stacie F. Beckerman, Magistrate Judge, Presiding

Argued and Submitted February 9, 2023 Submission Vacated April 10, 2023 Resubmitted July 25, 2023 Portland, Oregon

Filed July 31, 2023

Before: Mary H. Murguia, Chief Judge, and Danielle J.

Forrest and Jennifer Sung, Circuit Judges.

Opinion by Chief Judge Murguia

2 THE OREGON CLINIC, PC. V. FIREMAN’S FUND INS. CO.

SUMMARY *

Diversity/COVID-19 Business Losses

The panel affirmed the district court’s dismissal for failure to state a claim of medical provider Oregon Clinic’s complaint alleging that its insurer, Fireman’s Fund Insurance Company, improperly denied coverage for losses it sustained because of the COVID-19 pandemic.

The insurance policy provided Oregon Clinic with coverage for reduction of business income only if its insured property suffered “direct physical loss or damage.” Oregon Clinic alleged that it suffered “direct physical loss or damage” because of the COVID-19 pandemic and related governmental orders that prevented it from fully making use of its insured property. Fireman’s Fund denied coverage and Oregon Clinic sued, asserting claims for breach of contract and breach of the implied duty of good faith and fair dealing.

The panel certified to the Oregon Supreme Court the interpretation of “direct physical loss or damage” under Oregon law and stayed proceedings. The Oregon Supreme Court declined the certification request. The panel held that the Oregon Supreme Court would interpret “direct physical loss or damage” to require physical alteration of property, consistent with the interpretation reached by most courts nationwide. Because Oregon Clinic failed to state a claim under this interpretation, and because amendment would be futile, the panel affirmed the district court’s judgment.

*

This summary constitutes no part of the opinion of the court. It has been prepared by court staff for the convenience of the reader.

THE OREGON CLINIC, PC. V. FIREMAN’S FUND INS. CO. 3

COUNSEL

Seth H. Row (argued), Iván Resendiz Gutierrez, and Katelyn J. Fulton, Miller Nash LLP, Portland, Oregon; Jodi S. Green, Miller Nash LLP, Long Beach, California; for Plaintiff- Appellant. Brett D. Solberg (argued), DLA Piper LLP (US), Houston, Texas; Joseph D. Davison and Anthony Todaro, DLA Piper LLP (US), Seattle, Washington; for Defendant-Appellee. James M. Davis, Perkins Coie LLP, Seattle, Washington; Bradley H. Dlatt, Perkins Coie LLP, Chicago, Illinois; Stephen M. Feldman, Perkins Coie LLP, Portland, Oregon; for Amicus Curiae United Policyholders.

OPINION

MURGUIA, Chief Circuit Judge:

This appeal arises out of a commercial property insurance policy (“Policy”) that Oregon Clinic, P.C. (“Oregon Clinic”) purchased from Fireman’s Fund Insurance Company (“Fireman’s Fund”). The Policy provides Oregon Clinic, a medical provider with more than fifty locations in Oregon, with coverage for reduction of business income only if its insured property suffers “direct physical loss or damage.” In March 2020, after the COVID- 19 pandemic began, Oregon Clinic, like hundreds of other insured businesses nationwide, sought coverage under its Policy. It alleged that it suffered “direct physical loss or damage” because of the COVID-19 pandemic and related 4 THE OREGON CLINIC, PC. V. FIREMAN’S FUND INS. CO.

governmental orders that prevented it from fully making use of its insured property. Fireman’s Fund denied coverage.

Oregon Clinic then sued Fireman’s Fund in the United States District Court for the District of Oregon, asserting claims for breach of contract and breach of the implied duty of good faith and fair dealing. As most courts nationwide have done when faced with similar complaints, the District Court dismissed with prejudice Oregon Clinic’s complaint under Federal Rule of Civil Procedure 12(b)(6). Oregon Clinic timely appealed. At Oregon Clinic’s request, we certified to the Oregon Supreme Court the interpretation of “direct physical loss or damage” under Oregon law and stayed proceedings. The Oregon Supreme Court declined our certification request.

We reassume jurisdiction pursuant to 28 U.S.C. § 1291 and conclude that the Oregon Supreme Court would interpret “direct physical loss or damage” to require physical alteration of property, consistent with the interpretation reached by most courts nationwide. Because Oregon Clinic fails to state a claim under this interpretation, and because amendment would be futile, we affirm the District Court’s judgment.

I.

“[W]e accept the factual allegations of the complaint as true and construe them in the light most favorable to [Oregon Clinic].” Mudpie, Inc. v. Travelers Cas. Ins. Co. of Am., 15 F.4th 885, 889 (9th Cir. 2021) (first alteration in original) (citations omitted).

Oregon Clinic is a medical provider with fifty-seven locations in the Portland, Oregon metro area. Like it did to most businesses, the COVID-19 pandemic severely

THE OREGON CLINIC, PC. V. FIREMAN’S FUND INS. CO. 5

impacted Oregon Clinic. As alleged in Oregon Clinic’s complaint, between March and November 2020, “approximately twenty-two” of Oregon Clinic’s “employees or patients . . . confirmed they were infected with the [COVID-19] virus while they were on [its] premises.” And, given the virus’s asymptomatic spread and the large number of people who congregate in Oregon Clinic’s offices, it is “statistically certain or near-certain that the [COVID-19] virus was continuously dispersed into the air and on physical surfaces and other property in, on, and within 1,000 feet of [t]he Oregon Clinic’s offices, in early March 2020, and thereafter.” Accordingly, “[t]he continuous dispersal of the [COVID-19] virus into the air and onto physical surfaces and other property rendered . . . Oregon Clinic’s cleaning practices ineffective . . . , requiring physical and other changes” to its property and practices. Making matters worse for Oregon Clinic’s business operations, Oregon Governor Kate Brown issued a series of orders that required Oregon Clinic, and all other health clinics, to stop performing non-urgent healthcare procedures. These orders restricted or eliminated Oregon Clinic’s ability to use its facilities.

The pandemic and governmental orders had a detrimental effect on Oregon Clinic’s business income. For example, by mid-March 2020, Oregon Clinic’s daily patient visits had dropped from over 1,800 to as low as 300. Oregon Clinic was also forced to spend money on “purchas[ing] and alter[ing] business personal property” to “minimize the suspension” of its operations and “preserve and protect” its property. Oregon Clinic’s “net revenue[] dropped by $20,170,000” while it completed these changes.

Before the pandemic, Oregon Clinic purchased a commercial property insurance policy from Fireman’s Fund 6 THE OREGON CLINIC, PC. V. FIREMAN’S FUND INS. CO.

that provides Oregon Clinic with coverage for business income lost because of “direct physical loss or damage” to its property. As part of the Policy, Oregon Clinic also purchased additional specialty coverages from Fireman’s Fund. The Policy was effective at all times material to Oregon Clinic’s COVID-19 allegations, including in March 2020. Of major import here, coverage under each Policy provision expressly requires “direct physical loss or damage” to property. The Policy, however, does not define “direct physical loss or damage.”

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The Oregon Clinic, Pc v. Fireman's Fund Ins. Co., 75 F.4th 1064 (9th Cir. 2023).

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