The Oregon Clinic, PC v. Fireman's Fund Insurance Company

CourtDistrict Court, D. Oregon
DecidedDecember 15, 2021
Docket3:21-cv-00778
StatusUnknown

This text of The Oregon Clinic, PC v. Fireman's Fund Insurance Company (The Oregon Clinic, PC v. Fireman's Fund Insurance Company) is published on Counsel Stack Legal Research, covering District Court, D. Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
The Oregon Clinic, PC v. Fireman's Fund Insurance Company, (D. Or. 2021).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF OREGON

THE OREGON CLINIC, PC, an Oregon Case No. 3:21-cv-00778-SB professional corporation, OPINION AND ORDER Plaintiff,

v.

FIREMAN’S FUND INSURANCE COMPANY, a California corporation,

Defendant.

BECKERMAN, U.S. Magistrate Judge. This matter comes before the Court on Fireman’s Fund Insurance Company’s (“FFIC”) motion to dismiss The Oregon Clinic, PC’s (“TOC”) complaint for failure to state a claim upon which relief can be granted. See FED. R. CIV. P. 12(b)(6). The Court has jurisdiction over this matter pursuant to 28 U.S.C. § 1332, and all parties have consented to the jurisdiction of a U.S. Magistrate Judge pursuant to 28 U.S.C. § 636(c). For the reasons that follow, the Court grants FFIC’s motion to dismiss. /// /// BACKGROUND1 TOC is an “Oregon professional corporation consisting of more than thirty . . . medical specialties and subspecialties with over 263 providers practicing at fifty-seven locations in the Portland metro area.” (Compl. at 2.) FFIC is a California-based insurance company that sold TOC an “all-risk” “Property-Gard Pinnacle” insurance policy (the “Policy”). (Compl. at 3.) “The

Policy was effective at all times material to this litigation including in . . . March, 2020.” (Compl. at 4.) The Policy provides coverage for, among other things, “loss resulting from all ‘risks of direct physical loss or damage’ to covered property,” subject to certain exceptions. (Id.) TOC alleges that beginning in March 2020, as a result of the COVID-19 pandemic, the presence of COVID-19 in its offices, and “various governmental orders,” TOC “sustained direct physical loss or damage to property at or near its insured locations, and to dependent properties, resulting in significant interruption of and loss of business income, and costs to ensure patient and employee safety, to repair its damaged property, and to mitigate the loss of income.” (Compl. at 2.)

TOC alleges that FFIC improperly denied its claims for coverage, and TOC therefore filed this action on May 20, 2021, seeking a declaration of rights and alleging claims for breach of contract and breach of the implied covenant of good faith and fair dealing. (Compl. at 2, 34- 38.) On June 14, 2021, FFIC moved to dismiss TOC’s complaint pursuant to FED. R. CIV. P. 12(b)(6). (Def.’s Mot. to Dismiss (“Mot.”), ECF No. 7.) /// ///

1 This Opinion cites primarily to the CM/ECF-generated document and page numbers located at the top of each page. LEGAL STANDARDS To survive a motion to dismiss under FED. R. CIV. P. 12(b)(6), a plaintiff’s “complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). “A claim has facial plausibility when the plaintiff pleads factual

content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. (citing Twombly, 550 U.S. at 556). “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.” Mashiri v. Epsten Grinnell & Howell, 845 F.3d 984, 988 (9th Cir. 2017) (simplified). DISCUSSION FFIC raises three primary arguments in support of its motion to dismiss TOC’s complaint. First, FFIC argues that TOC has not alleged any “direct physical loss or damage” to property. (Mot. at 21.) Second, FFIC argues that TOC has not alleged facts sufficient to support coverage under the Policy’s “Loss Adjustment Expense” extension. (Mot. at 37.) Third and finally, FFIC argues that the Policy’s mortality and disease exclusion bars coverage. (Id.)

I. INSURANCE POLICY INTERPRETATION “In Oregon, the interpretation of an insurance policy is a question of law.”2 Factory Mut. Ins. Co. v. Peri Formworks Sys., Inc., 223 F. Supp. 3d 1133, 1137 (D. Or. 2016) (citing Hoffman Constr. Co. v. Fred S. James & Co., 836 P.2d 703, 706 (Or. 1992)). As the Oregon Supreme

2 As the parties have acknowledged (see, e.g., Pl.’s Corrected Resp. at 11 n.2), the Court “ha[s] diversity jurisdiction, so [it] must follow Oregon law with respect to the interpretation of the insurance policy.” Alexander Mfg., Inc. Emp. Stock Ownership Plan & Tr. v. Ill. Union Ins. Co., 560 F.3d 984, 986 (9th Cir. 2009) (citing Kabatoff v. Safeco Ins. Co. of Am., 627 F.2d 207, 209 (9th Cir. 1980)). Court has explained, “[i]f an insurance policy explicitly defines the phrase in question, [the court applies] that definition.” Holloway v. Rep. Indem. Co. of Am., 147 P.3d 329, 333 (Or. 2006) (citing Groshong v. Mut. of Enumclaw Ins. Co., 985 P.2d 1284, 1287 (Or. 1999)). But when the insurance policy does not define one of the terms in question, as is the case here, the court “resort[s] to various aids of interpretation to discern the parties’ intended meaning.” Id. (citation

omitted). “The first aid to interpretation is determining whether the term at issue has a plain meaning.” Groshong, 985 P.2d at 1287 (citing Hoffman, 836 P.2d at 706). “The meaning of a term is ‘plain’—that is, unambiguous—if the term is susceptible to only one plausible interpretation.” Id. “If the term has only one plausible interpretation, the ‘parties’ intent conclusively is established, and [the court’s] interpretive inquiry is at an end.’” Peri Formworks, 223 F. Supp. 3d at 1138 (quoting Groshong, 985 P.2d at 1287). Considering “the breadth and flexibility of the English language, the task of suggesting plausible alternative meanings is no challenge to capable counsel.” Id. (quoting Hoffman, 836 P.2d at 706). “Competing plausible

interpretations simply establish ambiguity that will require some interpretive act by the court.” Id. (citation omitted). If the parties present competing plausible interpretations and thus establish ambiguity, the court must then examine the ambiguous, undefined “term in light of the ‘particular context in which that term is used in the policy and the broader context of the policy as a whole.’” Id. (quoting Hoffman, 836 P.2d at 706). Finally, “[i]f the ambiguity remains after the court has engaged in [the aforementioned] analytical exercises, then any reasonable doubt as to the intended meaning of [the term] will be resolved against the insurance company and in favor of extending coverage to the insured.” Id. (quoting N. Pac. Ins. Co. v Hamilton, 22 P.3d 739, 742 (Or. 2001)) (simplified). II. DIRECT PHYSICAL LOSS OR DAMAGE TOC claims that it is entitled to coverage for its COVID-related losses under ten Policy provisions: (1) Property Coverage; (2) Business Income and Extra Expense Coverage;

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The Oregon Clinic, PC v. Fireman's Fund Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/the-oregon-clinic-pc-v-firemans-fund-insurance-company-ord-2021.