973 N.W.2d 507
Iowa2022Background
- Jesse’s Embers operated a bar/restaurant in Des Moines and closed in March 2020 in compliance with the Governor’s COVID-19 proclamation, later partially reopening in May 2020.
- It submitted a claim under its Business Owners Policy for Business Income, Extra Expense, and Civil Authority losses caused by the forced suspension.
- The policy covered loss caused by “direct physical loss of or damage to” covered property and defined Covered Cause of Loss as “Direct physical loss,” but included a Virus or Bacteria exclusion.
- Farm Bureau denied the claim, citing the policy’s physical-loss requirement and the virus exclusion; Jesse’s Embers sued for breach of contract and bad-faith denial.
- The district court granted summary judgment for Farm Bureau; Jesse’s Embers appealed to the Iowa Supreme Court.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether “direct physical loss of or damage to” covers mere loss of use from governmental closure | Loss of use from the Governor’s order triggers Business Income/Extra Expense coverage | The phrase requires a physical aspect or contamination; mere loss of use is insufficient | The phrase requires a physical aspect; plaintiff alleged no contamination, so no coverage |
| Whether Civil Authority coverage applies when a proclamation prohibited access | Governor’s order prohibiting access to the area triggers Civil Authority coverage | Civil Authority requires damage to nearby property causing dangerous physical conditions; proclamation was preventative | No—plaintiff alleged no damage to neighboring property and the proclamation responded to transmission risk, so Civil Authority does not apply |
| Whether the Virus exclusion bars coverage | Plaintiff argued exclusion should not bar recovery (e.g., no contamination alleged) | Insurer argued virus exclusion applies to losses from viruses | Court did not reach the exclusion because it found no coverage under the policy provisions |
| Whether the reasonable expectations doctrine expands coverage | Plaintiff claims agent failed to explain limits and expected income-loss coverage for shutdowns | Insurer points to lack of evidence of agent representations or reliance | Doctrine does not apply; plaintiff offered no evidence that fostered coverage expectations, so summary judgment proper |
Key Cases Cited
- Am. Guar. & Liab. Ins. v. Chandler Mfg. Co., 467 N.W.2d 226 (Iowa 1991) (policyholder bears initial burden to establish coverage)
- Boelman v. Grinnell Mut. Reins., 826 N.W.2d 494 (Iowa 2013) (limits on applying the reasonable expectations doctrine)
- Clark–Peterson Co. v. Indep. Ins. Assocs., 492 N.W.2d 675 (Iowa 1992) (framework for reasonable expectations analysis)
- Nationwide Agri–Bus. Ins. v. Goodwin, 782 N.W.2d 465 (Iowa 2010) (reasonable-expectations standards)
- Q Clothier New Orleans, L.L.C. v. Twin City Fire Ins., 29 F.4th 252 (5th Cir. 2022) (civil-authority orders issued to mitigate COVID-19 do not substitute for physical damage to nearby property)
- 10012 Holdings, Inc. v. Sentinel Ins., 21 F.4th 216 (2d Cir. 2021) (civil-authority coverage requires risk of physical loss to nearby property)
- Mudpie, Inc. v. Travelers Cas. Ins. of Am., 487 F. Supp. 3d 834 (N.D. Cal. 2020) (stay-at-home orders were preventative; no adjacent property damage alleged)
- Newchops Rest. Comcast LLC v. Admiral Indem. Co., 507 F. Supp. 3d 616 (E.D. Pa. 2020) (physical or structural damage required for civil-authority or business-income coverage)
- United Airlines, Inc. v. Ins. of the State of Pa., 385 F. Supp. 2d 343 (S.D.N.Y. 2005) (civil-authority coverage requires physical damage, not merely economic loss)
