323 A.3d 593
Pa.2024Background
- Plaintiff Ungarean, a dentist, operated Smile Savers Dentistry in Pennsylvania and purchased a commercial property policy from CNA/Valley Forge Insurance covering April 1, 2019 to April 1, 2020.
- In March 2020, Governor Wolf ordered closure of non-essential businesses due to COVID-19; Ungarean closed his practice except for emergency procedures, causing significant income loss.
- Ungarean filed a claim for business interruption losses under the policy’s Business Income, Extra Expense, and Civil Authority coverages; CNA denied coverage, arguing no physical loss or damage.
- Ungarean sued for declaratory judgment, obtaining summary judgment in his favor at trial and again on appeal at the Superior Court, both courts finding ambiguity in "direct physical loss of or damage to property."
- CNA appealed to the Pennsylvania Supreme Court, which reversed, holding the policy language was unambiguous and required physical alteration to the property for coverage.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does "direct physical loss of or damage to property" include loss of use under COVID shutdowns? | "Loss of use" even without physical alteration is covered. | Only physical alteration to property triggers coverage. | No; only physical alteration triggers coverage. |
| Did Governor Wolf's shutdown order trigger Civil Authority coverage? | Civil Authority coverage applies due to COVID orders limiting access. | Coverage only if order is due to direct physical loss/damage elsewhere. | No; shutdown was not due to physical loss/damage to property. |
| Are coverage exclusions (e.g. contamination, microbe, consequential loss) applicable? | Exclusions do not clearly and unambiguously bar coverage. | Exclusions apply; even if coverage triggered, bars apply. | Unnecessary to decide; primary coverage not triggered. |
| Is the policy language ambiguous, requiring interpretation in favor of insured? | Ambiguity exists; resolve in insured’s favor. | Language is unambiguous; loss requires physical alteration. | No ambiguity; single reasonable interpretation controls. |
Key Cases Cited
- 401 Fourth St., Inc. v. Invs. Ins. Grp., 879 A.2d 166 (Pa. 2005) (policy must be read as a whole; interpret according to the parties’ intent)
- Pa. Nat’l Mut. Cas. Ins. Co. v. St. John, 106 A.3d 1 (Pa. 2014) (plain and ordinary meaning governs unambiguous terms)
- Madison Constr. Co. v. Harleysville Mut. Ins. Co., 735 A.2d 100 (Pa. 1999) (ambiguity construed in favor of insured, but language should not be distorted)
- Hutchinson v. Sunbeam Coal Corp., 519 A.2d 385 (Pa. 1986) (ambiguity where language susceptible to different reasonable interpretations)
- Gallagher v. GEICO Indem. Co., 201 A.3d 131 (Pa. 2019) (intent from terms used in written insurance policy)
