HENDERSON ROAD RESTAURANT SYSTEMS, INC., dbа Hyde Park Grille, et al. v. ZURICH AMERICAN INS. CO.
CASE NO: 1:20 CV 1239
IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF OHIO EASTERN DIVISION
Judge Dan Aaron Polster
01/19/21
Before the Court are the following motions:
- Defendant Zurich American Insurance Company‘s (“Zurich“) Motion for summary Judgment (
ECF Doc. 14 ); and - Plaintiffs’ Motion for Summary Judgment on the Issue of Coverage under the Zurich Policy (
ECF Doc. 15 ).
On December 4, 2020, Zurich and Plaintiffs filed opposition briefs (
For the reasons explained below, the Court GRANTS summary judgment in favor of Plaintiffs on the insurance coverage issues alleged in Counts I and III of their complaint and DENIES summary judgment on Count II. Conversely, the Court DENIES Zurich‘s motion for summary judgment on Counts I and III of Plaintiffs’ complaint and GRANTS summary judgment on Count II.
I. Relevant Facts
Plaintiffs, Henderson Road Restaurant Systems, Inc. dba Hyde park Grille, Coventry Restaurant Systems, Inc., dba Hyde Park Chop House, Chagrin Restaurants, LLC dba Hyde Park Prime Steak House, JR Park LLC dba Hyde Park Prime Steak House, HP CAP LLC, dba Hyde Park Prime Steakhouse, NSHP, LLC dba Hyde Park Prime Steakhouse, HPD Restaurant Systems, Inc. dba Hyde Park Prime Steak House, 457 High Street Development, LLC, CAP Restaurant Development LLC, RJ Moreland Hills, LLC and Northville Development, LLC (“Plaintiffs“) operated restaurants in Ohio, Pennsylvania, Michigan, Indiana and Florida. In the spring of 2020, state governments issued orders restricting the operations of restaurants in an effort to abate the spread of the coronavirus (“COVID-19“). In response to these orders, Plaintiffs closed all but four of their Ohio restaurants on March 15, 2020. Those four Ohio restaurants continued to provide only carry-out dining until March 17, 2020, and then they closed.
Prior to the government closings, Plaintiffs’ restaurants received very few take-out orders; their businesses were comprised almost exclusivеly of in-person dining.
On March 24, 2020, Plaintiffs submitted a claim to Zurich under commercial insurance policy No. CPO 6220911-06 (“Policy“)2 for loss of business income caused by the state orders.
Business Income Coverage Form
A. COVERAGE
We will pay for the actual loss of “business income” you sustain due to the necessary “suspension” of your “operations” during the “period of restoration“. The “suspension” must be caused by direct physical loss of or damage to property at a “premises” at which a Limit of Insurance is shown on the Declarations for Business Income. The loss or damage must be directly caused by a “Covered cause of loss“. We will not pay more than the applicable Limit of Insurance shown on the Declarations for Business Income at that “premises.”
B. ADDITIONAL COVERAGES
1. Civil Authority
We will pay for the actual loss of “business income” you sustain for up to the number of days shown on the Declarations for Civil Authority resulting from the necessary “suspension” or delay in the start of your “operations” if the “suspension” or delay is caused by order of civil authority that prohibits access to the “premises” or “reported unscheduled premises.” That order must result from a civil authority‘s response to direct physical loss of or damage to property located within one mile from the “premises” or “reported unscheduled premises” which sustains a “business income” loss. The loss or damage must be directly caused by a “covered cause of loss“.
- The direct physical loss or damages that causes “suspension” of your “operations” occurs; or
- The date “operations” would have begun if the start of “operations” is delayed because of loss of or damage to any of the following:
- “Real property“, whether complete or under construction;
- Alterations or additions to “real property“; or
- “Personal property“:
- Used in such construction, alterations, or additions;
- Incidental to the occupancy of the area intended for construction, alteration, or addition; or
- Incidentаl to the alteration of the occupancy of an existing building or structure.
If you resume “operations“, with reasonable speed, the “period of restoration” ends on the earlier of:
- The date when the location where the loss or damage occurred could have been physically capable of resuming the level of “operations” which existed prior to the loss or damage, if the location had been restored to the physical size, construction, configuration, location, and material specifications which would satisfy the minimum requirements necessary to obtain all required building permits, occupancy permits, operating licenses, or similar documents; or
- The date when a new permanent location is physically capable of resuming the level of “operations” which existed prior to the loss or damage, if you resume “operations” at a new permanent location.
If you do not resume “operations“, or do not resume “operations” with reasonable speed (whether at your “premises” or “repоrted unscheduled premises” or elsewhere), the “period of restoration” will end on the date when the location where the loss or damage occurred could have been restored to the physical size, construction, configuration, location, and material specifications which existed at the time of loss or damage, with no consideration for any time:
- Which would have been required to make changes in order to satisfy the minimum requirements necessary to obtain all required building permits, occupancy permits, operating licenses, or similar documents; and
- Which would have been necessary to make the location physically capable of resuming the level of “operations” which existed prior to the loss or damage after the completion of repairs, replacement or rebuilding.
“Period of restoration” does not include any increased period required due to the enforcement of any ordinance or law that requires any insured or others to test for, monitor, clean up, remove, contain, treat, detoxify оr neutralize or in any way respond to, or assess the effects of “pollutants” or “microorganisms.”
The expiration of this policy will not cut short the “period of restoration.”
The Policy defines “covered cause of loss” as “a fortuitous cause or event, not otherwise excluded, which actually occurs during this policy period.”
C. EXCLUSIONS
1. Real or Personal Property
The exclusions * * * below and the excluded causes of loss in the REAL AND PERSONAL PROPERTY COVERAGE FORM, except Off-Premises Service Interruption, apply to loss of “business income” caused by or resulting from loss of damage to any property * * *”
The Real and Personal Property Coverage Form includes the following exclusions:
B. EXCLUDED CAUSES OF LOSS
11. Loss of Market or Delay
We will not pay for loss or damage caused by or resulting from loss of market, loss of use, or delay. This exclusion applies even if one of these excluded causes of loss was caused by or resulted from a “mistake” or “malfunction.”
12. Microorganisms
We will not pay for loss or damage consisting of, directly or indirectly caused by, contributed to, or aggravated by the presence, growth, proliferаtion, spread, or any activity of “microorganisms“, unless resulting from fire or lightning. Such loss or damage is excluded regardless or any other cause or event, including a “mistake” or “malfunction,” or weather condition, that contributes concurrently or in any sequence to the loss, even if such other cause or event would otherwise be covered.
But if a result of one of the excluded causes of loss is a “specified cause of loss“, other than fire or lightning, we will pay that portion of the loss or damage which was solely caused by that “specified cause of loss“.
We will also not pay for loss, cost, or expense arising out of any request, demand, order, or statutory or regulatory requirement that requires any insured or others to test for, monitor, clean up, remove, treat, detoxify, or neutralize, or in any way respond to, or assess the effects of “microorganisms“.
On April 30, 2020, Plaintiffs filed this case in the Cuyahoga County Court of Common Pleas.
44. None of Plaintiffs’ Insured Premises were closed as the result of the known or confirmed presence of SARS-CoV-2 or COVID 19 at any of the Insured Premises.
* * *
46. Plaintiffs did not provide any delivery, carry-out, take-out and/or curbside service from any of its Insured Premises while they were closed, [with the exception of the four Ohio locations.]
47. There were no known or presumed infected person(s) with COVID-19 at any of the Insured Premises at any time from March 15, 2020 to April 27, 2020.
48. There was no physical alteration or structural damage to any property at an Insured Premises any time from March 15, 2020 to April 27, 2020.
49. There was no physical obstruction affecting ingress or egress to any of the Insured Locations at any time from March 15, 2020 to April 27, 2020.
A. Zurich‘s Motion for Summary Judgment
Zurich filed its motion for summary judgment on October 30, 2020. Zurich argues that it is entitled to declaratory judgment because Plaintiffs’ losses were not covered by the Policy as a matter of law. Zurich contends that Plaintiffs’ economic losses arе not covered by the Policy because they were not caused by “physical loss or damage to property.”
Alternatively, Zurich argues that, even if there had been direct physical loss to Plaintiffs’ property, the Microorganism exclusion would exclude coverage. Simply summarized, Zurich argues that the underlying cause of loss was COVID-19; that COVID-19 is a microorganism; and that the Microorganism exclusion applies.
Zurich also contends that the additional Civil Authority provision does not apply because the states’ orders did not “prohibit access” to Plaintiffs’ premises. Zurich argues that the states’ orders permitted Plaintiffs to continue to operate on a carry-out and delivery basis and, therefore, did not prohibit access to Plaintiffs’ restaurants as required by the Policy. Zurich also argues that
Finally, Zurich argues that, because it properly denied coverage, it is entitled to summary judgment on Plaintiffs’ bad faith claim. Zurich argues that, even if the Court decides that coverage exists, its denial was not “arbitrary or capricious.”
Plaintiffs filed a memorandum in opposition on December 4, 2020.
Plaintiffs also contend that Zurich‘s cases are not on point. Plaintiffs argue that different policy language was involved in Mastellone; the court found that there was no evidence that the building was substantially “unusable” in Universal Image; and the Schmidt decision determined that a fraudulent cashier‘s check did not constitute “physical loss of or damage to property.”
Instead, Plaintiffs argue that the Court should find persuasive North State Deli, LLC, v. Cincinnati Ins. Co., No. 20 CVS 02569, 2020 N.C. Super LEXIS 38 (N.C. Super Ct. Oct. 7, 2020), which decided that the ordinary meaning of the phrase “direct physical loss” included the inability to possess something in the real, material or bodily world, resulting from a given cause without the intervention of other conditions. Plaintiffs also cite Cajun Conti LLC v. Certain Underwriters at Lloyd‘s, No. 2020-02558 (La Dist. Ct. Nov. 4, 2020) in which the court denied an insurer‘s dispositive motion because the restaurant had to drastically change its operations to exclude sit-down customers who were the majority of the restaurant‘s patrons.
Plaintiffs argue that even if the Court finds that thе Policy‘s “direct physical loss of or damage to property” language does not unambiguously provide coverage for their claims, that the language is, at a minimum, ambiguous. And, if the language is ambiguous, the Court must construe it in favor of the insured and against the insurer. Neal-Pettit v. Lahman, 125 Ohio St.3d 327, 2010-Ohio-1829, 928 N.E.2d 421, 424 (Ohio 2010).
Plaintiffs also argue that the government closure cases cited by Zurich are distinguishable. Plaintiffs argue that Diesel Barbershop, LLC v. State Farm Lloyds, No. 5:20 CV 461-DAE, 2020 U.S. Dist. LEXIS 147276 (W.D. Tex. Aug. 13, 2020) and Sandy Point Dental, PC v. Cincinnati Ins., Co., 2020 U.S. Dist. LEXIS 171979 (N.D. Ill. Sept. 21, 2020) involved policies that only covered “accidental direct physical loss to” or “direct physical loss to property.” Plaintiffs argue that here, the Policy language covering “direct physical loss of or damage to property” is more expansive and must be interpreted differently.
Plaintiffs also argue that 10e v. Travelers Indem. Co., 2:20 CV 04418-SVW-AS, 2020 U.S. Dist. LEXIS 165252 (C.D. Cal. Sept. 2, 2020) and Pappy‘s Barber Shops, Inc. v. Farmers Grp., Inc., No.: 20-CV 907-CAB-BLM, 2020 U.S. Dist. LEXIS 166808 (S.D. Cal. Sept. 11, 2020) are inapposite. In those cases, the courts imposed a “permanent dispossession”
Plaintiffs argue that the Microorganism exclusion does not apply because COVID-19 was not the underlying cause of Plaintiffs’ loss. Plaintiffs acknowledge that the government closure orders were issued in response to COVID-19, but argue that they were not actually caused by COVID-19. They argue that the Anti-Concurrent causation language does not exclude coverage because Zurich‘s interpretation of that clause would expand the Microorganism exclusion far beyond anything the parties could have reasonably intended or understood.
Finally, Plaintiffs concede that, if the Court finds that Zurich properly denied coverage, Plaintiffs’ bad faith claim should be summarily dismissed. However, if the Court finds that there is coverage, Plaintiffs request that they be given more time to conduct discovery and refile their motion for summary judgment on the bad faith claim.
Zurich filed a reply on December 18, 2020.
Zurich continues to argue that Plaintiffs cannot avoid the plain language of the Microorganism exclusion. Zurich argues that the Policy clearly excludes coverage for damages caused directly or indirectly by viruses and that there is no need for the Court to consider the dictionary definitions of microorganisms. Zurich argues that Plaintiffs’ losses were caused by COVID-19 and that the governmental orders were issued in direct response to the virus. Zurich also continues to argue that it should not be estopped from arguing that the Microorganism exclusion applies.
B. Plaintiffs’ Motion for Summary Judgment
Plaintiffs filed a cross-motion for summary judgment on October 30, 2020.
We will pay for the actual loss of “business income” you sustain due to the necessary “suspension” of your “operations” during the “period of restoration“. The “suspension” must be caused by direct physical loss of or damage to property at a “premises” at which a Limit of Insurance is shown on the Declarations for Business Income. The loss or damage must be directly caused by a “Covered cause of loss“.
In accordance with this language, Plaintiffs argue that they are entitled to coverage if they show that 1) they necessarily suspended their operations; 2) they suffered a loss of business income due to the suspension of their operations; 3) the suspension was caused by a direct physical loss of or damage to property a premises, and 4) the loss or damage was directly caused by a covered cause of loss.
Zurich filed a response in opposition to Plaintiffs’ motion for summary judgment on December 4, 2020.
As already argued in its motion for summary judgment, Zurich argues here that there is a growing consensus of cases around the country that have held that the business interruptions
Zurich argues again that the Microorganism exclusion bars coverage and that the governmental orders were issued in response to the SARS-CoV2 virus and COVID-19 disease. Zurich argues that the Microorganism exclusion applies to all loss “directly or indirectly caused by, contributed to, or aggravated by the ... spread, or any activity of ‘microorganisms.‘” Zurich argues that it should not be estopped from arguing that the microorganism exclusion applies because Ohio has not recognized the doctrine of regulatory estoppel and, even if it had, it would be inapplicable here.
Zurich argues that the loss of use exclusion also bars coverage. Zurich argues that its interpretation of this exclusion is not non-sensical (as argued by Plaintiffs) because it does not bar coverage when there is physical damage – which Zurich argues is necessary for coverage.
Plaintiffs also distinguish the Total Intermodal Servs. v. Travelers Prop. Cas. Co. of Am., 17-cv-04908, 2018 U.S. Dist. LEXIS 216917 (C.D. Cal. July 11, 2018) case cited by Zurich in support of its argument that physical loss of the premises requires permanent dispossession. The Total Intermodal court acknowledged that the same phrase in a different kind of insurance contract could mean something else. Plaintiffs also point out that, unlike Zurich‘s Policy, Travelers’ policy provided coverage for “sums [the insured became] legally obligated to pay as damages as a Motor Carrier, Warehouseman, Freight Forwarder, Logistics Service Provider or Other Bailee for direct physical loss of or damаge to covered property.” Id., at *3-4.
Plaintiffs also contend that the “Period of Restoration” definition does not redefine the business income coverage. Plaintiffs argue that, under the unambiguous language of the Policy, the “Period of Restoration” began on the dates the relevant government orders went into effect and ended or will end on the dates the in-person dining restrictions were/are fully lifted.
Plaintiffs continue to argue that Zurich should be estopped from arguing that the Microorganism exclusion applies based on Zurich‘s past representations to the Ohio Department
C. Zurich‘s Supplemental Authority
On December 23, 2020, Zurich filed supplemental authority in support of its motion for summary judgment. The supplemental authority is a Memorandum of Opinion and Order granting an insurer‘s motion to dismiss in Santo‘s Italian Café LLC dba Santosuossos Pizza Pasta Vino v. Acuity Insurance Company, No. 1:20 cv 00192 (N.D. Ohio Dec. 21, 2020). This supplemental authority embraces some of Zurich‘s аrguments. Specifically, the Santo‘s court, relying on Mastellone and Universal Image Prods., Inc., found that plaintiff failed to plead a threshold claim of ‘direct physical loss of or damage to’ its premises and that the government orders did not constitute a “physical intrusion on Santo‘s property.” The Santo‘s court also accepted the insurer‘s interpretation of the period of restoration term and decided that coverage was excluded under the insurer‘s policy‘s virus exclusion, as argued by Zurich in the instant case.
On December 31, 2020, Plaintiffs filed a response to Zurich‘s notice of supplemental authority.
A. Standard of Review
Summary judgment will be granted if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that “there is no genuine disputе as to any material fact and the movant is entitled to a judgment as a matter of law.”
B. Ohio Law Interpretation of Insurance Contracts
A federal court sitting in diversity applies the substantive law of the state in which it sits. Hayes v. Equitable Energy Res. Co., 266 F.3d 560, 566 (6th Cir. 2001). Because this Court is located in Ohio, it must apply Ohio law to the Zurich policy.4 Courts generally apply contract law when interpreting insurance policies. St. Mary‘s Foundry Inc. v Emp‘rs Ins. of Wausau, 332 F.3d 989. Determining whether language in an insurance policy is ambiguous is a matter of law decided by the Court. Potti v. Duramed Pharm., 938 F.2d 641, 647.
A court must “look to the plain and ordinary meaning of the language used in the policy unless another meaning is clearly apparent from the contents of the policy.” Westfield Ins. Co. v.
1. Ambiguity
The parties agree that Ohio law applies and that the Court must determine whether the Policy‘s language is ambiguous. Thus, the Court must first decide whether the Policy language is reasоnably susceptible of more than one interpretation. As explained below, it is.
Zurich‘s Policy provides that it will pay for “direct physical loss of or damage to ‘real property‘...”
Zurich does not focus on the language in the Policy. Instead, it argues that this Court must apply Ohio law interpreting the Policy language. But Zurich has not cited any Ohio cases interpreting the same language and applying it to real property. Zurich primarily relies on the Ohio Court of Appeals’ decision in Mastellone v. Lightning Rod Mut. Ins. Co., 175 Ohio App.3d 23. The Mastellone case involved a claim submitted on a residential homeowners’ policy, which did not provide business income coverage. The Mastellone policy provided coverage for direct loss to property “only if that loss is a physical loss to property,” and it excluded coverage for loss caused by “smog, rust or other corrosion, mold, wet or dry rot.” Id. at ¶ 60. Because the policy did not define “physical loss to property” the court found that coverage required a “physical
Zurich urges this Court to apply the Mastellone definition of “physical loss to” or “physical injury” to its policy and deny coverage on that basis. But the policy in Mastellone did not cover “direct physical loss of or damage to” the premises; it expressly specified that it would cover loss “only if that loss [was] physical loss to property.” Here, Zurich‘s policy does not expressly limit coverage to physical loss to property; it extends coverage to direct physical loss of property as well. There is no reason to believe that the Ohio Court of Appeals would have interpreted the Zurich Policy language as it did the homeowners’ policy in Mastellone. The distinct Policies used different language and were applied to different facts. Thus, the Mastellone decision offers little guidance in interpreting Zurich‘s Policy.
Zurich also cites Universal Image Prods., Inc. v. Fed. Ins. Co., 475 F. App‘x 569, 573 (6th Cir. 2012) for the proposition that Ohio law requires “tangible, physical losses,” not mere “economic losses.”
Like the Mastellone decision, the Universal Image decision did not interpret the same policy language as in the Zurich policy. Moreover, the Sixth Circuit‘s reference to Mastellone was only dicta and was directly related to mold contamination to a property. Consequently, the Universal Image decision provides very little guidance to the Court when interpreting Zurich‘s policy language.
Zurich also cites Schmidt v. Travelers Indemnity Co. of America, 101 F. Supp.3d 768, 781 (S.D. Ohio 2015) in which the court held that the alleged loss was not covered because there was no “‘direct physical loss of or damage to’ the cashier‘s checks because they were not physically lost or damaged, unlike [such as being] destroyed and lost in a fire.”
Unlike the other two Ohio cases cited by Zurich, the policy language in Schmidt is similar to Zurich‘s policy in that it provides coverage for “direct physical loss of or damage to” property. However, in Schmidt the insured sought coverage for a loss of personal property (cashier‘s checks), and the checks had not been lost or damaged. They were fraudulent. Thus, in Schmidt the interpretation and application of the policy language wаs relatively straight-forward. The court granted summary judgment because there had been no physical loss of or damage to the cashier‘s checks. The insured in Schmidt did not show that the policy language (as applied to the cashier‘s checks) was susceptible of more than one interpretation. But the application of the language “loss of” to personal property is different than it is to real property. Here, Plaintiffs
Zurich contends that the state orders did not preclude Plaintiffs from using their property, because they were still permitted to use them for take out orders. However, Zurich has not disputed that prior to the states’ orders, Plaintiffs’ properties were used almost exclusively for in person dining. Saccone Decl., ¶ 4, ECF Doc. 15-1 at 2. Nor has Zurich asserted any facts showing that Plaintiffs would have been able to realistically transition their businesses to take-out restaurants or that they could have still used their properties (which were mostly used for dine-in custоmers) for take-out orders.
Zurich also argues that there is no coverage under the Policy because Plaintiffs did not permanently lose their properties. Zurich cites a case interpreting similar policy language and holding that coverage required a “permanent” loss, Real Hosp., LLC v. Travelers Cas. Ins. Co. of Am., Case No. 2:20 cv 00087-KS-MTP, 496 F. Supp. 3d 987, 2020 U.S. Dist. LEXIS 208599 (S.D. Miss. Nov. 4, 2020). The Real Hospitality court, applying Mississippi law (similar to Ohio‘s), rejected the plaintiffs argument that the “loss of” their property due to a closure in response to governmental orders was covered under the Travelers policy because the loss had not involved a “permanent dispossession” of real property. In requiring a permanent loss, the court stated that it was following the insurer‘s logical approach to the phrase “loss of,” and it cited Total Intermodal Servs. v. Travelers Prop. Cas. Co. of Am., Case No. CV 17-4908, 2018 U.S. Dist. LEXIS 216917, another case examining the language “direct physical loss of or damage to Covered Property.”
But in Total Intermodal, the court rejected the insurer‘s argument that “loss of” and “damage to” were interchangeable phrases. Rather, the court held that each phrase must be
Moreover, by accepting the “logical” approach of the insurer‘s interpretation of “loss of” as a “permanent dispossession,” the Real Hospitality court construed Travelers’ policy language - language chosen by Travelers – in Travelers’ favor. As shown below, the standard definitions of the word “loss,” a word not otherwise defined by Zurich‘s policy, is not limited to “permanent dispossession.” The word lost does not always involve permanency, and real property can be lost and later returned or restored. If a term is not defined in the policy, the Court must look to the plain meaning of the words, not persuasive authority from other courts. Zurich‘s Policy did not require a permanent “loss of” property and permanency is not embodied in the definition of loss. Adding this requirement would only be interpreting an ambiguous term in favor of the insurer – something Ohio law does not permit.
Zurich correctly argues that the Court must apply Ohio law to the interpretation of its Policy. Ohio law provides that if a policy is reasonably susceptible of more than one interpretation, it must be construed strictly against the insurer and in favor of the insured. See, King v. Nationwide Ins. Co., 35 Ohio St. 3d 208. Here, because Zurich‘s Policy is susceptible
2. Coverage6
Zurich‘s policy provides business income coverage for:
The actual loss of “business income” you sustain due to the necessary “suspension” of your “operations” during the “period of restoration”. The “suspension” must be caused by direct physical loss of or damage to property аt a “premises” at which a Limit of Insurance is shown on the Declarations for Business Income. The loss or damage must be directly caused by a “covered cause of loss.”
ECF Doc. 12-1 at 168.
Plaintiffs have shown that there was a suspension of their operations. The Policy defines “suspension” as “[t]he slowdown or cessation of your business activities.” ECF Doc. 12-1 at 101. It defines “operations” as “[y]our business activities occurring at the covered location prior to the physical loss or damage;” and “[t]he location is tenantable prior to the physical loss or damage.” The parties stipulated that the Plaintiffs closed their premises on various dates in response to the states’ orders. ECF Doc. 12 at 6-7. Thus, Plaintiffs have shown that there was a necessary “suspension” or “slowdown or cessation” of their business activities.
Plaintiffs have shown that there was a loss of business income due to the suspension of their operations. The Policy defines “business income” as “Net income“; plus “Continuing expenses.” ECF Doc. 12-1 at 84. “Net income” means “the net profit or loss, including rental
- Your continuing normal operating expenses including, but not limited to:
- Payroll;
- Rental payments as tenants; and
- Factory overhead, and
* * *
Plaintiffs have submitted the declaration of Joseph Saccone stating that Plaintiffs have suffered significant financial losses as a result of the government closures. ECF Doc. 15-1 at 1. And Zurich does not deny that Plaintiffs have suffered a loss of business income.
Plaintiffs argue that, because the Policy does not define “physical,” “loss,” “damage,” or “property,” the Court should consider Webster‘s Dictionary to define these terms:
Definition of physical7
2 a : having material existence : perceptible especially through the senses and subject to the laws of nature everything physical is measurable by weight, motion, and resistance— Thomas De Quincey
b : of or relating to material things
Definition of loss8
1 : DESTRUCTION, RUIN // to save the world from utter loss— John Milton
2 a : the act of losing possession : DEPRIVATION //loss of sight
Definition of damage9
1 : loss or harm resulting from injury to person, property, or reputation
2 damages plural : compensation in money imposed by law for loss or injury // The judge awarded them $5,000 in damages.
Definition of property10
* * *
2 a : something owned or possessed specifically : a piece of real estate
b : the exсlusive right to possess, enjoy, and dispose of a thing : ownership
c : something to which a person or business has a legal title
After considering the ordinary definitions of the undefined words in the Policy, the Court finds that the Plaintiffs have shown that their business operations were suspended by direct physical loss of or damage to property at the premises.
Plaintiffs have also shown, applying a plain reading of the definition of “period of restoration,” that the period ended or will end on the dates the states’ restrictions are lifted because that will constitute the “date when the location where the loss or damage occurred could have been physically capable of resuming the level of ‘operations’ which existed prior to the loss or damage.” ECF Doc. 12-1 at 94. Plaintiffs are now permitted, in some capacity, to operate their restaurants in Ohio, Indiana, Michigan, Pennsylvania, and Florida with in-person dining. ECF Doc. 15-1 at ¶ 7.
Finally, Plaintiffs have shown that the loss or damage was caused by a “covered cause of loss.” The Policy defines “covered cause of loss” as a “fortuitous cause or event, not otherwise excluded, which actually occurs during this policy period.” Webster‘s dictionary defines “fortuitous” as “occurring by chance.”11 Plaintiffs have shown that the state orders leading to the restaurants’ closings were caused by a fortuitous event. As argued by Plaintiffs, no one could
D. Exclusions
1. Microorganism Exclusion
Zurich argues that the Policy‘s Microorganism exclusion applies to exclude coverage in this case. The Policy‘s Microorganism exclusion states:
12. Microorganisms
We will not pay for loss or damage consisting of, directly оr indirectly caused by, contributed to, or aggravated by the presence, growth, proliferation, spread, or any activity of “microorganisms“, unless resulting from fire or lightning. Such loss or damage is excluded regardless or any other cause or event, including a “mistake” or “malfunction,” or weather condition, that contributes concurrently or in any sequence to the loss, even if such other cause or event would otherwise be covered.
But if a result of one of the excluded causes of loss is a “specified cause of loss”, other than fire or lightning, we will pay that portion of the loss or damage which was solely caused by that “specified cause of loss”.
We will also not pay for loss, cost, or expense arising out of any request, demand, order, or statutory or regulatory requirement that requires any insured or others to test for, monitor, clean up, remove, treat, detoxify, or neutralize, or in any way respond to, or assess the effects of “microorganisms”.
ECF Doc. 12-1 at 106.
Zurich argues that COVID-19 “indirectly” caused Plaintiffs to close their restaurants. But this is not entirely accurate. There was “no known or presumed infected person(s) with COVID-19 at any of the Insured Premises at any time from March 15, 2020 to April 27, 2020.” ECF Doc. 12 at 7, ¶ 47. Thus, it was clearly the government‘s orders that caused the closures. Ironically, Zurich later argues in its motion for summary judgment that the government orders “responded to a public health crisis,” and were not related to any damage at the Plaintiffs’ properties. ECF Doc. 14 at 16. This argument seems to undermine the purpose of the Microorganism exclusion which was plainly to exclude coverage for damage caused by microorganisms at the Plaintiffs’ properties.
The insurer, being the оne who selects the language in the contract, must be specific in its use; an exclusion from liability must be clear and exact in order to be given effect. Lane v. Grange Mut. Cos., 45 Ohio St. 3d 65, citing American Financial Corp. v. Fireman‘s Fund Ins. Co., 15 Ohio St. 2d 171, 239 N.E.2d 33 (1968). Here, Plaintiffs’ argument prevails because the Microorganism exclusion does not clearly exclude loss of property caused by a government closure. Plaintiffs’ restaurants were not closed because there was an outbreak of COVID-19 at
Going forward, Zurich could undoubtedly include an exclusion for government closures in its policies. But the Policy that Plaintiffs purchased did not contain such an exclusion. Thus, it would be contrary to Ohio‘s laws of contract interpretation to apply the Microorganism Exclusion to the unprecedented government closures that occurred in 2020, particularly when the parties have stipulated that their premises were not closed as the result of known or confirmed presence of COVID-19 at any of the premises. ECF Doc. 12 at 7, ¶ 47. This is the conclusion that must be reached under Ohio law because the Policy‘s language did not clearly identify the unusual and unforeseeable events that led to the closings of Plaintiffs’ properties. Nor could Plaintiffs have been aware of such an exclusion when they purchased a policy and paid premiums to Zurich for coverage.
This interpretation is further supported by the fact that, in 2006, when insurers sought approval from the Ohio Department of Insurance for the Microorganisms exclusion, they explained that, despite the broad language of the exclusion, they were seeking to avoid coverage for “viral and bacterial contamination” of properties. Zurich argues that Ohio law has not recognized the doctrine of regulatory estoppel. ECF Doc. 16 at 12. That may be. But, at the least, the 2006 representations to the Ohio Department of Insurers show the insurers’ intent in adding the Microorganisms exclusion to their policies. They were attempting to exclude coverage for property damage caused by the contamination of viruses and bacteria on the
Zurich argues that the anti-concurrent causation language in the Microorganism exclusion further supports its position. Zurich cites the Microorganism exclusion‘s language stating that “regardless of any other cause or event . . . that contributes concurrently or in any sequence to the loss, even if such other cause or event would otherwise be covered.” But this argument is dependent on a finding that Microorganisms caused, at least in part, damage to Plaintiffs’ property. Such a finding would be contrary to the parties’ stipulation that none of Plaintiffs’ restaurants “were closed as the result of the known or confirmed presence of SARS-CoV-2 or COVID 19 at any of the Insured Premises.” ECF Doc. 12, ¶ 44. Similarly, Boughan v. Nationwide Property & Cas. Co., No. 1-04-57, 2005-Ohio-244, 2005 Ohio App. LEXIS 179 at *10 (3rd Dist.), the Ohio case cited by Zurich stating that “Ohio courts look to the underlying cause of loss” is inapposite because the Boughan decision was based on the recognized application of the policy‘s exclusion to the insureds’ damages – settling floors and rotting floorboards. The anti-concurrent language of the exclusion does not apply here because it cannot be said that one of the causes of loss was contamination of COVID-19 on the Plaintiffs’ premises, a fact to which Zurich has stipulated.
Under Ohio law, the Court must attempt to construe an exclusion, not in conformity with “what the insurer now says it intended the words to mean,” but “in conformity with the intention of the parties as gathered from the ordinary and commonly understood meaning of the language employed.” Bluemile, Inc., Atlas Indus. Contrs, Ltd., Nos. 16AP-789, 16AP-791, ¶ 24, 2017-Ohio-9196, 102 N.E.3d 579 (10th Dist.). Here, we know that insurers included the Microorganism exclusion in their polices to exclude coverage for damage to properties caused by
2. Loss of Use Exclusion.
In their motion for summary judgment, Plaintiffs anticipated that Zurich would argue that that the “Loss of Market or Delay” exclusion will exclude coverage in this case. Zurich did not actually argue this exclusion in its motion, but in subsequent filings it takes up this argument. See ECF Doc. 16 at 14. The “Loss of Market or Delay” exclusion provides:
We will not pay for loss or damage caused by or resulting from loss of market, loss of use, or delay. This exclusion applies even if one of these excluded causes of loss was caused by or resulted from a “mistake” or “malfunction.”
ECF Doc. 12-1 at 106. Plaintiffs argue that this exclusion does not apply because, if it did, it would void business income coverage in its entirety. Plaintiff cites case law (later vacated by agreement of the parties) finding a similar exclusion inapplicable because it would have vitiated the policy‘s business income сoverage. Oregon Shakespeare Festival Ass‘n, v. Great Am. Ins. Co., Case No. 1:15 cv 1932-CL, 2016 U.S. Dist. LEXIS 74450 at *15 (D. Or. June 7, 2016).
Zurich argues that this provision would not bar coverage when there is physical damage caused by a covered peril, such as a fire, that closes a restaurant while it is being repaired. ECF Doc. 16 at 14. But that is not at all clear from a plain reading of the Loss of Market or Delay exclusion. In fact, this exclusion could be argued to exclude coverage if an insured lost the use of property. The Business Income Coverage provides that Zurich will pay for “loss of business income” sustained “due to the necessary suspension of operations caused by direct physical loss of or damage to property“. Here, the Loss of Use exclusion would vitiate the Loss of Business
E. Bad Faith
Count II of Plaintiffs’ complaint is a bad faith claim based on Zurich‘s denial of coverage. It is well established that an allegation of bad faith made against an insurer for its handling a claim for coverage will survive only if the record shows that there were no circumstances in the case which could be viewed as creating a reasonable justification for that carrier‘s actions. See Zoppo v. Homestead Ins. Co., 71 Ohio St. 3d 552, 644 N.E.2d 397 (1994). Plaintiffs have requested additional time to conduct discovery on the issue of bad faith. However, no amount of discovery would change the fact that Zurich had a reasonable justification for determining that there was no coverage under its Policy.
Although this Court disagrees with the holding in Zurich‘s supplemental authority, it does illustrate that Zurich had a reasonable justification for denying coverage. Other courts have agreed with the arguments asserted by Zurich and found in favor of insurers. Zurich denied coverage based on its own interpretation of the Policy. Because the Policy was susceptible to more than one interpretation, it must be construed in favor of Plaintiffs as this Court has done in accordance with Ohio law. However, given the “growing consensus of courts” that have rejected
IV. Conclusion
Based on the foregoing, the Court GRANTS, in part and DENIES, in part, Plaintiffs’ (ECF Doc. 15) and Defendant‘s (ECF Doc. 14) Motions for Summary Judgment. The Court GRANTS summary judgment to Plaintiffs on the insurance coverage issue alleged in Counts I and III of their complaint and DENIES summary judgment on Plaintiffs’ bad faith claim in Count II. Conversely, the Court DENIES summary judgment to Defendant Zurich on Counts I and III of Plaintiffs’ complaint and GRANTS summary judgment on Plaintiffs’ bad faith claims.
The Court‘s order on Counts II and III is final and appealable. The Court‘s order on Plaintiffs’ Count I - breach of contract claim is not final and appealable because damages have not yet been determined. The Court and parties agreed to accelerate the legal issues in this litigation before conducting discovery on damages. Because Count I involves a controlling question of law as to which there is substantial ground for difference of opinion and because an immediate appeal from this order may materially advance the ultimate termination of the litigation, I hereby certify the legal issue in Count I for interlocutory appeal pursuant to
IT IS SO ORDERED.
/s/ Dan Aaron Polster
Dan Aaron Polster
United States District Judge