RICHARD KAHN and AARK ENTERPRISE LLC d/b/a MAULDIN‘S, individually and on behalf of all others similarly situated v. PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY
1:20-cv-781
IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
February 8, 2021
Hon. John E. Jones III
MEMORANDUM
February 8, 2021
This case arises from the economic havoc wrought by the COVID-19 pandemic. Plaintiffs operated a restaurant that, like far too many businesses across the country, had no choice but to close its doors soon after the virus reached the United States last spring. Plaintiffs submitted a claim to their insurance company, hoping that their business losses would be covered in their all-risk policy. Unfortunately for Plaintiffs, their insurance company rejected their claim. Like thousands of similarly situated business owners, Plaintiffs challenged that denial in
I. BACKGROUND
A. Factual Allegations and Procedural History
In accordance with the standard of review applicable to a motion to dismiss, the following facts are derived from Plaintiffs’ Amended Complaint, (Doc. 22), and viewed in the light most favorable to them.
Plaintiffs formerly owned and operated a restaurant named “Mauldin‘s,” named for the South Carolina town in which it was located. (Doc. 22 at ¶¶ 2, 10). In September 2019, Plaintiffs obtained an “all-risk” commercial insurance policy (the “Policy“) from Defendant Pennsylvania National Mutual Casualty Insurance Company (“Penn Mutual” or “Defendant“), which is headquartered in Harrisburg, PA. (Id. at ¶¶ 12-13, 15). An “all-risk” insurance policy covers all risks of loss unless expressly excluded. (Id. at ¶ 15). Plaintiffs’ Policy was intended to provide a full year of coverage, to expire on September 19, 2020. (Id. at ¶ 13). Six months later, however, the COVID-19 crisis spread to the United States.
South Carolina officials reported the first instances of COVID-19 in the state on March 6, 2020. (Id. at ¶ 23). The following week, on March 13, Governor McMaster declared a state of emergency and closed schools in two counties. (Id. at ¶ 24). On March 14, the South Carolina Department of Health recommended that symptomatic individuals avoid public gatherings and stay home from work and school. (Id.). By March 20, Governor McMaster had closed schools, “urged” citizens to cancel, postpone, or reschedule public gatherings, and encouraged social distancing. (Id. at ¶ 25). One week later, on March 27, Greenville County (where Mauldin‘s is located) reported the first death сonnected to COVID-19, and a Department of Heath physician advised the public to stay home and avoid non-essential public interactions. (Id. at ¶ 26). On April 6, Governor McMaster issued
Because South Carolina residents were advised to stay home, Mauldin‘s suffered a significant loss of business. (Id. at ¶ 29). By late March, Plaintiffs “were forced” to close the restaurant. (Id.). Hoping that their loss of business income would be covered by the Policy, Plaintiffs submitted a claim to Defendant. (Id.). On March 31, 2020, Defendant denied the claim. (Id.).
Plaintiffs initiated this putative class action on May 12, 2020. (Doc. 1). Defendant filed a motion to dismiss on June 19. (Doc. 7). On June 25, Plaintiffs moved for a stay of proceedings pending resolution by the Judicial Panel on Multidistrict Litigation (“JPML“) of their motion to transfer the action, along with hundreds of other related cases, to centralized pretrial proceedings pursuant to
On August 14, Defendant advised the Court that the JPML denied transfer to a centralized proceeding. (Doc. 27). Accordingly, Defendant re-filed its Motion to Dismiss (the “Motion“) on September 2, (Doc. 31), with a brief in support on September 8, (Doc. 34). Plaintiffs filed their brief in opposition to the Motion on September 30, (Doc. 42), to which Defendant replied on October 14, (Doc. 14). The Motion is therefore ripe for review.
B. The Insurance Policy
The Policy contains several provisions relevant to the motion sub judice.3 First, the Policy‘s “Business Income” coverage provision states:
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 premises which are described in the Declarations and for which a Business Income Limit of Insurance is shown in the Declarations. The loss of damage must be caused by or result from a Covered Cause of Loss. . . .
(Doc. 31-1 at 56). Defendant also agreed to pay for certain “Extra Expense[s]“—“necessary expenses [Plaintiffs] incur during the ‘period of restoration’ that
(1) The date when the property at the described premises should be repaired, rebuilt or replaced with reasonable speed and similar quality; or
(2) The date when business is resumed at a new permanent location.
(Id. at 63).
The Policy also provides coverage under a “Civil Authority” provision, which states:
We will pay for the actual loss of Business Income you sustain and necessary Extra Expense causеd by action of civil authority that prohibits access to the described premises due to direct physical loss of or damage to property, other than at the described premises, caused by or resulting from any Covered Cause of Loss
(Id. at 57).
Under both the “Business Income” and “Civil Authority” provisions, the “Covered Causes of Loss” are defined as “Risks of Direct Physical Loss unless the loss is” explicitly excluded or limited in the Policy. (Id. at 67). One of those
A. The exclusion set forth in Paragraph B. applies to all coverage under all forms and endorsements that comprise this Coverage Part, including but not limited to forms or endorsements that cover property damage to buildings or personal property and forms or endorsements that cover business income, extra expense or action of civil authority.
B. We will not pay for loss or damage caused by or resulting from any virus, bacterium or other microorganism that induces or is capable of inducing physical distress, illness or disease.
(Id. at 89).
II. STANDARD OF REVIEW
In considering a motion to dismiss pursuant to
A
Under the two-pronged approach articulated in Twombly and later formalized in Iqbal, a district court must first identify all factual allegations that constitute nothing more than “legal conclusions” or “naked assertions.” Twombly, 550 U.S. at 555, 557. Such allegations are “not entitled to the assumption of truth” and must be disregarded for purposes of resolving а
However, “a complaint may not be dismissed merely because it appears unlikely that the plaintiff can prove those facts or will ultimately prevail on the merits.” Phillips, 515 F.3d at 231 (citing Twombly, 550 U.S. at 556–57).
III. DISCUSSION
Under Pennsylvania law,4 courts interpreting insurance policies “are guided by the polestar principle that insurance policies are contracts between an insurer
Here, the legal sufficiency of all three of Plaintiffs’ claims depends on whether Defendant‘s denial of coverage pursuant to the Policy was reasonable.5 Defendant asserts that coverage was properly denied for two main reasons. First, Defendant argues that Plaintiffs’ allegations are insufficient to bring their claim within the Policy‘s coverage grant for “direct physical loss of or damage to property,” as is required. Because Plaintiffs did not plead any “physical loss of or damage to” their prоperty, the claim was appropriately denied. Defendant argues
Upon careful review of the Policy, the parties’ well-briefed arguments, and the numerous decisions our colleagues within the Third Circuit have issued concerning these exact issues, we find that Defendant did indeed properly deny coverage and that Plaintiffs’ Amended Complaint must therefore be dismissed.
i. Business Income
Defendant agreed in the Policy‘s Business Income coverage provision to pay Plaintiffs for the loss of income sustained by the business due to any “necessary ‘suspension’ of [] operations.” (Doc. 31-1 at 56). The Policy explicitly states that only losses incurred “during the ‘period of restoration‘” would be covered, and that the suspension of business operations must have been “caused by direct physical loss of or damage to property.” (Id.). Plaintiffs argue that because the Policy does not define “direct physical loss,” the provision is ambiguous—and since Plaintiffs’ interpretation of the term (that the loss of the business‘s intended use or function can constitute “physical loss“) is reasonable, the Motion must be denied. (Doc. 42
First, even though “physical loss” is not defined in the Policy, that does not render the term ambiguous. See, e.g., Telecomm. Network Design v. Brethren Mut. Ins. Co., 5 A.3d 331, 336–37 (Pa. Super. Ct. 2010) (“[T]he fact that the term . . . is not defined and can imply several meanings is insufficient to create ambiguity.“). Rather, the term is clear when one considers the ordinary meaning of the words and when read in the context of the policy. See id. The word “physical“—which modifies both “loss” and “damage” in the Business Income provision—means “[o]f, relating to, or involving material things; pertaining to real, tangible objects.” Physical, BLACK‘S LAW DICTIONARY (11th ed. 2019) (emphasis added). As a preeminent insurance treatise has explained, insurance policies that include “physical loss or damage” as a prerequisite for coverage have been “widely held to exclude alleged losses that are intangible or incorporeal and, thereby, to preclude any claim against the property insurer when the insured merely suffers a detrimental economic impact unaccompanied by a distinct, demonstrable, physical alteration of the property.” 10A Couch on Ins. § 148:46 (3d ed. 2020). “When the structure of the property itself is unchanged to the naked eye, however, and the insured alleges that its usefulness for its normal purposes has been destroyed or
This conclusion—that “physical loss” must require some tangible issue with the physical structure of the business‘s premises—is bolstered by reference to surrounding terms in the Policy. As we have explained, the Business Income coverage provision explicitly states that only business losses incurred “during the ‘period of restoration‘” would be covered. (Doc. 31-1 at 56). The Policy explains that this “period of restoration” ends either when the covered premise is “repaired, rebuilt or replaced” or when business operations are “resumed at a new permanent location.” (Id.). This language strongly implies that the Policy was only intended to cover business losses sustained over a period when the property had some physical or structural issue that prevented the business from operating. If we adopt Plaintiffs’ proposed construction—that “physical loss” could include a loss of the business‘s intended function—this language in the definition of “period of restoration,” plus the phrase itself, would be rendered entirely superfluous. We cannot issue an interpretation of a contractual provision that would lead to this result. See Clarke v. MMG Ins. Co., 100 A.3d 271, 276 (Pa. Super. Ct. 2014) (“[Pennsylvania‘s] rules of construction do not permit words in a contract to be treatеd as surplusage . . . if any reasonable meaning consistent with the other parts can be given to it.“) (quoting Tenos v. State Farm Ins. Co., 716 A.2d 626, 631 (Pa. Super. Ct. 1998)). “Indeed,” if we are “forced to choose between two competing interpretations of an insurance policy, we are bound, as a matter of law, to choose the interpretation which allows us to give effect to all of the policy‘s language.” Id. (quoting Millers Cap. Ins. Co. v. Gambone Bros. Dev. Co., 941 A.2d 706, 716 (Pa. Super. Ct. 2007), appeal denied, 963 A.2d 471 (Pa. 2008)); see also Phila. Parking Auth. v. Fed. Ins. Co., 385 F. Supp. 2d 280, 289 (S.D.N.Y. 2005) (applying Pennsylvania law and concluding that the phrase “direct physical loss or damage,” when considered in the context of the insurance policy, “requires that claimed loss or damage must be physical in nature“). Only Defendant‘s construction of the Business Income provision gives effect to all of the Policy‘s pertinent language and terms—Plaintiffs’ does not.
Second, while the Third Circuit has not yet ruled on any COVID-19 insurance disputes, we are guided by relevant, binding precedent regarding what constitutes “direct physical loss of or damage to property” for insurance coverage purposes. In Port Authority of New York and New Jersey v. Affiliated FM Ins. Co., 311 F.3d 226 (3d Cir. 2002), the Third Circuit considered whether buildings afflicted with asbestos sustained any “physical loss or damage” that could be covered by insurance. Looking to the “physical damage” component of the provision, the court noted that “[p]hysical damage to a building as an entity by sources unnoticeable to the naked eye must meet a higher threshold” than damage “from an
The key terms in Port Authority are “building” and “structure.” Plaintiffs here do not allege that the physical structure thаt houses their restaurant was physically unusable—just that the intended purpose of the business (serving food to patrons indoors) could not be executed due to the state‘s guidance to avoid public gatherings. But the Third Circuit in Port Authority clearly distinguished between a building (not a business) that was physically unusable and one that was contaminated but still physically safe to inhabit. There are no facts alleged here to support a conclusion that the building in which Mauldin‘s was located was rendered physically unusable. The business may have suffered economically, but
Finally, we are persuaded by the unanimity among our colleagues on this exact issue. We have yet to identify a decision within the Third Circuit that has reached a result contrary to the one we reach today. See, e.g., Frank Van‘s Auto Tag, LLC v. Selective Ins. Co. of the Se., No. CV 20-2740, 2021 WL 289547, at *6 n.4 (E.D. Pa. Jan. 28, 2021) (“Although the Court takes note of the growing body of case law in COVID-19 business interruption insurance cases, it makes an independent judgment. This is what is required. . . . Here, however, given the language of the Policy at issue, the Court does not disagree with the shared conclusion that loss or damage cannot merely be economic and still be ‘physical.’ That conclusion could conceivably be different if, for example, the policy language
Thоugh there has been a dearth of published Pennsylvania state court rulings on these issues, we have identified one that largely adopted the reasoning of our federal district court colleagues, but no others that addressed the merits of the various coverage arguments.7 See Scranton Club v. Tuscarora Wayne Mut. Group, Inc., No. 2020-02469 at 36 (Pa. Com. Pl. Lackawanna Cnty. Jan. 25, 2021) (“The Scranton Club has not alleged any facts which may arguably satisfy the ‘direct physical loss or damage’ requirement for . . . coverage under the policy. It also has not alleged the requisite repair, restoration, or replacement of its premises during its ‘period of restoration.’ Accordingly, it is clear and free from doubt that the Scranton Club cannot recover under the business income аnd extra expense provisions of the policy, and for that reason, Tuscarora‘s demurrer to those claims
will be sustained.“). We are obligated, of course, to render an independent
While there have been decisions from other federal district courts that support Plaintiffs’ position, we decline to follow the reasoning of these holdings. For instance, Plaintiffs cite to Studio 417, Inc. v. Cincinnati Ins. Co., a decision from the Western District of Missouri that denied the insurer‘s motion to dismiss. 478 F. Supp. 3d 794 (W.D. Mo. 2020). There, however, the plaintiffs had alleged that COVID-19 “particles attached to and dаmaged” its property, while Plaintiffs here do not. See id. at 802 (“Plaintiffs here have plausibly alleged that COVID-19 particles attached to and damaged their property, which made their premises unsafe and unusable. This is enough to survive a motion to dismiss.“); see also Blue Springs Dental Care, LLC v. Owners Ins. Co., No. 20-CV-00383-SRB, 2020 WL 5637963, at *6 (W.D. Mo. Sept. 21, 2020) (“As discussed earlier in this Order, Plaintiffs plausibly allege that COVID-19 had physically occupied and contaminated their dental clinics and thereby deprived them of their use of those clinics by making them unusable.“). Plaintiffs also point to Urogynecology Specialist of Fla. LLC v. Sentinel Ins. Co., Ltd, where a Middle District of Florida court also denied an insurer‘s motion to dismiss. See No. 20-CV-1174, 2020 WL 5939172 (M.D. Fla. Sept. 24, 2020). There, however, the only issue the court
Overall, we conclude that Defendant properly denied coverage under the Business Income coverage provision—the policy unambiguously required “physical loss of or damage to property,” which must mean some physical
ii. Civil Authority
In the Civil Authority coverage provision, Defendant agreed to pay “for the actual loss of Business Income [Plaintiffs] sustain and necessary Extra Expense caused by actiоn of civil authority that prohibits access to the described premises due to direct physical loss of or damage to property, other than at the described premises, caused by or resulting from any Covered Cause of Loss.” (Doc. 31-1 at 57). This provision, like the Business Income coverage provision, expressly requires some nexus to “direct physical loss of or damage to property.” (Id.). Unlike the Business Income provision, however, the Civil Authority provision requires “a covered cause of loss [that damages or causes a physical loss of] another property in the immediate area of the insured property, prompting a civil authority to respond to the covered cause of loss.” ATCM Optical, Inc. v. Twin City Fire Ins. Co., Nо. CV 20-4238, 2021 WL 131282, at * 6 (E.D. Pa. Jan. 14, 2021) (emphasis added). Plaintiffs here do not allege any loss of or damage to another property caused by any “covered cause of loss” that triggered an action of civil authority. Rather, Plaintiffs only allege that South Carolina‘s orders to avoid public spaces “constituted a prohibition of access to Plaintiffs’ business property.” (Doc. 22 at ¶ 62). But a plain reading of the Civil Authority coverage provision
iii. Virus Exclusion
According to Plaintiffs, Defendant‘s denial of their claim for insurance coverage “heavily relied on” the Policy‘s Virus Exclusion, which stated that
Because we concluded that Defendant properly denied coverage under the Business Income and Civil Authority provisions, we need not decide whether coverage would have nonetheless been precluded under the Virus Exclusion. We do observe, however, that “several courts within this Circuit have [] concluded the language of the provision is not only unambiguous, but unambiguously bars coverage for COVID-19-related losses.” Frank Van‘s Auto Tag, LLC, 2021 WL 289547, at *8 (citing Humans & Res., LLC v. Firstline Nat‘l Ins. Co., No. 20-CV-2152, 2021 WL 75775, at *8 (E.D. Pa. Jan. 8, 2021)); see also Toppers Salon & Health Spa, Inc. v. Travelers Prop. Cas. Co. of Am., No. 20-CV-03342, 2020 WL 7024287, at *3 (E.D. Pa. Nov. 30, 2020) (“The language [in the Virus Exclusion] is not ambiguous, and it applies to Covid-19, which is caused by a coronavirus that
Because we conclude that Plaintiffs were ineligible for insurance coverage under the Business Income and Civil Authority coverage provisions in the Policy, even a successful argument that the Virus Exclusion wаs not intended to apply to COVID-19 cannot rescue the Amended Complaint. Defendant properly denied coverage, and so Plaintiffs cannot state a claim upon which relief can be granted.
IV. CONCLUSION
For the foregoing reasons, we shall grant the Motion to Dismiss and dismiss the Amended Complaint. A separate order shall issue in accordance with this ruling.
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