The Final Nails in the Coffin: California Supreme Court Rejects Coverage for COVID-19 Business Interruption Claims

Stephen L. Raucher

In Another Planet Entertainment, LLC v. Vigilant Ins. Co., 15 Cal. 5th 1106 (2024), the California Supreme Court clarified that the actual or potential presence of COVID-19 on an insured’s premises generally does not constitute direct physical loss or damage to property within the meaning of a commercial property insurance policy.

Plaintiff Another Planet, a promoter and venue operator for live entertainment, filed suit against defendant Vigilant Insurance following Vigilant’s denial of coverage for business losses resulting from the COVID-19 pandemic. The district court granted Vigilant’s motion to dismiss, finding Another Planet failed to allege facts showing direct physical loss or damage to property needed to trigger coverage. On appeal, the Ninth Circuit certified to the California Supreme Court the question of whether the actual or potential presence of the COVID-19 virus causes direct physical loss or damage to property.

The Supreme Court invoked the “long-standing California view” that direct physical loss to property requires distinct, demonstrable, physical alteration of property. The Court maintained this physical alteration must result in some injury or impairment of the property itself. As the Court explained, “The physical alteration need not be visible to the naked eye, nor must it be structural, but it must result in some injury to or impairment of the property as property.”

Another Planet argued the COVID-19 virus causes direct physical damage to property by physically altering surfaces on a microscopic level. The Court found Another Planet failed to explain how the property was actually damaged by the presence of the COVID-19 virus. “The mere fact of microscopic bonds between the virus and a surface says little about the effect of such microscopic bonds on that surface.” The Court noted that the “relevant physical characteristics” of the property were unaffected by the presence of the COVID-19 virus.

The Court also found unpersuasive Another Planet’s complaint that the actual or potential presence of COVID-19 virus rendered its property unusable for its intended purpose. To the extent the physical presence of the virus caused the property to become unusable, the Court found Another Planet failed to establish a distinct, demonstrable, physical alteration to the property: “Where a substance is alleged to cause harm to humans, rather than property, it must still alter the property itself in a lasting and persistent manner.”

The Court refrained from deciding whether the COVID-19 virus could ever constitute direct physical loss or damage to property. However, the Court characterized Another Planet’s allegations as “typical of the allegations offered by many insureds in similar situations.”

The California Supreme Court shut off a second avenue to coverage in John’s Grill, Inc., et al., v. The Hartford Financial Services Group, Inc., et al., 2024 Cal. LEXIS 4241. In John’s Grill, the Court upheld the restrictive language of an insurance policy’s limited fungi, bacteria or virus coverage endorsement, reversing the Court of Appeal’s finding that ambiguous language rendered the coverage illusory.

Under specific additional coverage provided by the endorsement, the insurer agreed to pay for loss or damage caused by virus. The policy defined loss or damage as direct physical loss or damage to property, as well as the cost of structural mitigation work to remove a virus and testing for it once the work was done. A separate clause provided the endorsement applied only when the virus resulted from one or more specified causes of loss, including fire, explosion, windstorm, vandalism, and water damage.

Though John’s Grill acknowledged it could not meet the specified cause of loss limitation, it contended the limitation was illusory and unenforceable because the specified causes “are not the kind of things that cause a virus,” rendering the limitation impossible to satisfy. The Court of Appeal agreed, finding the clause did not offer a realistic prospect for virus-related coverage. The California Supreme Court reversed, holding the Court of Appeal erred by declining to enforce the limitation.

Noting that it has never actually recognized an “illusory coverage doctrine as such,” the Supreme Court emphasized that the test for coverage must focus on the “objectively reasonable expectations of coverage.” The Court found that clear and unambiguous policy language defined the factual scenarios in which John’s Grill would have coverage. “A reasonable insured would understand that virus coverage under the Limited Fungi, Bacteria or Virus Coverage endorsement was limited and would be available only if the virus resulted from certain causes.” Based on the policy language, John’s Grill could not show an objectively reasonable expectation for virus-related coverage beyond the policy’s terms.

The Court went on to hold that even John’s Grill’s own articulation of the illusory coverage doctrine was insufficient to justify disregarding the plain language of the policy. The Court found that John’s Grill had not sufficiently alleged that the forces and phenomena identified in the specified cause of loss limitation were incapable of creating conditions fairly said to be a proximate cause of a virus. The fact that John’s Grill’s particular business arrangements made it unlikely to benefit from the limited virus coverage was insufficient to render the promised coverage illusory.

Thus, even where the policy purported to provide some coverage for virus-related losses, the Court found there was none. So ends the search for COVID-19 business interruption coverage in California.

 

Insurance Coverage Issues Arising from Habitability Claims

Stephen L. Raucher

Presented by Stephen L. Raucher | July 25, 2024

On July 25, 2024, Stephen L. Raucher, a seasoned litigator with extensive experience in real estate and insurance coverage, delivered an insightful webinar on Insurance Coverage Issues Arising from Habitability Claims for the Apartment Association of Greater Los Angeles (AAGLA). This presentation is now available on-demand for property owners, managers, and real estate professionals seeking to better understand how to protect themselves from costly habitability claims.

Webinar Highlights:

● Understanding Habitability Claims: What they are and the immediate steps property owners must take when notified of an issue.

● Habitability Exclusions: Clarifying whether these exclusions always prevent coverage, and exploring additional exclusions like mold, vermin, and bedbugs.

● Impact of Exclusions: How various exclusions affect the settlement of claims.

● California Habitability Standards: An overview of unlivable conditions, including lead paint, mold, poor ventilation, gas or sewage leaks, and pest infestations.

● Risk Mitigation: Practical steps property owners can take to minimize their exposure to habitability claims and ensure proper coverage.

Stephen’s in-depth knowledge of habitability issues and insurance coverage makes this a must-watch for anyone involved in property management or real estate.

Watch the full webinar here: Insurance Coverage Issues Arising from Habitability Claims – Apartment News Publications (aptnewsinc.com)

 

Annual Insurance Update: COVID-19 Coverage, New Wrinkles in Bad Faith, and More

On Thursday, April 7, 2022, Stephen L. Raucher  and Michael R. Sohigian will present an MCLE webinar through BHBA entitled “Annual Insurance Update: COVID-19 Coverage, New Wrinkles in Bad Faith, and More” (register in link).  The program will examine the most important cases from 2021 regarding insurance coverage and bad faith, focusing in particular on liability and property policies.

 

Annual Insurance Update: COVID-19 Coverage, New Wrinkles in Bad Faith, and More

On Thursday, April 7, 2022, Stephen L. Raucher  and Michael R. Sohigian presented an MCLE webinar through BHBA entitled “Annual Insurance Update: COVID-19 Coverage, New Wrinkles in Bad Faith, and More“.  The program examined the most important cases from 2021 regarding insurance coverage and bad faith, focusing in particular on liability and property policies.

 

Entitlement to Equitable Subrogation Does Not Transform Legal Claims Against Third Parties into Equitable Claims

Stephen L. Raucher

In Michael Berg et al., v. Pulte Home Corp. (“Berg”), the Third District Court of Appeal analyzed the question of whether an entitlement to equitable subrogation, as opposed to the underlying action itself, determines the right to a jury trial. Berg v. Pulte Home Corp., 67 Cal. App. 5th 277, 282 (2021). Pulte Home Corp. (“Pulte”), a general contractor, was sued by homeowners for allegedly violating building standards, breach of contract, and breach of express warranty. St. Paul Mercury Insurance Company (“St. Paul”) defended Pulte as an additional insured under a general liability policy.

Pulte had an agreement with its subcontractors whereby they each agreed to “indemnify and defend Pulte against all liability and claims, judgments, suits or demands for damages to persons or property arising out of, resulting from, or relating to that subcontractor’s performance of the work under the Agreement and any Contractor Project Agreement”. It was undisputed in Berg that there were alleged damages that resulted from or related to each of the subcontractors’ work for Pulte.

St. Paul thereafter sought reimbursement for the defense of St. Paul from three of these subcontractors through equitable subrogation. This claim rested on the assertion that the subcontractors were in breach of their contract with Pulte. The trial court found that St. Paul had proven all elements of its equitable subrogation claim. Damages were awarded and determined by a jury trial in a second phase.

St. Paul appealed, arguing that there is no right to a jury trial in an equitable subrogation claim because it is a claim in equity. This argument relied on a conclusion reached by the Fourth District Court of Appeal in Pulte Home Corp. v. CBR Electric, Inc., 50 Cal. App. 5th 216 (2020), namely that no jury trial right exists in such an equitable subrogation action. However, the Berg court reasoned that, “an insurer’s entitlement to equitable subrogation does not transform its insured’s legal claims against third parties into equitable ones.”  Therefore, it disagreed with the conclusion reached in CBR Electric.

The Berg Court reasoned that equitable subrogation consists of two phases: entitlement and enforcement. The first phase (entitlement) asks whether the insurer is entitled to equitable subrogation, and the Berg court concluded such an inquiry is appropriately performed by a trial court sitting as a court of equity. In the second phase (enforcement), where the question is whether the insurer prevails against the third parties, the Court reasoned that the right to a jury trial was dependent on the nature of the claim(s). In sum, if the underlying claim is legal, then a jury trial is appropriate. Likewise, if the underlying claim is of an equitable nature, then a court of equity would be the trier of fact. Notably, the Berg Court found support for this two-phase approach in the Supreme Court of California’s decision in Offer v. Superior Court. While that case did not address this exact question, it “distinguish[ed] between the equitable nature of subrogation…and the independent equitable or legal nature of the action to which the insurer asks to be subrogated on the other.” (Citing Offer v. Superior Court, 194 Cal. 114, 123 (1924)).

As noted previously, St. Paul’s claim was based on a breach of contract – a legal claim. Thus, based on the foregoing reasoning, the Court affirmed the decision of the trial court to grant a jury trial.

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