Fla. Dentist's Bid For COVID-19 Loss Coverage Axed

By Daphne Zhang
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Law360 (September 3, 2020, 4:10 PM EDT) -- A Florida federal judge handed a win to Allied Insurance Co. of America, freeing the insurer from having to pay for a dental clinic's claimed COVID-19 related losses, holding that the policy's virus exclusion clearly bars coverage.

U.S. District Judge John L. Badalamenti tossed Mauricio Martinez, DMD, P.A.'s suit seeking coverage for losses stemming from state-mandated closures because of COVID-19 Tuesday, holding that the dental practice's alleged losses are not covered by the policy, which expressly excludes damages caused by a virus.

"Martinez's damages resulted from COVID-19, which is clearly a virus, neither the Governor's executive order narrowing dental services to only emergency procedures nor the disinfection of the dental office of the virus is a 'covered cause of loss" under the plain language of the policy's exclusion," the judge wrote in the order.

The Cape Coral, Florida, dental practice, doing business as Gulf Coast Smiles, has argued that the business income and civil authority provisions of the Allied policy cover the clinic's revenue loss from government closure orders, which limited dental services to emergency procedures during the pandemic.

The clinic alleged that Allied breached the insurance contract by denying coverage in April, contending that it also suffered extra cost from cleaning and decontaminating its covered property during the pandemic.

In Tuesday's order, Judge Badalamenti shot down the dentist's allegations, stressing that "the loss or damage asserted was not due to a 'covered cause of loss,'" adding that the policy precludes any "insurer liability for loss or damage caused 'directly or indirectly' by any virus."

The judge dismissed the dentist's breach of contract claim and its request for declaratory relief, holding that in order for the insurer to provide coverage, losses from business suspension must be caused by direct physical loss or damage, yet the dentist failed to demonstrate that as required by the policy.

Counsel for the parties did not immediately reply to requests for comment.

The dental office is represented by Carlos J. Cavenago, III of Parvey & Frankel Attorneys, PA.

Allied insurance is represented by Thomas A. Keller od Butler Weihmuller Katz Craig LLP

The case is Mauricio Martinez, DMD, P.A. v. Allied Insurance Company of America, case number 2:20-cv-00401, in the U.S. District Court for the Middle District of Florida

--Editing by Amy Rowe.

For a reprint of this article, please contact reprints@law360.com.

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Case Information

Case Title

Mauricio Martinez, DMD, P.A. v. Allied Insurance Company of America


Case Number

2:20-cv-00401

Court

Florida Middle

Nature of Suit

Insurance

Judge

John L. Badalamenti

Date Filed

June 04, 2020

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