Opinion

Santa Ynez Band of Chumash etc. v. Lexington Ins. Co.

Court
California Court of Appeal
Filed
Apr 27, 2023
Status
Published
Cited by
0 cases
Authority
More cited than 23.2%

The opinion

Filed 4/27/23

CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION SIX

SANTA YNEZ BAND OF 2d Civ. No. B320834

CHUMASH MISSION (Super. Ct. No. 20CV01967)

INDIANS OF THE SANTA (Santa Barbara County)

YNEZ RESERVATION

CALIFORNIA,

Plaintiff and Appellant,

v.

LEXINGTON INSURANCE

COMPANY,

Defendant and Respondent.

Here we interpret an insurance contract that provides

coverage for physical loss or damage to real or personal property.

Experts disagreed whether the property was permanently

damaged or altered by the COVID-19 virus landing on its surface.

We decide this is not a loss as provided in the insurance

contract. Some courts have ruled the phrase “the COVID-19

virus has altered the property” to be sufficient as an allegation of

property damage in cases involving demurrers. In a motion for

summary judgment, however, the plaintiff must show the

alteration is so material that it caused specific economic damage

to the property to make a sufficient property damage insurance

claim.

The Santa Ynez Band of Chumash Mission Indians of the

Santa Ynez Reservation California (Chumash) appeals a

judgment following the granting of a motion for summary

judgment in favor of Lexington Insurance Company (Lexington)

in Chumash’s lawsuit against Lexington for denial of insurance

coverage. We conclude, among other things, that Chumash did

not present sufficient evidence to show that the COVID-19 virus

caused physical property damage to its casino and resort so as to

fall within the property damage coverage provisions of the

Lexington insurance policy. We affirm.

FACTS

The Chumash Casino and Resort (Casino and Resort) is a

large business enterprise of Chumash open to the public. It

consists of a 320-room hotel, a 145,000-square-foot “gaming

floor,” 2,500 video gaming machines, 50 table games, a poker

room, and a bingo room. It includes four restaurants, a 325-seat

buffet, a 125-seat café, a 145-seat food court, and a 125-seat “fine

dining restaurant.” It includes a 1,500-seat “multipurpose

venue” known as “the Samala Showroom.” The Casino and

Resort employs “an average of 1,767 [employees].” It has

recorded an “average 9,012 patrons per day on weekdays, and

11,392 per day on weekends.”

In March 2020, Casino and Resort General Manager Bill

Peters concluded that “the COVID-19 virus was present on and

interacting with surfaces at the casino-resort.” “By March 15,

2020, [Chumash] became aware of employees who were

complaining of symptoms consistent with COVID-19.”

2.

The Chumash business committee, a governing body of

Chumash, promptly ordered the Casino and Resort “closed.” The

official Chumash tribal resolution regarding the closure stated

COVID-19 “is causing physical loss or damage to property on or

near tribal lands, including, without limitation, the Chumash

Casino and Resort.”

The Casino and Resort remained closed through June 10,

2020. Between the closure and reopening, Chumash made

“repairs and upgrades” to its property. These included: 1) the

installation of temperature check machines, 2) plexiglass barriers

at “gaming machines and tables,” and 3) barriers “between tables

in employee break areas.”

The Insurance Policy

Chumash had an insurance policy with Lexington

providing for “ ‘All Risk’ property damage coverage.” The all risk

clause provided: “ ‘Subject to the terms, conditions and

exclusions stated elsewhere herein, this Policy provides insurance

against all risk of direct physical loss or damage occurring during

the period of this Policy.’ ” The policy contained “business

interruption” coverage “[a]gainst loss resulting directly from

interruption of business, services or rental value caused by direct

physical loss or damage, as covered by this Policy to real and/or

personal property insured by this Policy, occurring during the

term of this Policy.” (Italics added.)

The policy contained an “extra expense” provision “to cover

the necessary and reasonable extra expenses occurring during

the term of this Policy at any location as hereinafter defined,

incurred by the Named Insured in order to continue as nearly as

practicable the normal operation of the Named Insured’s business

following damage to or destruction of covered property by a

3.

covered peril which is on premises owned, leased or occupied by

the Named Insured.” (Italics added.)

The policy had an “interruption by civil authority”

provision that provided: “This Policy is extended to include the

actual loss sustained by the Named Insured, as covered

hereunder during the length of time, not exceeding 30 days, when

as a direct result of damage to or destruction of property by a

covered peril(s) occurring at a property located within a 10 mile

radius of the covered property, access to the covered property is

specially prohibited by order of a civil authority.” (Italics added.)

The policy also had a “protection and preservation of

property” provision that provided, in relevant part: “In case of

actual or imminent physical loss or damage of the type insured

against by this Policy, the expenses incurred by the Named

Insured in taking reasonable and necessary actions for the

temporary protection and preservation of property insured

hereunder shall be added to the total physical loss or damage

otherwise recoverable . . . .” (Italics added.)

Duane Dowell, the Chumash director of risk management,

declared, “[T]he Policy does not contain any provision which

purports to exclude coverage for physical loss or damage due to

viruses or pandemics.” He said Lexington first added a

“communicable Diseases” exclusion provision in its next policy on

July 1, 2020.

Denial of the Claim

Chumash made a claim with Lexington for “property

damage to the Chumash Casino and Resort” due to the COVID-

19 virus. It claimed the damage rendered its facilities “unsafe

and unusable.” The claim included the tribal closure order and

“confirmation” that an employee “was infected with COVID-19

4.

prior to closure.” (Boldface and underlining omitted.) Lexington

denied the claim.

Chumash filed an action against Lexington alleging causes

of action for declaratory relief, breach of contract, and breach of

the implied covenant of good faith and fair dealing. Chumash

filed a motion for summary adjudication. Lexington filed a cross

motion for summary judgment claiming Chumash did not qualify

for coverage because the Casino and Resort did not sustain

property damage as a result of the COVID-19 virus.

To show property damage, Chumash relied on declarations

from Lawrence Mayer, M.D., Ph.D., an academic researcher and

professor, and Doctor Ivan Dmochoski, a research scientist and

biochemist. Dmochoski said the “surfaces at the Chumash

Casino and Resort were physically altered” because of the

contamination from the COVID-19 virus. The “affected surfaces

may be permanently altered.” Mayer said it was “a statistical

near-certainty that the virus was present at the Chumash Casino

and Resort on and before March 15, 2020.” (Boldface and

underlining omitted.) He said the virus “physically altered the

surfaces of the property and equipment at the Casino.” (Boldface

and underlining omitted.) As a result of the virus contamination,

Chumash had to make physical alterations to its property to

attempt to reopen it for the public. This included, among other

things, the installation of over 1,000 plexiglass barriers and the

reduction of seats at the casino.

Lexington’s expert Doctor Alexis Sauer-Budge, a

microbiologist, declared the virus cannot damage property

surfaces and may be disinfected using standard disinfection

methods.

5.

The trial court granted summary judgment in favor of

Lexington. It ruled, “As a matter of California law, COVID-19

does not cause ‘direct physical loss or damage’ to property.”

DISCUSSION

Summary Judgment

“Summary judgment provides courts with ‘a mechanism to

cut through the parties’ pleadings in order to determine whether,

despite their allegations, trial is in fact necessary to resolve their

dispute.’ ” (San Jose Neurospine v. Aetna Health of California

(2020) 45 Cal.App.5th 953, 957.) “ ‘ “On appeal, the reviewing

court makes ‘ “an independent assessment of the correctness of

the trial court’s ruling [regarding summary judgment], applying

the same legal standard as the trial court in determining whether

there are any genuine issues of material fact or whether the

moving party is entitled to judgment as a matter of law.” ’ ” ’ ”

(Id. at p. 958) “ ‘Our task is to determine whether a triable issue

of material fact exists.’ ” (Ibid.) “ ‘[A]ny doubts as to the

propriety of granting a summary judgment motion should be

resolved in favor of the party opposing the motion.’ ” (Ibid.)

Triable Issues of Fact

“[T]he threshold requirement for recovery under a contract

of property insurance is that the insured property has sustained

physical loss or damage.” (Simon Marketing, Inc. v. Gulf Ins. Co.

(2007) 149 Cal.App.4th 616, 623.) “Physical damage” may

include “physical alteration.” (Marina Pacific Hotel & Suites,

LLC v. Fireman’s Fund Ins. Co. (2022) 81 Cal.App.5th 96, 109

(Marina Pacific).)

A business may not generally claim property damage

simply because it lost income or was required to shut down

because of the COVID-19 virus. But it may fall within the

6.

insurance property damage coverage provisions by showing the

COVID-19 virus altered its property and caused physical damage.

(Marina Pacific, supra, 81 Cal.App.5th at p. 101; Brown Jug, Inc.

v. Cincinnati Ins. Co. (6th Cir. 2022) 27 F.4th 398, 403; Los

Angeles Lakers, Inc. v. Federal Ins. Co. (C.D.Cal. 2022) 591

F.Supp.3d 672, 677 (Los Angeles Lakers).)

United Talent Agency

Lexington cites United Talent Agency v. Vigilant Ins. Co.

(2022) 77 Cal.App.5th 821 (United Talent Agency). There the

court, quoting from a federal decision, said, “ ‘While the impact of

the virus on the world . . . can hardly be overstated, its impact on

physical property is inconsequential: deadly or not, it may be

wiped off surfaces using ordinary cleaning materials, and it

disintegrates on it own in a matter of days.’ ” (Id. at p. 835, italics

added.) Relying on another federal decision, it said, “ ‘[T]he

virus’s inability to physically alter or persistently contaminate

property differentiates it from radiation, chemical dust, gas,

asbestos, and other contaminants whose presence could trigger

coverage . . . .’ ” (Id. at p. 836, italics added.)

Lexington contends the federal decisions relied on in

United Talent Agency, supra, 77 Cal.App.5th 821, and numerous

other federal decisions, show, as a matter of law, that Chumash

cannot prevail.

Federal Decisions

Federal decisions may be persuasive, but California courts

are not bound by the decisions of the lower federal courts.

(People v. Bradley (1969) 1 Cal.3d 80, 86.) Yet, even so, the

federal courts are not completely in agreement on the impact of

the virus. Lexington relies on statements about the

7.

inconsequential impact of the virus on business property that the

United Talent Agency court quoted from some federal decisions.

But other federal courts have held the COVID-19 virus can

damage business property, and its damage to businesses can be a

covered loss under standard “loss or damage” provisions of

business insurance policies. (Brown Jug, Inc. v. Cincinnati Ins.

Co., supra, 27 F.4th at p. 403 [complaint for damage coverage is

sufficient where plaintiff alleges “COVID-19 was present” and it

“materially altered all or part of the property”]; Los Angeles

Lakers, supra, 591 F.Supp.3d at p. 677 [same].)

Recent California Decisions

Recent California decisions have departed from United

Talent Agency, supra, 77 Cal.App.5th 821.

The theory relied on in United Talent Agency was rejected

in Marina Pacific, supra, 81 Cal.App.5th 96. There Marina

Pacific reversed the sustaining of a demurrer against a policy

holder. It discussed the legal standard for factual proof for

property damage insurance coverage involving COVID-19. It

noted that the United Talent Agency court concluded “the

COVID-19 virus does not damage property,” but it did so “without

evidence” to support its conclusion. (Marina Pacific, at p. 111.)

The United Talent Agency court also declared its “general belief

that surface cleaning may be the only remediation necessary to

restore contaminated property to its original, safe-for-use

condition.” (Marina Pacific, at p. 111.) But, as the Marina

Pacific court noted, “That was not always the understanding of

the appropriate precautions to take with items potentially

exposed to the virus.” (Ibid.) Consequently, whether the virus

caused property damage is determined by the evidence presented

in each case. The Marina Pacific court said some federal courts

8.

had adopted a “common sense” theory that “COVID-19 does not

physically alter the structure of property.” (Id. at p. 114.) But

instead of making such an assumption, the courts should

“actually receive evidence” on that issue. (Ibid.)

Other California courts have also rejected the rule that the

virus cannot cause damage. (Inns-by-the-sea v. California

Mutual Ins. Co. (2021) 71 Cal.App.5th 688, 710 (Inns-by-the-sea).)

There the court said it did not follow the “across-the-board rule

that a virus can never give rise to a “ ‘direct physical loss of or

damage to property.’ ” (Ibid.)

In Shusha, Inc. v. Century National Ins. Co. (2022) 87

Cal.App.5th 250, 262-263, the court also rejected the United

Talent Agency rule that the virus cannot cause physical damage

to business property.

Moreover, in light of Marina Pacific, the Ninth Circuit has

also recently questioned whether the United Talent Agency

decision is currently consistent with California law. (Another

Planet Entertainment, LLC v. Vigilant Insurance Co. (9th Cir.

2022) 56 F.4th 730, 733-734 [requesting certification to the

California Supreme Court].)

Chumash’s Failure of Proof

We do not take issue with recent California decisions

holding that business plaintiffs may be able to show that the

COVID-19 virus caused damage to their property so as to fall

within the property damage provisions of a business insurance

policy.

The issue here, however, is whether Chumash presented

sufficient evidence to show that the virus actually caused

physical damage to its property.

9.

The coverage provisions of the Lexington policy require

proof of physical damage to property. Alteration of business

property is a factor that may fall within the coverage provisions

of a property damage business insurance policy. (Marina Pacific,

supra, 81 Cal.App.5th at p. 109.) But the alteration must cause

physical damage for the business to be eligible for coverage under

the Lexington policy. If there is alteration of property without

physical damage, then there is no proof of an economic loss that

can be compensated under the policy. The ordinary meaning of

the term “physical damage to property” does not include a virus

on the property.

Chumash contends its experts said the property had been

physically altered. A plaintiff opposing a summary judgment

motion involving a property damage coverage claim must 1) be

able to present proof that the alteration of its property actually

caused damage; 2) identify the specific property that had been

damaged; 3) and especially present proof whether that property

had to be replaced or was no longer usable; and 4) present

evidence of the dollar amount of its loss. (See, e.g., Abdelhamid

v. Fire Ins. Exchange (2010) 182 Cal.App.4th 990, 1000.)

As Lexington notes, if the alteration of the Chumash

property caused damage, then Chumash should have been able to

show, for example, that its carpeting, gaming tables, gambling

devices, and playing cards had to be replaced or could not be used

again. But there are no such facts presented here. This is fatal

to the Chumash claim.

The Casino and Resort’s physical building structure

remained intact and was not changed. Chumash employees

worked there before, during, and after the shutdown. As

Lexington notes, “[N]o property was repaired, rebuilt or

10.

replaced.” There was no showing of the type of damage that

policyholders could reasonably expect to be compensated for, such

as alteration causing damage by fire, flood, or by physical impact

to the property.

Chumash claims it installed plastic barriers. But that was

to make the standard pandemic-related precautions that many

businesses made to reopen to the public after a shutdown. It is

not proof that its property had been damaged.

Chumash notes that it shut down its property. But it

presented no evidence to show that the shutdown was for the

purpose of repairing or replacing damaged items such as rugs,

gaming tables, or gambling machines. Those items remained

intact before, during, and after the shutdown. There was no

showing that the virus impaired its gambling machines or that

any other items of its property had been destroyed or damaged so

they could not be used again.

A business may rely on experts to prove property damage.

But here the Chumash experts’ declarations were not sufficient

for that purpose. They said that “surfaces at the Chumash

Casino and Resort were physically altered.” But such general or

conclusory statements do not suffice for a valid insurance claim.

The experts did not specifically identify which property was

altered. That is a fatal omission. An insurance carrier could not

be expected to investigate property damage without knowing

what property to examine. If a business, as here, is not able to

specifically identify the property that was damaged: 1) it is not in

a position to make an insurance claim, and 2) it is not in a

position to prove its case or oppose summary judgment.

During the claim procedure, Lexington asked Chumash for

additional information regarding its claim for coverage. In

11.

response, the Chumash representative said, “Our claim is more

accurately stated that the business loss is due to the orders of the

state, local, and tribal civil authorities (which we have previously

given you) and which were issued due to the ongoing pandemic.”

(Italics added.)

Had the Chumash Casino and Resort sustained property

damage, it was required to specify what property was damaged

and to submit a claim for the dollar amount of that loss. The

absence of such information supports Lexington’s decision to

deny coverage.

DISPOSITION

The judgment is affirmed. Costs on appeal are awarded in

favor of the respondent.

CERTIFIED FOR PUBLICATION.

GILBERT, P. J.

We concur:

YEGAN, J.

BALTODANO, J.

12.

James F. Rigali, Judge

Superior Court County of Santa Barbara

______________________________

Roxborough, Pomerance, Nye & Adreani, Nicholas P.

Roxborough and Vincent S. Gannuscio for Plaintiff and

Appellant.

Gibson, Dunn & Crutcher, Richard J. Doren, Matthew A.

Hoffman, Daniel R. Adler, Katarzyna Ryzewska and Kenneth H.

Oshita for Defendant and Respondent.

13.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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