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Florida Court maintains coverage for Doctor Office & # 39 ;s COVID-19 insurance



In another gain for policyholders, on September 24, 2020, the U.S. District Court of the Central District of Florida denied the Sentinel Insurance Company's claim to reject the policyholder's medical office claim for COVID-19 related business interruption coverage. Urogynecology Specialist of Florida LLC v. Sentinel Insurance Company Ltd. Case No: 6: 20-cv-1174-Orl-22EJK (M.D. Fla. September 25, 2020). The Court carried out a genuine analysis of the policy language exclusion language of the policy and found that the insurer had not fulfilled its burden to show that the proposed treatment of the exclusion language is the only reasonable interpretation.

The policyholder was forced to close his business. after Florida's declaration of emergency due to the COVID-1

9 pandemic. Sentinel denied the policyholder's claim of business interruption coverage under its property policy. The policyholder sought a declaration of coverage from the Florida State Court, and the action was then removed to the Middle District of Florida, where the Sentinel filed a motion to dismiss based on the policy 'virus exclusion. The court denied the dismissal proposal and declined to rule on coverage in the dismissal proposal.

In particular, the Court stated that aspects of the policy undoubtedly made it ambiguous. [1] The virus exclusion states that the insurer does not pay for loss or damage caused directly or indirectly by the presence, growth, spread, spread or any activity of "fungi, wet rot, dry rot, bacteria or viruses." However, the Court pointed out that the denial of losses due to the COVID-19 pandemic "does not logically correspond to the grouping of virus exclusion with other pollutants, so that the policy necessarily foresaw and intended to deny coverage for this type of business loss."

In addition, the Court was not persuaded by Sentinel's reference to cases confirming similar viral exclusions and found them distinguishable from COVID-19: all of which were covered by policy exemptions. It is important that none of the cases are about the unique circumstances that COVID-19 has had in our society – a difference that the court considers significant.

Finally, the Court stated that there is no binding case – law on the interplay between the COVID-19 pandemic and the standard exclusion of viruses to merit dismissal.

This decision rightly rejects the arguments of many insurance companies, which have sought to evade their liability for COVID-19-related claims by reading virus exclusions to a large extent, in violation of Florida law.

[1] The court noted that the insurer's failure to provide the court with full policy made it impossible to make a decision regarding the simple language of the policy.


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