Philadelphia-based Rothman Orthopaedics and Zurich American Insurance are locked in a dispute over COVID-19 damages coverage.
Rothman filed a complaint against Zurich in the Philadelphia County Court of Common Appeals Aug. 5, seeking additional funds to cover losses the practice incurred from statewide stay-at-home orders during the pandemic.
The complaint argues Zurich's policy pays for "[d]irect physical loss of or damage to covered property caused by 'microorganisms,' including the cost of removal of the 'microorganisms.'"
Rothman demanded Zurich reimburse for elective procedures that were not performed because of the stay-at-home orders in Philadelphia and New Jersey, where the practice's clinics are located, and sterilization for the facilities where COVID-19 was present.
According to the complaint, Zurich representatives assured Rothman it could recover certain business income losses amid the shutdown during a June 12, 2020, conference call. Zurich then issued a June 25 position letter determining it would not cover a portion of Rothman's insurance claim for four administrative and research locations.
Zurich said it denied coverage because access to the facilities wasn't prohibited and the practice didn't receive a "notice of closing" from a governmental authority or authorized public health official. Rothman requested in the complaint that the court require Zurich provide coverage under its policy and monetary damages exceeding $75,000 in addition to other relief benefits.