Menu Close

New DOL Protections for Workers in Temporary Agricultural Employment

The U.S. Department of Labor has published the final rule, “Federal Register – Improving Protections for Workers in Temporary Agricultural Employment in the United States” effective on June 28, 2024.

The final rule strengthens protections for temporary agricultural workers by making several changes to H-2A program regulations to bolster the Department’s efforts to prevent adverse effect on workers in the U.S. and ensure that H-2A workers are employed only when there are not sufficient able, willing, and qualified U.S. workers available to perform the work.

These changes include empowering workers to advocate on behalf of themselves and their coworkers regarding working conditions; improving accountability for employers using the H-2A program; improving transparency and accountability in the foreign labor recruitment process; requiring seat belts in most vehicles used to transport workers; enhancing existing enforcement provisions; improving transparency into the nature of the job opportunity by collecting additional information about owners, operators, managers, and supervisors to better enforce program requirements; clarifying when a termination is “for cause” to protect essential worker rights; and revising provisions and codifying protections that are outdated, unclear, or subject to misinterpretation in the current regulations.

The final rule also strengthens protections for temporary agricultural workers when employers fail to properly notify workers that the start date of work is delayed, and clarifies and streamlines procedures to prevent noncompliant employers from using the Employment Service.

The Department of Labor will host a public webinar on Thursday, June 6, 2024, to educate employers, agricultural associations, farm labor contractors, farmworkers, advocates, and other interested members of the public on the changes to the H-2A and Wagner-Peyser Employment Service programs made by the 2024 Farmworker Protection Final Rule.

Participants of this webinar will learn from the Office of Foreign Labor Certification, the Office of Workforce Investment, and the Wage and Hour Division about the key aspects of this rule.

The Final Rule will become effective June 28, 2024, and OFLC will begin accepting applications subject to the provisions of this rule on August 29, 2024.

Additional Information

– – Final Rule: Improving Protections for Workers in Temporary Agricultural Employment in the United States
– – Frequently Asked Questions
– – H-2A Employer’s Guide to the Final Rule “Improving Protections for Workers in Temporary Agricultural Employment in the United States”
– – Flyer: Protections for Workers Employed Under the H-2A Program (English and Spanish)
– – Flyer: Protections for U.S. Workers Under the H-2A Program (English and Spanish)
– – Proposed rule

OSHA Announces Changes to the Structure of Regional Operations

The Department of Labor just announced strategic changes to the structure of its Occupational Safety and Health Administration’s regional operations designed to direct its resources effectively and make the agency more resilient.

The changes include the creation of a new OSHA regional office in Birmingham, Alabama, overseeing agency operations in the state, and those in Arkansas, Kentucky, Louisiana, Mississippi and Tennessee as well as the Florida Panhandle. The Birmingham Region will address the area’s growing worker population and the hazardous work done by people employed in food processing, construction, heavy manufacturing and chemical processing.

OSHA is also planning to merge Regions 9 and 10 (view the new regional map) into a new San Francisco Region to improve operations and reduce operating costs.

As part of the changes, the agency will also rename its regions to associate them by geography, rather than its current practice of assigning numbers to regions. As such, the area OSHA calls Region 4 will be renamed the Atlanta Region with jurisdiction over Florida, excluding the Panhandle; Georgia, North Carolina and South Carolina. The current Region 6 will be renamed the Dallas Region and have jurisdiction over workplace safety issues in New Mexico, Oklahoma and Texas.

The composition of OSHA’s other regions will remain the same.

The changes reflect the nation’s demographic and industrial changes since the passage of the OSH Act and will allow our professionals to better respond to the needs of all workers, including those historically underserved,” explained Assistant Secretary for Occupational Safety and Health Doug Parker.

“With a stronger enforcement presence in the South and more consolidated state oversight and whistleblower presence in the West – an area dominated by states that operate their OSHA programs – we can direct our resources where they’re needed most.”

OSHA plans to fully transition to its new regional structure later in fiscal year 2024. Once implemented, the agency’s regional maps and contact information online will be updated publicly.

Cal/STERS/PERS & WC Carriers Subrogation Rights in MedMal Cases

Arasely Soto was injured during a routine medical procedure and had to retire from her job as a public school teacher. She sued her medical providers for medical malpractice and also sought disability retirement benefits from the California State Teachers’ Retirement System (CalSTRS).

The Sotos attended a CalSTRS benefits planning session in January 2018. CalSTRS gave them information and documents about applying for disability benefits. The documents explained CalSTRS’s “[r]ight of subrogation” as follows: “[I]f you pursue a claim against a third party for the same impairment that entitles you to a disability benefit from CalSTRS, you must notify us. This is true even if the claim has not yet resulted in a court action. [¶] CalSTRS has the right to participate in the claim by filing our own action against the responsible party, intervening in your claim, or filing a lien against any judgment you may recover. [¶] If you don’t notify CalSTRS and you recover – or have already recovered – a monetary sum from the third party, you may be required to reimburse CalSTRS for part of the costs of your disability benefit.”

One day after the Sotos’ benefits planning session with CalSTRS, they released their claims against Dr. Borna in exchange for a six-figure settlement. Ten days later, Arasely filled out an application for disability benefits. Her application stated that her injuries were caused by employees of the hospital, including Dr. Borna.CalSTRS acknowledged receipt of Arasely’s application for disability benefits in February 2018. That same day, the court in the malpractice action granted the Sotos’ request to dismiss Dr. Borna from the lawsuit.

In May 2018, the Sotos released their claims against the hospital in exchange for a seven-figure settlement. Eight days later, the Sotos dismissed the malpractice action with prejudice.

CalSTRS brought suit against the Sotos, seeking to enforce its right to subrogation or reimbursement. The complaint alleges that CalSTRS is entitled to be reimbursed for Arasely’s disability benefits from her settlement with the malpractice defendants.

CalSTRS moved for summary adjudication on its declaratory relief cause of action, and the Sotos moved for summary judgment. In connection with both motions, the Sotos argued that Civil Code section 3333.1 bars any subrogation claim that CalSTRS would have asserted against the malpractice defendants.

Subdivision (a) of section 3333.1 authorizes a defendant in a medical malpractice action to introduce evidence of a variety of ‘collateral source’ benefits – including health insurance, disability insurance or worker’s compensation benefits.” Subdivision (b) of the statute provides, in turn, that ‘[n]o source of collateral benefits introduced pursuant to subdivision (a) shall recover any amount against the plaintiff nor shall it be subrogated to the rights of a plaintiff against a defendant.”

In opposition, CalSTRS argues that (1) CalSTRS was not a source of collateral benefits for purposes of section 3333.1; (2) Arasely’s disability retirement benefits were never introduced as evidence in the malpractice action; and (3) the statutes governing CalSTRS’s right of subrogation were enacted after section 3333.1, and the later-enacted statutes prevailed.

The trial court ruled in favor of Cal/STERS. The Court of Appeal affirmed the trial court in the published case of Soto v. Super. Ct. -E081902 (May 2024). It expressed no opinion on the parties’ legal arguments concerning the applicability of section 3333.1 in general.

The Legislature enacted section 3333.1 in 1975 as part of the Medical Injury Compensation Reform Act (MICRA), a wide-ranging statutory scheme designed to reduce the cost of medical malpractice insurance ‘by limiting the amount and timing of recovery in cases of professional negligence. MICRA addressed the problem in numerous ways, including by revising certain legal rules applicable to medical malpractice litigation. (

Education Code section 24500 grants CalSTRS “a right of subrogation” for the amounts CalSTRS “paid and became obligated to pay as disability retirement allowances, disability allowances, family allowances, or survivor benefit allowances.” (Ed. Code, § 24500; see Ed. Code, § 22174.)

The Legislature enacted the statutes giving CalSTRS a right of subrogation in 1988. (Ed. Code, former §§ 23300-23305, added by Stats. 1988, ch. 380, § 1, pp. 1699-1700, repealed and reenacted as Ed. Code, §§ 24500-24505 by Stats. 1993, ch. 893, §§ 1-2, pp. 4867, 4973-4974.) According to the legislative history, the CalSTRS subrogation provisions were “patterned” on the subrogation provisions governing the California Public Employees’ Retirement System (CalPERS).

“The CalPERS provisions also incorporate the workers’ compensation statutes, and the pertinent language of the CalSTRS and CalPERS subrogation provisions is nearly identical.”

The workers’ compensation subrogation provisions bar double recovery by an employee who claims workers’ compensation benefits “and also seek[s] damages for the employee’s injury or death from negligent third parties.”

Section 3333.1, subdivision (a), does not specify how jurors should use the collateral source evidence, but “the Legislature apparently assumed that in most cases the jury would set plaintiff’s damages at a lower level because of its awareness of plaintiff’s ‘net’ collateral source benefits.

But the employer’s consent is not required if the settlement includes only the employee’s claim for damages that will not be paid by workers’ compensation benefits. (Lab. Code, § 3859, subd. (b); Marrujo, at p. 978.) That is, the employee may segregate their claim from that of the employer and settle it without the employer’s consent. (Board of Administration v. Glover (1983) 34 Cal.3d 906, 913 (Glover); Marrujo, at p. 978.)

If the employee segregates and settles their claim in that manner, then the settlement is not subject to the employer’s claim for reimbursement of workers’ compensation benefits, while the employer retains its subrogation right “against the alleged tortfeasor to recover payments it had made to its employee.” (Glover, at p. 914; Marrujo, at p. 978; Lab. Code, § 3860, subd. (b).) But if the employee settles an unsegregated claim (i.e., a claim that includes both the employer’s claim for reimbursement of benefits and the employee’s claim for damages not compensated by benefits), then the employer may seek reimbursement out of the settlement proceeds.

The Sotos did not offer any evidence that the malpractice defendants sought to introduce evidence of Arasely’s disability retirement benefits in the underlying action, so section 3333.1 was never triggered. In addition, if the Sotos had offered such evidence, then section 3333.1 would be irrelevant. The same evidence would tend to show that CalSTRS has no reimbursement claim against the Sotos for reasons independent of section 3333.1.

Court Proceeding Must be Stayed (Not Dismissed) When Arbitration is Ordered

Wendy Smith and others are are current and former delivery drivers for anon-demand delivery service operated by Keith Spizzirri and his co-defendants. The Plaintiffs sued Defendants in Arizona state court, alleging violations of federal and state employment laws.

Plaintiffs claimed that defendants misclassified them as independent contractors, failed to pay required minimum and overtime wages, and failed to provide paid sick leave. After removing the case to federal court, Defendants moved to compel arbitration and dismiss the suit.

Plaintiffs conceded that all of their claims were arbitrable, but they argued that §3 of the Federal Arbitration Act (FAA) required the District Court to stay the action pending arbitration rather than dismissing it entirely.

The District Court issued an order compelling arbitration and dismissing the case without prejudice. The court noted that “the text of 9 U. S. C. §3 suggests that the action should be stayed,” but that Circuit precedent “instructed that ‘notwithstanding the language of §3, a district court may either stay the action or dismiss it outright when, . . . the court determines that all of the claims raised in the action are subject to arbitration.’ “

Because “all claims raised [were] subject to arbitration,” the District Court concluded that it “retain[ed]discretion to dismiss the action.”

The Ninth Circuit affirmed. While that court likewise acknowledged that “the plain text of the FAA appears to mandate a stay,” the court explained that it was bound by Circuit precedent recognizing the District Court’s “discretion to dismiss.” Forrest v. Spizzirri, 62 F. 4th 1201, 1203, 1205 (2023).

Judge Graber, joined by Judge Desai, concurred, asserting that the Ninth Circuit’s position was wrong and urging U.S. Supreme Court “to take up this question,which it has sidestepped previously, and on which the courts of appeals are divided.”

The U.S. Supreme Court granted certiorari to answer the question it previously left open and resolve the Circuit split.

The US Supreme Court, in a unanimous decision on May 16, 2024, ruled in favor of Smith in Smith v. Spizzirri. The court decided that federal courts are obligated to stay lawsuits, not dismiss them, when both parties agree to arbitration and one party requests a stay. This applies to cases where the court has already ruled that the claims belong in arbitration.

“In this statutory interpretation case, text, structure, and purpose all point to the same conclusion: When a federal court finds that a dispute is subject to arbitration, and a party has requested a stay of the court proceeding pending arbitration, the court does not have discretion to dismiss the suit on the basis that all the claims are subject to arbitration.”

Here the FAA provides when any issue in a suit is subject to arbitration, the court “shall on application of one of the parties stay the trial of the action until such arbitration has been had in accordance with the terms of the agreement, providing the applicant for the stay is not in default in proceeding with such arbitration.”

Here, as in other contexts, the use of the word ‘shall’ creates an obligation impervious to judicial discretion.

“Finally, staying rather than dismissing a suit comports with the supervisory role that the FAA envisions for the courts. The FAA provides mechanisms for courts with proper jurisdiction to assist parties in arbitration by, for example, appointing an arbitrator, see 9 U. S. C. §5; enforcing subpoenas issued by arbitrators to compel testimony or produce evidence, see §7; and facilitating recovery on an arbitral award, see §9.”

“Keeping the suit on the court’s docket makes good sense in light of this potential ongoing role, and it avoids costs and complications that might arise if a party were required to bring a new suit and pay a new filing fee to invoke the FAA’s procedural protections. District courts can, of course, adopt practices to minimize any administrative burden caused by the stays that §3 requires.”

WCAB Affirms Sanctions Against Monrovia Memorial Hospital

Bertha Perez sustained injury to her back while working for World Variety Produce as a produce packer on August 27, 2010. On May 1, 2011, she underwent surgery, and lien claimant, Monrovia Memorial Hospital, provided the employer’s carrier, Zurich North America, with an invoice for $67,497.95.

Pursuant to the recommendations made by its bill review company, Zurich paid $15,857.48. Monrovia Memorial Hospital filed its lien for the balance of its invoice.

On May 6, 2015, a WCJ ordered lien claimant and defendant to forward all relevant documentation and/or evidence as to the value of the lien claimant’s services to a jointly selected bill review expert, Stelzner and Kyle Consulting.

On March 14, 2016, the matter proceeded to a lien conference and the parties set the matter for trial. Over the next few years a number of hearings took place regarding the issues surrounding the lien of Monrovia Memorial Hospital.

On September 18, 2018, defendant filed a Petition for Restitution/Reimbursement in which it alleged that “[r]ather than provide the information to IBR as directed by the Court, the lien claimant submitted the billing again to defendant which accidentally paid it in full.” Zurich requested reimbursement for the $51,640.47 check issued to Monrovia Hospital on May 16, 2018 for unjust enrichment. On October 26, 2018, the matter proceeded to trial on defendant’s claim for restitution and defendant’s petitions for sanctions, costs and fees.

On January 3, 2019, the WCJ issued Amended Findings and Orders, ordering lien claimant to pay restitution in the sum of $51,640.00 as well as sanctions, costs and attorneys’ fees under section 5813 and WCAB Rule 10561. Lien claimant sought reconsideration of the WCJ’s January 3, 2019 Amended Findings and Orders. On March 25, 2019, the WCAB granted reconsideration based upon a lack of substantial evidence to support the WCJ’s findings.

Because the WCJ did not admit any exhibits or testimony during the October 26, 2018 trial, the WCAB panel was unable to determine whether lien claimant would be unjustly enriched if it retained the disputed payment or whether sanctions were justified. Thus it rescinded the WCJ’s decision and returned the matter to the trial level for further proceedings.

The matter appeared again for trial on September 23, 2019, at which time the parties submitted exhibits and testimony. On November 8, 2019, the WCJ issued the disputed F&O, finding that, pursuant to the IBR calculation issued on November 12, 2015, the reasonable value of lien claimant’s services was $15,857.48, which defendant had previously paid.

The WCJ also ordered that lien claimant pay defendant $51,640.00 in restitution as a result of unjust enrichment. The WCJ also found that lien claimant and its representative employed bad faith, frivolous litigation tactics in violation of section 5813 and WCAB Rule 10561 warranting sanctions in the amount of $2,500.00 payable to the WCAB. The WCJ also awarded defendant costs and fees to be determined by subsequent court order.

After this second Petition for Reconsideration was filed by Monrovia, the November 8, 2019 F&O was affirmed in the panel decision of Perez v World Variety Produce –ADJ7447035 (May 2024).

In its Petition for Reconsideration, lien claimant contends that the WCJ erred by 1) awarding restitution to defendant, as there is no evidence of unjust enrichment, and 2) awarding sanctions, costs, and fees, as there is no evidence that it engaged in bad faith or frivolous conduct in violation of section 5813 or WCAB Rule 10561. Both assertions were rejected by the WCAB panel.

Restitution is an equitable remedy which has primarily been utilized by courts to prevent unjust enrichment. Under certain circumstances it has been held that administrative tribunals such as the [WCAB] may appropriately employ equitable remedies. Such use by the Board would seem particularly justified, for example, when fraud has been charged and proven.” (American Psychometric Consultants, Inc. v. Workers’ Comp. Appeals Bd. (Hurtado) (1995) 36 Cal.App.4th 1626, 1645-1646 [60 Cal.Comp.Cases 559], citations omitted.)

In this case, the WCJ found that lien claimant engaged in improper conduct leading to unjust enrichment, where it circumvented defendant’s typical processes for handling disputed lien claims. Specifically, the WCJ found that lien claimant intentionally bypassed defendant’s internal procedures by demanding payment from its medical review department, rather than its claims department, and that lien claimant knew or should have known that the resulting payment in full was made in error, particularly where the bill amount was still being litigated.

Here, the WCJ found that sanctions should issue as a result of lien claimant’s willful failure to comply with the court’s May 6, 2015 Findings and Order requiring it to forward all documentation showing the value of its services for IBR for roughly three years.

WCRI Study Compares Hospital Outpatient Payments in 36 States

With rising hospital costs a focus of public policy debates across the country, a new study from the Workers Compensation Research Institute (WCRI) finds that hospital outpatient payments are lower and growing slower in states with fixed-amount fee schedules.

“This study provides meaningful comparisons of hospital payments across states, as system policymakers and stakeholders monitor hospital payment trends in relation to reforms of hospital outpatient fee regulations,” said Ramona Tanabe, WCRI’s CEO.

The study, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 13th Edition, compares hospital payments for a group of common outpatient surgeries in workers’ compensation across 36 states from 2005 to 2022. The 36 study states represent 88 percent of the workers’ compensation benefits paid in the United States.

The following is a sample of the study’s findings:

– – Hospital payments per outpatient surgical episode in states with percent-of-charge-based fee regulations were 65 to 196 percent higher than the median of the study states with fixed-amount fee schedules in 2022. In states with no fee schedules, they were 65 to 128 percent higher.
– – The growth in hospital outpatient payments per episode among non-fee schedule states ranged from 41 percent in Arizona to 75 percent in New Jersey, while the payments in the median fixed-amount fee schedule state without substantial changes in regulations increased about 17 percent from 2011 to 2022.
– – This study also provides a comparison between workers’ compensation hospital outpatient payments and Medicare rates. For example, the variation between the average workers’ compensation payments and the Medicare rates for a common group of procedures across states ranged from a low of 40 percent (or $2,743) below Medicare in Nevada to a high of 443 percent (or $25,202) above Medicare in Alabama.

The study also provides an analysis of major policy changes in states with recent fee schedule reforms. For example, effective November 15, 2022, Mississippi updated the state’s Ambulatory Payment Classification (APC)-based fee schedule, from the 2019 Medicare APC values to the 2022 Medicare APC values. In 2022, the hospital outpatient payments increased by 15 percent. Other policy changes are also reviewed in the report.

17 Prosecutors Awarded $8.55 Million to Prosecute Wage Theft

The California Department of Industrial Relations and the Labor Commissioner’s Office completed the first cycle of funding for the Workers’ Rights Enforcement Grant Program, which provides opportunities for public prosecutors in California to develop and implement wage theft enforcement programs in their regions.

This funding creates opportunities for public prosecutors in California to prosecute wage theft and deter employers from engaging in unlawful labor law practices in the workplace. The grants will enable prosecutors to address wage theft cases in their jurisdictions and provide resources so they can address exploitative labor industry trends, barriers workers confront in reporting violations and obstacles to holding perpetrators accountable within their respective communities.

Labor Commissioner Lilia García-Brower said “Wage theft is a persistent problem, and this funding helps address it in local communities across our state. The 17 applications we received demonstrate prosecutors’ commitment to curtail and eradicate this abusive behavior. We look forward to continuing our work with public prosecutors, community organizations and industry leaders to eliminate this serious and costly crime.”

The 17 public prosecutors who applied for the grant will receive awards as detailed below:

Alameda District Attorney – $335,935
Contra Costa District Attorney – $720,000
Fresno City Attorney – $720,000
Long Beach City Prosecutor – $414,392
Los Angeles City Attorney – $317,543
Los Angeles County Counsel – $475,000
Los Angeles District Attorney – $733,351
Napa District Attorney – $102,531
Oakland City Attorney – $425,655
Orange County District Attorney – $750,000
San Diego City Attorney – $669,251
San Diego District Attorney – $750,000
San Francisco City Attorney – $410,000
San Francisco District Attorney – $160,451
San Mateo District Attorney – $739,396
Santa Clara County Counsel – $679,220
Sonoma District Attorney – $147,275

The Department of Industrial Relations’ Division of Labor Standards Enforcement (California Labor Commissioner’s Office) combats wage theft and unfair competition by investigating allegations of illegal and unfair business practices.

The Labor Commissioner’s Office in 2020 launched an interdisciplinary outreach campaign, “Reaching Every Californian.” The campaign amplifies basic protections and builds pathways to affected populations, so workers and employers understand legal protections and obligations, as well as the Labor Commissioner’s enforcement procedures. Californians can follow the Labor Commissioner on Facebook and X (Twitter).

Patient Coordinator for O.C. Sober Living Home Arrested for Kickbacks

A patient intake coordinator for an addiction treatment facility in Orange County was just arrested on a federal grand jury indictment alleging he conspired to pay $37,000 in illegal kickbacks to so-called “body brokers” in exchange for finding him new patients.

Luis Guerrero, 53, of Santa Ana, was arrested. He is scheduled for arraignment in the United States District Court in Santa Ana. Guerrero is charged with one count of conspiracy and three counts of offering or paying illegal remunerations for referrals to the clinical treatment facility that employed him.

According to the indictment that a grand jury returned on May 22, Guerrero sought the services of two body brokers in referring patients to his employer’s Orange County-based addiction treatment facility, which treated patient populations that received health care benefits through health insurers.

Guerrero allegedly then negotiated kickback payments to the body brokers on behalf of the facility and arranged for the body brokers to receive thousands of dollars per patient in illegal kickbacks. The indictment alleges that these kickbacks were intended as compensation to the brokers for referring patients and to induce them to continue referring patients so Guerrero could meet a monthly patient intake quota – a condition of his employment with the facility.

Guerrero also assisted the body brokers in paying thousands of dollars directly to the patients, as a further kickback to compensate the patients for allowing the facility to bill their insurance providers for treatment, the indictment alleges. For example, during a call with a body broker over an encrypted messaging service, Guerrero arranged for a patient to receive a $5,000 electronic payment and agreed to assure the patient that “we’ll do something to put money in her hands before she leaves or before she arrives [home],” according to the indictment.

In October 2020, Guerrero allegedly negotiated payment of $37,000 in kickbacks to the body brokers in exchange for their referral of five patients over the previous two months, leading to a $30,000 partial payment to the body brokers later that month.

An indictment is merely an allegation, and the defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

If convicted of all charges, Guerrero faces a statutory maximum sentence of 35 years in federal prison.

The FBI is investigating this matter. Assistant United States Attorneys Benjamin R. Barron and Nandor Kiss of the Santa Ana Branch Office are prosecuting this case.

May 20, 2024 – News Podcast


Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: CHP Employee and Fourteen Others Charged in Insurance Fraud Ring. Employee Death Leads to Alleged $2M Premium Fraud Prosecution. County DA’s Office Probes Internal Theft of Insurance Fraud Grant Funds. Cal/OSHA Proposes to Extend and Modify Temporary Silica Safety Standard. WCIRB Releases Fourth Quarter 2023 Experience Report. NCCI 2023 Metrics Show Continued Strength of Workers Comp System. DWC to Impose Sanctions for EAMS E-Filer User Errors. New Study Shows Diseases Linked to Night Shift Work.

California Supreme Court Resolves Pandemic Insurance Coverage Dispute

At the outset of the COVID-19 pandemic, and for some time thereafter, many businesses were forced to curtail their operations or close entirely. Some of these businesses sought coverage for their financial losses from their commercial property insurers under conventional first-party “all risk” or “open peril” insurance policies.These policies generally predicate coverage on “direct physical loss or damage” to the insured property or nearby property.

State and federal courts across the country have considered whether conventional property insurance policies provide coverage for pandemic-related losses, including whether the COVID-19 virus satisfies the threshold requirement of direct physical loss or damage to property. California courts have reached different conclusions on this issue,

The question arises in the context of a civil lawsuit filed by Another Planet Entertainment, LLC against its property insurer, Vigilant Insurance Company.

Another Planet operates venues for live entertainment. It suffered pandemic-related business losses when its venues closed, and Vigilant denied Another Planet’s subsequent claim for insurance coverage. Another Planet filed suit in federal district court, alleging that the actual or potential presence of the COVID-19 virus at its venues or nearby properties caused direct physical loss or damage to property and triggered coverage under its insurance policy.

The district court granted Vigilant’s motion to dismiss for failure to state a claim, and Another Planet appealed. According to the Ninth Circuit, the issue on appeal “is whether [Another Planet’s] allegations, if taken as true, were sufficient to show ‘direct physical loss or damage to property’ as defined by California law.” Because the Ninth Circuit concluded that resolution of this question of California law could determine the outcome of the case pending before it, the Ninth Circuit certified the question to the California Supreme Court.

The California Supreme Court concluded that “consistent with the vast majority of courts nationwide, that allegations of the actual or potential presence of COVID-19 on an insured’s premises do not, without more, establish direct physical loss or damage to property within the meaning of a commercial property insurance policy” in the published case of Another Planet Entertainment, LLC v. Vigilant Insurance Co -S277893 (May 2023).

Under California law, direct physical loss or damage to property requires a distinct, demonstrable, physical alteration to property. 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.

The factual allegations of Another Planet’s complaint, which we accept as true for purposes of this proceeding, do not satisfy this standard. While Another Planet alleges that the COVID-19 virus alters property by bonding or interacting with it on a microscopic level, Another Planet does not allege that any such alteration results in injury to or impairment of the property itself. Its relevant physical characteristics are unaffected by the presence of the COVID-19 virus.”

In rare situations, a property may suffer direct physical loss where it is not damaged in a conventional sense, including where a chemical contaminant or noxious odor infiltrates the property and renders it effectively unusable or uninhabitable. In such a case, the contaminant or odor may cause direct physical loss, but only where the source of the property’s unusability or uninhabitability is sufficiently connected to the property itself. This situation may arise when the effect of the contaminant or odor is so lasting and persistent that the risk of harm is inextricably linked or connected to the property.”

“While we conclude Another Planet’s allegations are insufficient, and it appears that such allegations represent the most common allegations in support of pandemic-related property insurance coverage, we cannot and do not in this proceeding determine that the COVID-19 virus can never cause direct physical loss or damage to property. Our contemplation of the virus and the affected property is necessarily limited by Another Planet’s factual allegations. ”