By Samuel A. Lopez – USA Herald
The Illinois Appellate Court’s First Division recently issued its ruling in CC-Development Group, Inc. v. Evanston Insurance Co., 2025 IL App (1st) 230863-U, a case that underscores the critical importance of understanding policy language in tailored insurance contracts. Plaintiffs, operators of the “Vi Senior Living” brand, sought $19.7 million in insurance coverage for COVID-19-related losses. Their argument hinged on coverage for operational interruptions, cleanup costs, and physical damage due to the pandemic. However, the court sided with the insurers, highlighting the pitfalls of ambiguous or restrictive policy terms.
Case at a Glance
- Case Title: CC-Development Group, Inc. v. Evanston Insurance Co.
- Defendants: Evanston Insurance Co., Landmark American Insurance Co., and other major insurers, including AXIS Surplus Insurance Co. and Lloyd’s of London.
- Court & Date: Illinois Appellate Court, First Division, January 13, 2025.
- Judge: The Honorable Celia Gamrath, presiding.
- Outcome: Claims against Evanston dismissed; limited reversal and remand for claims against Landmark.
The plaintiffs argued their insurance policies, specifically the “Crisis Management” and “Contaminated Food/Communicable Disease” provisions, should cover their losses. Evanston, however, relied on an “Organic Pathogens” exclusion to deny coverage. This exclusion explicitly barred claims arising from pathogens like viruses, effectively negating coverage for COVID-19-related losses.
The court upheld Evanston’s argument, finding the exclusion valid and enforceable, noting it was prominently stated and unambiguous. Judge Celia Gamrath ruled that the policy exclusions did not render the referenced coverages entirely illusory, as coverage could apply in other, non-pandemic-related scenarios. Ultimately, the court dismissed the claims against Evanston with prejudice, leaving the plaintiffs without recourse for their multimillion-dollar losses.
In a twist, the court partially reversed the dismissal of claims against Landmark American Insurance Co. The court found Landmark’s application of its “Pathogenic or Poisonous Biological or Chemical Materials” exclusion rendered the “Contaminated Food/Communicable Disease” provision illusory. As a result, the plaintiffs’ claims under this coverage provision could proceed. However, the court’s decision against the other insurers—including AXIS Surplus Insurance and Lloyd’s—remained intact.
(NOTE) In the context of insurance law, a provision illusory refers to a situation where a coverage provision or clause in an insurance policy appears to offer protection but is rendered ineffective or meaningless by other parts of the policy, such as exclusions or limitations.
This case demonstrates how insurance companies, with their expertise in contract negotiation and drafting, often prevail in coverage disputes. They dictate the terms, which can either restrict or expand coverage based on the inclusion or exclusion of specific language. It’s a poignant lesson for those purchasing tailored insurance policies. With the lessons from COVID-19, one might think we’re better equipped to anticipate such events, but what about the next unforeseen crisis?
Insurance companies are increasingly using advanced predictive models, now enhanced by AI, to forecast risks like fire, earthquakes, or hurricanes. Policyholders could match this foresight by employing experts in contract law and predictive modeling to ensure their policies are not just protective but predictive. If the plaintiffs had used such models, they might have foreseen the need for explicit pathogen coverage.
Insurance companies regularly prevail in cases like this because they operate with the foresight and expertise to draft contracts favoring their position. Their predictive modeling, enhanced by advanced technologies like AI, enables them to anticipate and exclude emerging risks such as pandemics. Policyholders, however, often fail to match this insight, leaving them vulnerable to uncovered losses during crises.
If businesses are to avoid the pitfalls encountered by CC-Development Group, Inc., they must adopt a more proactive approach:
