Nobody enjoys hearing, “This is going to hurt a little,” at the dentist. A small business owner hearing it from an insurance company probably does not feel much better. A recent Texas dental practice case offers a painful lesson about business interruption claims. The policyholder must prove that the insurer’s delay impacted the theoretical restoration schedule and that the resulting loss was covered.
In Mahant Dental, PLLC d/b/a Cotton Wood Dental v. Massachusetts Bay Insurance Company, 1 a failed water valve damaged a dental office and interrupted operations. The insurer ultimately paid more than $418,000, including $163,440 for business income. The policyholder claimed more was owed. The court granted summary judgment for the insurer, ending the case.
This dispute has the ingredients of many smaller commercial business interruption claims. Water damages leased premises. The landlord and tenant have different views about who must repair what. Equipment requires evaluation. The business needs income while its doors are closed. The insurer pays in installments. Eventually, everybody has a different calendar showing when the business supposedly should have reopened. Somewhere in that process, the owner is still trying to make a living.
The insurer’s building consultant estimated that repairs would take sixty to ninety days. The policyholder responded that the insurer did not issue payment for interior repairs until February 2023, months after the insurer’s selected December endpoint for business income. How was the policyholder supposed to finish work before receiving money it claimed was needed to perform it? The question deserved an answer supported by evidence.
The policyholder also argued that because the original office never reopened, it was entitled to twelve months of business income. That argument went too far. The policy’s restoration period ended at the earliest of the date repairs theoretically should have been completed, resumption of business at a new permanent location, or the maximum specified period. A twelve-month maximum does not promise twelve months of payment. Permanent closure does not, by itself, establish the covered duration.
Here is the part public adjusters should underline in their working files. The policyholder did have a business-income expert. According to the opinion, however, that expert used twelve months because counsel instructed him to do so. He did not rebut the insurer’s sixty-to-ninety-day repair estimate. An accountant can calculate the financial consequences of an eight-month interruption. Somebody still must establish why eight months is the appropriate covered period. Otherwise, the calculation has a very precise answer attached to an unsupported assumption.
I would have developed the adjustment-time argument discussed in my prior post, Adjustment Time Still Counts in Period of Restoration Disputes. A contractor’s estimate of how long physical work requires does not necessarily establish when restoration reasonably should have been completed. Adjustment decisions, payment, procurement, and access to necessary funds may affect that date. The question is what actually prevented timely restoration and how that obstacle fits the policy and applicable law.
In the JW Aluminum litigation discussed in that post, a South Carolina federal court allowed evidence concerning whether insurers’ delayed payments impeded repairs and affected the period of interruption. The court allowed evidence about the policyholder’s ability to obtain rebuilding funds. That ruling is persuasive, not controlling authority in Texas, but it illustrates the factual inquiry that matters. The insurer can argue that money was available and repairs could have proceeded. The policyholder can show why the insurer’s conduct prevented that from happening.
Not every day spent adjusting a claim automatically adds another day of business-income coverage. A public adjuster should build the chronology while events are occurring. When was the repair scope known? When did the insurer have the information needed to pay? What work awaited a particular payment? What did the contractor require before starting? What funds were actually available? Which activities could proceed simultaneously? Those answers turn “the insurer took too long” into evidence of a specific delay and its consequences.
A qualified restoration expert could have addressed whether this dental office reasonably could be repaired within the insurer’s window. The expert could also have evaluated whether sixty to ninety days represented construction time after necessary prerequisites were satisfied. Dental plumbing, electrical work, equipment installation, and testing might matter if supported by the actual repair requirements. The expert supplies a defensible schedule; the financial expert calculates the policy-defined income loss over that schedule. The witnesses need to be working from the same calendar.
There was another complication. The dentist acquired a nearby practice and began operating there shortly after the loss. The policyholder said this was a planned expansion. The insurer treated it as a permanent resumption of operations elsewhere. Contemporaneous acquisition plans, staffing arrangements, patient transfers, equipment movements, and separate financial records would help explain what happened. A new corporate name does not answer every question about whether the insured business continued at another address.
The equipment claim offers an equally practical lesson. The policyholder’s brief relied on a dental supplier’s proposal for more than $409,000. The court noted that the proposal was not in the summary-judgment record and that the policyholder had not supplied evidence rebutting the insurer’s equipment opinions. A replacement price tells us what something costs. It does not establish that the particular item sustained covered damage or required replacement. Photographs, testing, repair findings, and qualified equipment testimony can supply that connection. A substantial price tag cannot do all that work by itself.
I also question the insurer’s suggestion that improvements were outside coverage simply because they existed before the dentist bought the practice. The quoted policy language included qualifying improvements acquired at the insured’s expense. Purchasing an existing practice may involve acquiring existing improvements. The acquisition documents, lease, and ownership evidence matter. The court nevertheless found no competent proof that additional payment was owed. A promising policy interpretation still needs facts and a supported dollar amount.
The opinion’s treatment of prompt payment deserves separate scrutiny. Finding that no additional benefits remain payable does not establish that all benefits were paid on time. Eventual full payment does not eliminate statutory prompt-payment liability for amounts owed but paid after the applicable deadline. A proper analysis requires the information-receipt dates, amounts contractually owed, payment dates, and statutory deadlines. The delayed payment issue should not disappear simply because the insurer eventually wrote enough checks.
Smaller businesses often face these disputes. Their claims require careful proof. Public adjusters can make an enormous difference by documenting the restoration schedule, identifying equipment issues early, tracking payments, and recognizing when specialized help is needed. By the time litigation begins, “everybody knew we could not reopen” is a poor substitute for records explaining why.
The lesson from this dental claim is to connect the damage, the delay, the restoration period, and the money. Challenge an unrealistic schedule with facts. Explain how adjustment affected repairs. A little preventive work on the claim file may spare the policyholder a much more painful extraction later.
Thought For The Day
“Some tortures are physical, and some are mental, but the one that is both is dental.”
—Ogden Nash
1 Mahant Dental v. Massachusetts Bay Ins. Co., No. 3:24-cv-1791 (N.D. Tex. Oct. 29, 2026). See Plaintiff’s Brief in Support of its Response to Defendant’s Motion for Summary Judgment.
