Cozen O'Connor's Property Insurance Law Observer

Court Finds Policy Term, “Windstorm,” to be Ambiguous in Coverage Dispute Involving Tornado

Driving on straight dirt road towards the ominous tornado storm through the cultivated fields of wheat and corn crops.

In Mankoff v. Privilege Underwriters Reciprocal Exchange (2024 WL 322297 (Tex. App.—Dallas Jan. 29, 2024)), the Court determined that the term “windstorm” was ambiguous as utilized in the subject insurance policy.

The insureds suffered property damage caused by a tornado and subsequently submitted a claim to their insurer.  The insurer paid only a portion of the claim because it maintained that the tornado that struck and damaged the property was a “windstorm” and, therefore, the claim was subject to the policy’s “Windstorm or Hail Deductible.”  That provision stated:

5.  Deductible

Unless otherwise noted in this policy, the base deductible or one of the special deductibles shown on your Declarations or by endorsement is the amount of a covered loss you will pay.

Windstorm or Hail Deductible

In the event of direct physical loss to property covered under this policy caused directly or indirectly by windstorm or hail, the Windstorm or Hail deductible listed on your Declarations is the amount of the covered loss for dwelling, other structures and contents that you will pay.  The Windstorm or Hail deductible does not apply to coverage under 7. Loss of Use.  The Windstorm or Hail deductible applies regardless of any other cause or event contributing concurrently or in any sequence.

The policy also included a base deductible which was waived for covered losses other than those caused by a windstorm, hail, or earthquake:

Waiver of Deductible

For a covered loss caused by a peril other than windstorm or hail or earthquake that is greater than $50,000, we will waive the base deductible.  This waiver of deductible only applies if the base deductible shown on your Declarations is $25,000 or less.

This waiver of deductible does not apply to special deductibles for windstorm or hail or earthquake.  This waiver of deductible also does not apply to a special construction deductible.

Consequently, the insureds sued to recover the withheld deductible arguing that the tornado that caused the damage was not a windstorm and, as a result, their deductible was waived.

In construing the term “windstorm,” the Court noted that its primary concern was to ascertain the parties’ intentions as expressed in the policy.  As the policy did not define “windstorm,” the Court considered its common, ordinary meaning while reading the term “in context and in light of the rules of grammar and common usage.”  This also included the use of dictionaries and its usage in other authorities.

On the one hand, in support of their position, the insureds provided the following examples:

On the other hand, the insurer made the following arguments in support of its contention that a tornado is a type of windstorm and that the deductible “unambiguously applies to damage caused by a tornado”:

In Mankoff, the insurer asserted that the definition of “windstorm” approved in Weatherman had been consistently adopted in Texas cases and, thus, the term was not ambiguous.  However, the Court noted that neither Weatherman nor any of the other cases cited by the insurer determined whether the term “windstorm” was an unambiguous term as a matter of law or whether “tornado” was encompassed in the term “windstorm.”

In light of these positions, the Court held that the term “windstorm” as used in the policy was reasonably susceptible to more than one meaning, and that it was therefore ambiguous.  It explained that the parties “cite[d] authorities defining ‘windstorm’ in different ways,” and “definitions provided by those authorities were facially reasonable but conflicting.”  The Court also concluded that because the insureds’ interpretation of the term was reasonable, it was required to construe the deductible in their favor.

Conclusion

As demonstrated in Mankoff, lines can be drawn to distinguish otherwise seemingly congruous terms.  For that reason, insurers are advised to incorporate explicit definitions in all policy forms.  Failure to do so could open the door to conflicting interpretations and findings of ambiguities.  While terms may appear plain on their face, insurers and their underwriters should consult with industry experts as a prudent approach to mitigate litigation exposure.

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