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Intentional Loss Exclusion Could Apply Even to Unintended Damage, Says the Tenth Circuit

The Tenth Circuit recently held that, under Kansas law, an intentional loss exclusion precludes coverage for damage caused by an intentionally set fire even if the actual resulting damage is unintended. In Taylor et al. v. LM Insurance Corp., Case No. 20-3166 (10th Cir. Jul. 11, 2022), the named insureds’ 18-year-old daughter (who was also an “insured” under the policy) was home alone and used a lighter to ignite her father’s side of her parents’ bedspread, intending to “make him mad.” Though she intended to, and believed she had, put out the fire, the fire spread and caused damage to the insureds’ home. About The Authors

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Posted in Uncategorized

New York Court Holds Coverage for Excavation Damage Precluded by Earth Movement Exclusion

According to a recent ruling by a New York appellate court, coverage for excavation damage is precluded by the policy’s earth movement exclusion. In 3502 Partners LLC v. Great American Insurance Co. of New York, Case No. 2021-03449 (N.Y. App. 1st Dep’t Apr. 21, 2022), an insured sued its insurer under a first-party policy, alleging in its complaint that its property sustained damage as a direct result of excavation work at an adjacent lot. About The Authors

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Posted in Uncategorized

Accepting Coverage for Part of a Claim May Subject an Insurer to the Appraisal Process Under Tennessee Law

Accepting coverage for part of a claim may subject an insurer to a policy’s appraisal process when the extent of covered damage is in dispute, according to a recent ruling issued by the Eastern District of Tennessee. In Morrow v. State Farm Fire & Cas. Co., Case No. 1:21-CV-00133-DCLC-CHS, 2022 WL 885863 (E.D. Tenn. Mar. 22, 2022), a severe storm with strong winds and tornadic activity damaged the insured’s home in Manchester, Tennessee. After the storm, the insured promptly reported the damage to her home to her insurer. The insured’s policy covered direct physical loss to her home, other structures on her property, and her personal property. The insurer acknowledged that the damage to the insured’s home was covered under

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Posted in Uncategorized

Renewal of Property Policy Requires Living Insured

A policy renewal requires a living insured to form a valid insurance contract, the Sixth Circuit recently ruled. In Boby Davis, et al. v. Westfield Ins. Co., Case No. 21-2797 (6th Cir. Mar. 14, 2022), Della Shields received a yearly homeowner’s insurance policy covering her home in Muskegon, Michigan from 2013 until her death in March 2018. Shields was the sole named insured in the yearly policy declarations. About The Authors

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Posted in Uncategorized

Second Circuit Holds No Coverage for COVID-19 Business Interruption Losses

The Second Circuit has now joined the Fifth, Sixth, Seventh, Eighth, Ninth, Tenth, and Eleventh Circuits in holding that no insurance coverage exists for business interruption losses caused by the Covid-19 pandemic and the associated government orders. In 10012 Holdings Inc. v. Sentinel Insurance Co. Ltd., No. 21-80-cv, Slip. Op. (2d Cir. Dec. 27, 2021), the insured fine arts gallery and dealership in New York City sought coverage under three provisions of its insurance policy for losses and extra expenses incurred when it suspended its operations in accordance with government restrictions on non-essential businesses during the Covid-19 pandemic. When the insurer denied coverage, the insured filed suit asserting claims for breach of contract and declaratory judgment. The United States District

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Posted in Uncategorized

Insurer Wins First Jury Trial on Coverage for COVID-19 Business Interruption Losses

An insurer has won the first jury trial on coverage for Covid-19 business interruption losses after a federal jury in the Western District of Missouri issued a verdict in favor of The Cincinnati Insurance Company in K.C. Hopps Ltd. v. Cincinnati Insurance Co., Case No. 4:20-cv-437 (W.D. Mo. 2021). In K.C. Hopps, the insured, K.C. Hopps Ltd. (“Hopps”), owned and operated bars, restaurants, catering services, and event spaces in the Kansas City metropolitan area. In response to the Covid-19 pandemic, civil authorities in Missouri and Kansas issued stay-at-home orders in March of 2020. In accordance with the orders, Hopps’ operations were limited to delivery, drive-through, and carry-out services. Hopps submitted a claim to its insurer, Cincinnati Insurance Company, for coverage

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Posted in Coverage

Court in Montana Applies Anti-Concurrent Causation Clause to Earth Movement Exclusion

A district court in Montana recently applied an anti-concurrent clause in a property insurance policy to preclude coverage based on an earth movement exclusion. In Ward v. Safeco Ins. Co. of Amer., No. 1:19-CV-0133-SPW, 2021 WL 3492294 (D. Mont. Aug. 9, 2021), the insured’s tenant reported that water was leaking from a main pipe serving the insured’s property, and the leak caused some soft spots to form in the floor of the kitchen. The insurer and agent’s subsequent inquiries led to the understanding that a leak under a slab affected the soil, which caused the house to settle, which then caused damage to the house. About The Authors

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Posted in Anti-Concurrent Causation

Eleventh Circuit Becomes Second Federal Appellate Court To Hold No Coverage For COVID-19 Business Losses

In the second federal appellate ruling on Covid-19 business losses, the Eleventh Circuit has joined the Eighth Circuit in holding that they do not trigger coverage because they do not involve “physical loss” or “physical damage” to property. In Gilreath Family & Cosmetic Dentistry Inc. v. Cincinnati Insurance Co., No. 21-11046, Slip. Op. (11th Cir. Aug. 31, 2021), the insured dentistry practice canceled routine and elective dental procedures at the beginning of the Covid-19 pandemic in response to state orders and CDC recommendations. Because these procedures made up the bulk of its business, the insured lost a substantial portion of its usual income. To recover that lost income, the insured filed a claim for business interruption coverage with its insurer.

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Posted in Federal Appeals

No Bad Faith When Insurer Relied on Opinion of Independent Consultant

The Court of Appeals of Georgia recently held that an insurer’s reliance on the report of an independent consultant creates a presumption that it did not act in bad faith in denying coverage. In Montgomery v. Travelers Home and Marine Ins. Co., 859 S.E.2d 130 (Ga. Ct. App. 2021), the insured made a claim under her homeowners insurance policy for water damage to her basement that she asserted had been caused by a ruptured garden hose. The insurer’s claims adjuster inspected the property two days later and saw damage that appeared to be from ground water rather than the ruptured hose. The adjuster sought input from his supervisor, who suggested that he hire an independent engineer to determine the cause

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Posted in Bad Faith

Claim Investigation Not Necessarily Protected by Work Product Doctrine in Illinois

In determining when the work product doctrine is triggered, the Northern District of Illinois recently held that, rather than adopting a bright-line rule, the issue should be decided on a case-by-case basis at the court’s discretion. In Club Gene and Georgetti, LP v. XL Insurance America, Inc., No. 20 C 652, 2021 WL 1239197 (N.D. Ill. Apr. 2, 2021), the insured’s steakhouse was damaged in a fire. When the insured sued for coverage, the insurer refused to produce documents prepared in the course of its investigation of the claim on the basis of the work product doctrine. The issue of contention was: at what point in an insurer’s claim investigation can the insurer claim that litigation was reasonably anticipated? In

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Posted in Claim Investigation
About The Property Insurance Law Observer
For more than four decades, Cozen O’Connor has represented all types of property insurers in jurisdictions throughout the United States, and it is dedicated to keeping its clients abreast of developments that impact the insurance industry. The Property Insurance Law Observer will survey court decisions, enacted or proposed legislation, and regulatory activities from all 50 states. We will also include commentary on current issues and developing trends of interest to first-party insurers.
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