New Jersey Court Rejects Theory of Spoliation By Encouragement

shutterstock_74696500 Three years out, Superstorm Sandy litigation continues to wend its way through New Jersey’s courts.  Last weekend, a federal judge in the state handed a victory to the insurer in Stiso v. State Farm Fire & Cas. Co., 2015 U.S. Dist. LEXIS 155762, 2015 WL 7296081 (D.N.J., Nov. 18, 2015).  In doing so, the court reaffirmed the enforceability of what it called anti-concurrent causation (ACC) “lead-in” language.  It also rejected the doctrine of “spoliation based on encouragement” – the policyholders had argued that they could not meet the burden of showing that all of their loss was caused by a covered peril because the carrier had “actively encouraged” them to begin repair early on and thereby “persuaded” them to destroy evidence that they subsequently needed.

The insureds owned a split-level home in Point Pleasant Beach.  The structure was two-and-one-half blocks from the Atlantic, and it was inundated when Superstorm Sandy struck on October 29, 2012; water lines inside the home were four-and-one-half feet high on the lower level and 12” high on the upper story’s walls.  The policyholder made clam for $154,186.  Read more ›

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Posted in Anti-Concurrent Causation, Flood, Sewer Backup, Spoliation, Superstorm Sandy, Water

The Elephant in the Room – Catastrophic Property Damage from a Cyber Attack

This past October was the country’s first National Cyber Security Awareness Month, and that makes it an appropriate time to touch on a very troubling first-party exposure.  Every day brings news of massive cyber attacks on retailers, financial institutions, and hospitals and healthcare companies, with the aim of stealing digital assets such as Personally Identifiable Information (PII).  What has received far, far less attention, however, is the prospect of a cyber attack designed to escape the virtual world in order to do physical damage to tangible property in the real one.

shutterstock_297688691The ultimate risk is enormous.  Computerized industrial control systems run the world’s financial institutions, its manufacturing and chemical facilities, its transportation systems, and its energy infrastructure, including the electrical grid and power and water treatment plants.  These control systems are composed of devices such programmable logic controllers (PLCs) and supervisory control and data acquisition (SCADA) equipment that were originally designed to be open systems, which is to say systems focused on interoperability and ease of communication and repair.  Security was a secondary consideration at best.  If hijacked by a piece of malware, such systems could cause property damage and business interruption loss on a literally catastrophic scale. Read more ›

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Posted in Cyber, Cyber Insurance, Explosion, Fire, Terrorism Insurance

Fifth Circuit Refuses To Predict Texas Will Adopt a Sophisticated Insured Exception to Contra Proferentem

Texas has yet to address whether it recognizes a sophisticated insured exception to the doctrine of contra proferentem, and the state’s federal Court of Appeals declined an opportunity to make a prediction about that question in mid-August of this year in Certain Underwriters at Lloyds London v. Perraud, 2015 WL 4747318, 2015 U.S. App. LEXIS 14349 (5thCir., Aug. 12, 2015).  The judges split 2-1 on whether the contract of insurance was ambiguous in nature, but all three were unwilling to reach the sophisticated insured issue.  The case involved a director’s and officer’s (D&O) liability policy, but the issue implicates first-party coverage as well.  It also contains a useful survey of the approaches that courts have taken to this exception from jurisdictions around the country.

shutterstock_197340095Two of its policyholder’s employees sought reimbursement under the D&O policy for attorney’s fees and costs after successfully defending against federal criminal charges.  The carrier denied liability based on a “change in control” exclusion that barred coverage if the alleged wrongful acts occurred after new management had taken control of the insured, and it filed a declaratory judgment action seeking to vindicate that position.  On cross-motions for summary judgment, the district court found the exclusion to be ambiguous, and it interpreted it in favor of coverage pursuant to Texas’ contra proferentem doctrine – a rule of contractual interpretation that provides that an ambiguous term is to be construed against the draftsman.  It also rejected the insurer’s invitation to apply a sophisticated insured exception to that doctrine. Read more ›

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Posted in Ambiguity

Insurers From Coast to Coast Notch Suit Limitation Victories

Over the last several months, courts in Washington, Kansas, and Virginia have awarded victories to carriers asserting a suit limitation defense, and there are three valuable takeaways from the decisions.  First, the insurer need not demonstrate that it was prejudiced by the failure to file suit within the limitations period; suit limitation provisions are not like notice of loss or proof of loss clauses.  Second, the clock starts running on the suit limitation period when the policyholder has knowledge of the occurrence which ultimately gives rise to his or her loss, not when he or she has knowledge of the cause of that occurrence.  Third, the provision is a contractual limitations period and, as such, not subject to state laws governing the operation of statutes of limitations.

shutterstock_69907915The first case was Andrews v. St. Paul Guardian Ins. Co., 2015 U.S. Dist. LEXIS 104172, 2015 WL 4724574 (W.D. Wash., Aug. 9, 2015).  The insured’s home in Seattle experienced the Nisqually Earthquake in February 2001, but he saw no sign of structural distress at the time.  In 2014, he was planning a home improvement project and had the deck inspected, and it was then that he first learned of what he characterized as “massive visible damage” to foundation footings which “may” have been caused by the quake eleven years earlier.  He brought suit after the carrier denied liability.  Read more ›

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Posted in Collapse, Earthquake, Prejudice, Suit Limitation, Water

Pennsylvania Court Orders Production of Underwriting Files On Similar Claims By Other Policyholders

shutterstock_93698392Carriers routinely resist efforts to compel production of the underwriting and claims files on other policyholders on the basis of relevance.  Early last month in H.J. Heinz Co. v. Starr Surplus Lines Ins. Co., 2015 WL 5781295, 2015 U.S. Dist. LEXIS 138080, (W.D.Pa., Oct. 1, 2015), an insurer lost that fight when a federal court in Pennsylvania required it to produce the files.  The case is noteworthy, but arguably limited in terms of its application to other disputes.  A Phase One trial was directed solely to the insurer’s efforts to rescind the policy because of material misrepresentations in the application, and discovery addressing whether the insured was being treated the same way as other similarly-situated policyholders was uniquely important given that fact.  As the court recognized, it was “the main mechanism” for plaintiff to defend itself.

The insured manufactured and sold a dry, high-protein baby cereal in China.  On August 18, 2014, the Food & Drug Administration of Zhejian Providence seized hundreds of boxes of the product after tests revealed high levels of lead.  The cause was ultimately determined to be a contaminated production run of defatted soy powder from Qingdao Longhi Food Company, one of the policyholder’s ingredient suppliers.  The insured recalled the cereal and made claim under its product contamination policy for an “on-going” loss that it estimated to be in excess of $30 million. Read more ›

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Posted in Contamination, Contamination and Product Recall, Discovery, Rescission

Florida Court Rejects Claim Replacement Of Undamaged Property Is Necessary For Aesthetic Uniformity

Late last week a federal court in Florida tossed a condominium association’s claims that it was entitled to replace undamaged hallway carpeting, wallpaper, baseboards, and woodwork in order to “achieve aesthetic uniformity” with similar hallway components replaced after water damage.  In Great Amer. Ins. Co. v. Towers of Quayside No. 4 Condominium Ass’n., 2015 U.S. Dist. LEXIS 150358, 2015 WL 6773870 (S.D. Fla., Nov. 4, 2015), the court held that replacing undamaged property to insure “matching” is only appropriate if the repairs concern “a continuous run” of items such as that.

shutterstock_175299539The policyholder owned a 25-story condominium building in Miami.  There was a tiled elevator landing on each floor separating the east and west hallways, and those portions of the structure on floors three through twenty-five had a uniform appearance by design.  On February 11, 2013, a valve broke in an air conditioning unit on the east side of the 11th floor, and cascading water damaged the hallways on the east side of the building all the way down to the third floor. Read more ›

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Posted in Direct Physical Loss or Damage, Valuation, Water

New York Court Holds Public Adjuster Entitled to Fee Even Though Claim Settled After Ten Years Of Litigation

Disputes between the insured and its public adjuster (PA) are frequently contentious and have the unfortunate potential to draw the carrier into litigation.  A perfect example is last week’s decision in Public Adj. Bur., Inc. v. Greater N. Y. Mut. Ins. Co., et al., 2015 NY Slip OP 07942, 2015 WL 6510639, 2015 N.Y. App. Div. LEXIS 8000 (N.Y.App.Div., Oct. 29, 2015), where New York’s intermediate level appellate court held that the PA was entitled to its fee for performing “valuable services” even though those evidently ceased when suit was filed and it then took an additional ten years of bitter and protracted litigation to bring about a settlement.

shutterstock_234130801While not as prolonged and torturous as Dickens’ Jarndyce v. Jarndyce, the case litigated in one form or another for fifteen years.  After a garage collapse in lower Manhattan in early 1999, the policyholder retained the PA and executed a retainer agreement that set the adjuster’s fee at 7% “of the amount of loss and salvage . . . when adjusted or otherwise recovered.”  Efforts to settle with the insurer were unsuccessful, however, and the insured brought suit in 2001.  Two trials, three trips to the Appellate Division, and ten years later, a settlement was reached in May of 2010. Read more ›

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Posted in Collapse, Loss Adjustment, Public Adjusters

Vermont Supreme Court Collapse Case Underscores Danger of Insuring Against the “Risk” of a Peril

Three months ago in Equinox on the Battenkill Mgmt. Ass’n. v. Philadelphia Indem. Ins. Co., 2015 VT 98 (Vt., Aug. 7, 2015), Vermont’s highest court held that a policy insuring against the “risks of . . . collapse” affords considerably broader coverage than one insuring against “direct loss [by] collapse.”  While the latter covers only a falling in, the former encompasses situations in which collapse is imminent and perhaps even situations in which “the insured building’s structural integrity has degraded to the point where it cannot be safely and reliably used.”  The case is a cautionary tale for underwriters everywhere, and it also contains a useful survey of “risk of collapse” jurisprudence from around the country.

shutterstock_263206079The policyholder was a management association that operated a condominium complex in Manchester.  Many of the units had cantilevered balconies, and those began experiencing structural problems in 2007.  By 2012, it had become apparent that joists under the balconies had suffered moisture infiltration leading to rot and deterioration, and a structural engineer recommended that they be taken out of service altogether.  According to the insurer’s expert, this was attributable to “construction and design issues.”

The insured made claim, contending that it suffered a compensable loss under an additional coverage afforded for the peril of collapse occasioned by “hidden decay;” the joists had never been inspected or exposed prior to 2012.  The claim was denied, however, because the contract of insurance excluded loss caused by “[f]aulty, inadequate, or defective . . . [d]esign, specifications, workmanship, repair [or] construction.” Read more ›

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Posted in Collapse, Direct Physical Loss or Damage, Faulty Workmanship or Design, Hidden Decay

Massachusetts Court: Loss of Drink Product Caused By Faulty Workmanship And Design of Bottle Caps Not a Covered Ensuing Loss

shutterstock_241763938Monday saw a unanimous panel of Massachusetts’ intermediate level appellate court reject a policyholder’s ensuing loss arguments.  In H.P. Hood LLC v. Allianz Global Risks U.S. Ins. Co., 2015 Mass. App. LEXIS 175, 2015 WL 6629484 (Mass., Nov. 2, 2015), the justices held that the loss of over two million bottles of an energy drink was not separate or different in kind but rather “directly caused by, and completely bound up in” the excluded peril — faulty workmanship and design of the bottle caps.

The insured produced a high-performance protein supplement known as Myoplex for Abbott Laboratories, and it had contracted to manufacture some forty million bottles in 2009.  The drink was a “shelf stable” beverage that did not require refrigeration until after it was opened, and that meant that the bottles had to maintain a hermetic seal.  In May of 2009, “secure seal” testing revealed that some 7% of the bottle caps were failing to maintain a seal, and Abbott ultimately rejected all two million bottles in the May 2009 production run.  Subsequent investigation disclosed that the liners in the caps became more slippery over time.  That meant that the caps needed more torque than the existing production process called for to seal properly. Read more ›

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Posted in Direct Physical Loss or Damage, Ensuing Loss, Faulty Workmanship or Design

Minnesota Harmonizes the Mortgage Clause and the Vacancy Clause

Two days ago, Minnesota’s highest court unanimously held that a mortgagee’s recovery for vandalism damage to a vacant building is only barred by the vacancy clause if the insured’s acts caused the vacancy.  The decision is  Commerce Bank v. West Bend Mut. Ins. Co., 2015 WL 6498468, 2015 Minn. App. LEXIS 85 (Minn., Oct. 28, 2015)   If breached, the vacancy clause still automatically operates to void coverage for the insured, but it does not necessarily do the same for the mortgagee, and the determination entails addressing a question of fact.

shutterstock_312263147The policyholder had a building in Burnsville that had been vacant for four months when the mortgagee/bank was added to the contract of insurance.  Seven months later, while still vacant, the structure was vandalized.  The bank submitted an insurance claim, but this was denied because the policy recited that loss by vandalism was excluded “[i]f the building where loss or damage occurs has been vacant for more than 60 consecutive days before that loss or damage occurs.”

The bank brought suit.  The policy contained a so-called “standard” or “union” mortgage clause that provided that if the insurer denies a claim because of the insured’s acts or because the insured has failed to comply with the terms of the policy, “the mortgageholder will still have the right to receive loss payment” if it pays any premium due upon request and submits a sworn statement in proof of loss.  The trial court granted the bank’s motion for summary judgment, holding that it was entitled to recover despite the vacancy, but the court of appeals reversed and found in favor of the carrier. Read more ›

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Posted in Mortgagees, Vacancy and Unoccupancy, Vandalism
About The Property Insurance Law Observer

For more than five 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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