Seventh Circuit Holds Insured Entitled to a New Roof for Purely Cosmetic Hail Damage

The Seventh Circuit is becoming a difficult venue for insurers.  In November we reported that the Court of Appeals had held that the phrase “continuous or repeated exposure” in definition of occurrence meant that a continuous trigger theory applied, leaving the carrier exposed to a claim for 11 years of gradual water damage that was first reported 5 years after the last insurance policy expired.  Last month, in Advance Cable Co. v. Cincinnati Ins. Co., 2015 WL 3630699, 2015 U.S. App. LEXIS 9805 (7th Cir., Jun. 11, 2015), the same court held that cosmetic hail damage to a roof that had no affect on the structure’s functionality or life expectancy nonetheless constituted “direct physical loss” and required the insurer to pay for a replacement.

shutterstock_88109659Advance Cable had a building in Middleton, Wisconsin that sustained hail damage on April 3, 2011.  The insurer’s claim representative inspected the roof and observed no damage.  Six months later, the policyholder was contemplating a sale, and the buyer had the structure looked at.  Its inspector stated that there was “definitely hail damage,” and the insured asked the carrier to reopen its claim.  The resulting report by the insurer’s representative found hail dents up to 1” in diameter but concluded that these neither “affect[ed] the performance of the [roof] panels” nor “detract[ed] from the panels’ life expectancy.”  There was no evidence of record to the contrary. Read more ›

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Posted in Direct Physical Loss or Damage, Hailstorm

New York Court: Broadly-Worded Flood Limit “Meaningless” Unless it Applies to Any Kind of Loss Caused by Flood

Yesterday in El-Ad West LLC v. Zurich American Ins. Co., 2015 WL 4078762, 2015 N.Y. App. Div. LEXIS 5753 (N.Y.App.Div., Jul. 7, 2015), a unanimous panel of New York’s intermediate level appellate court held that a flood sub-limit capped all loss caused by flood, without regard to whether it was physical damage to property or a “downstream” financial loss such as delay in completion.  In the words of the opinion, reading the contract of insurance in such a way as to find that the flood sub-limit did not apply to delay in completion losses “would render the flood limit meaningless with respect to that coverage.”  The panel thereby affirmed a Superstorm Sandy decision that we reported on in July of last year; it was a case of first impression in New York.

shutterstock_39408994The policyholder was a developer that was converting an office building in Tribeca in lower Manhattan into luxury condominiums when Superstorm Sandy flooded the premises in October of 2012.  The storm caused more than $20 million in property damage and delay in completion loss.  The insured had a builder’s risk policy with a $115 million overall limit of liability, but there was a $7 million sub-limit for delay in completion and a $5 million sub-limit for “all losses or damages arising during a continuous condition as defined in the definition of FLOOD.”

The insured contended that it was entitled to recover $12 million, arguing that the delay in completion loss was not subject to the flood sub-limit.  The insurer disagreed, and litigation ensued.  On June 27, 2014, the trial court agreed with the carrier and granted partial summary judgment.  As the judge’s opinion explained, the broad definition of what kind of loss was subject to the $5 million flood sub-limit meant that “a loss that would not have occurred but for a flood is subject to a $5 million annual aggregate limit, without regard to the type of loss suffered since the expression ‘all losses or damages arising during [a flood]’ clearly does not exclude non-physical losses.” Read more ›

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Posted in Builders' Risk, Delay in Completion, Flood, Superstorm Sandy

Texas Court Rejects Ambiguity Arguments Bottomed on a Single Phrase

shutterstock_235607581Last Thursday in King v. Burwell, 2015 WL 2473448, 2015 U.S. LEXIS 4248 (U.S., Jun. 25, 2015), Chief Justice Roberts explained that “[a] provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme” when construing a law.  In the same fashion, it is inappropriate to find ambiguity residing in a single phrase in a contract of insurance when the meaning can be clarified by referring to the policy as a whole.  That was the teaching of a recent opinion by a unanimous panel of Texas’ intermediate level appellate court in 3109 Props. L.L.C. v. Truck Ins. Exch., 2015 WL 3827580, 2015 Tex. App. LEXIS 6146 (Tex.Ct.App., Jun. 18, 2015).

The insured was filmmaker Richard Linklater, the director of over a dozen films including Matthew McConaughey’s debut, the 1993 coming of age comedy Dazed and Confused.  Linklater had a $500,000 archive of his various film projects in a building in Paige, Texas.  In September of 2011, that was destroyed by the Bastrop County Complex Fire, a 32,000-acre inferno that did $325 million in insured property damage in southeast Texas; it is still the state’s most destructive blaze. Read more ›

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Posted in Ambiguity, Fire, Newly-Acquired Property, Wildfire

Oklahoma Holds Question of Whether Fracking Causes Earthquakes is for the Courts to Decide.

The issue of whether hydraulic fracturing or “fracking” causes earthquakes has first-party insurance implications because policies typically exclude damage from tremors attributable to man-made causes as opposed to purely unnatural ones.  We’ve discussed the issue in two recent posts after Insurance Commissioners in Oklahoma and Pennsylvania publicly warned carriers against denying earthquake claims on the basis that they were attributable to oil and gas drilling.  The jury is still out on the issue, but scientific evidence linking fracking to the tremors is accumulating rapidly.

shutterstock_140632915At the present time, Oklahoma is at the “sharp end of the spear” with respect to this issue because the state experienced fully 567 quakes of Magnitude 3.0 or greater in 2014.  That is the more than in the proceeding 30 years combined, and Oklahoma is on track to see fully 1100 such earthquakes n 2015!  When he released his bulletin in March, the state’s Insurance Commissioner stated that his office would assume that the state’s quakes were not man-made “[u]ntil a legal ruling is made.”  It now appears that just such a ruling may well be coming in the Sooner State.

Two days ago in Ladra v. The New Dominion, LLC, 2015 OK 53, 2015 WL 3982748, 2015 Okla. LEXIS 71 (Okla., Jun. 30, 2015), a unanimous state Supreme Court cleared the way for a lawsuit over causation to go forward.  The plaintiff contends that disposal of the massive amounts of wastewater from fracking by injection into deep wells caused a serious 2011 earthquake.  That matter, as well as other litigation that the decision will inevitably spawn, will be closely followed by both the energy industry and by fracking opponents, and it should be monitored by insurers as well given what the court called the “dramatic increase in the frequency and severity of earthquakes” in Oklahoma and other frack-high jurisdictions and the consequent ramping-up of resulting insurance claims. Read more ›

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Posted in Causation, Earthquake, Homeowners Coverage, Regulation

Missouri Court: “Equivalent” Requires that Replacement Siding be Both Equal in Value and Virtually Identical

In December, we published a post about a Minnesota Supreme Court case that held that under a replacement cost policy, the phrase “comparable material and quality” meant that all of the siding on 20 buildings had to be replaced to avoid a color mismatch, even though less than 2% had actually been damaged by hail.  According to the court, that was necessary to ensure a “reasonable” color match.  Last week, a unanimous panel of Missouri’s intermediate level appellate court reached a similar conclusion under a replacement cost contract of insurance that required replacement “for equivalent construction and use.”  In Alessi v. Mid-Century Ins. Co., 2015 WL 3874799, 2015 Mo.App. LEXIS 679 (Mo.App., Jun. 23, 2015), the judges held that the word “equivalent” requires that replacement be both “equal in value” and “virtually identical.”

shutterstock_74756989The policyholder owned a home in St. Charles that sustained siding damage in a hailstorm in April 2012.  The damage was confined to the home’s northern side, and the carrier paid the actual cash value for replacement of all of the siding on that portion of the building.  Because the original siding was no longer manufactured, however, the insured contended that she was entitled to recover for replacing the siding on the entire structure, and she brought suit after the insurer refused. Read more ›

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Posted in Direct Physical Loss or Damage, Hailstorm, Replacement Cost, Valuation

New York Court: Undefined Word “Occurrence” in a Deductible Provision Must be Construed by the Finder of Fact

Many property policies expressly define the term “occurrence” to encompass a series of similar and related events.  Last month, however, in Rokeach v. Hanover Ins. Co., 2015 WL 2400097, U.S. Dist. LEXIS 6580 (May 19, 2015, S.D.N.Y.), a New York federal court held that when the word is employed in the policy’s deductible provision without either emphasis or quotation marks, it is effectively undefined, and the question of whether it should be understood to denote a single occurrence or a series of multiple occurrences must be determined by the jury.

shutterstock_35357998The policyholder operated a welding business in Uniondale, and the company stored scrap metal in an ungated yard on the property.  As summarized by the court, the undisputed facts were as follows:

Thieves collected and carted away multiple separate loads of Mr. Rokeach’s property between mid-June 2011 and the date of their arrest on July 21, 2011.  The evidence suggests that the thefts were linked – the two thieves who were ultimately arrested were seen on the property multiple times, the thieves “staged” material during some trips for removal in other trips; they used the same means to steal the property – pulling up in the same truck in the same location multiple times to load the material. Read more ›

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Posted in Ambiguity, Deductible, Occurrence, Theft or Dishonesty

Washington Supreme Court Misses Opportunity to Clarify the Meaning Of “Collapse”

shutterstock_236211700Washington State has long been a jurisdiction with no judicial pronouncement as to the meaning of the term “collapse” in a property insurance policy, but that changed last Thursday when the state’s Supreme Court issued its decision in Queen Anne Park Homeowners Ass’n v. State Farm Fire & Cas. Co., 2015 WL 3795796, 2015 Wash. LEXIS 695 (Wash., Jun. 18, 2015).  The court found that the term, as used in the insurance policy before it, was ambiguous.  It then adopted a definition of “collapse,” but its use of uncertain terms in that definition may only lead to further ambiguity, and the likely result will be yet more expensive litigation concerning older policies that contain similar “collapse” language.

The Queen Anne Park Condominium in Seattle was insured by a State Farm policy against “accidental direct physical loss” unless excluded.  The policy extended coverage to “any accidental direct physical loss to covered property involving collapse of a building or any part of a building caused by . . . hidden decay.”  The coverage extension also stated that “collapse does not include settling, cracking, shrinking, bulging or expansion.”  Other than that, however, the policy left the term “collapse” undefined. Read more ›

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Posted in Ambiguity, Collapse, Hidden Decay

Missouri Court Clarifies What Constitutes An Ensuing Loss

Last week in Performance Arts Cmty. Improvement Dist. v. ACE Amer. Ins. Co., 2015 WL 3491292, 2015 U.S. Dist. LEXIS 71592 (W.D. Mo., June 3, 2015), a federal court in Missouri shot down an insured’s arguments that a wall collapse caused by the excluded peril of defective design was a covered ensuing loss under a builder’s risk policy.  The developer admittedly erred in calling an for excess amount of concrete slurry to be pumped behind the structure, but the policyholder contended that the collapse that that mistake caused was a separate loss by “excessive lateral pressure.”  The court analogized to that to arguing that the collapse of a defectively-designed building was a separate loss caused by the covered peril of gravity.

shutterstock_160130774The policyholder had contracted for the construction for a parking garage adjacent to a performing arts center in Kansas City, and the project included the installation of a 50’ high concrete retaining wall between the structure and an adjacent limestone rock face.  The original design called for up to 18” of concrete slurry to be poured between the wall and the limestone embankment, but, at the general contractor’s insistence, it was modified to permit up to 36” of the fill material to be installed. While the slurry was being pumped in place, the wall cracked and failed, and it was uncontested that the change to 36” of fill was a design defect.

The insured made claim under its builder’s risk policy, but the carrier denied because the contract of insurance barred coverage for a loss caused by “[e]rror, omission or deficiency in design, plans, specifications, engineering or surveying.”  That exclusion was prefaced by an ensuing loss exception that restored coverage when “direct physical loss or damage by an insured cause of loss ensues,” however.  The policyholder brought suit, contending that excessive pressure caused by the additional fill constituted a covered ensuing loss. Read more ›

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Posted in Builders' Risk, Collapse, Ensuing Loss, Faulty Workmanship or Design

Ninth Circuit: Under Arizona Law Mudslide Can Be Covered as the Direct Result of Fire

Last Friday, a unanimous panel of the Ninth Circuit held that loss from the excluded peril of mudslide occurring one month after a wildfire could be covered as the “direct” result of the blaze.  In Stankova v. Metropolitan Prop. & Cas. Ins. Co., 2015 WL 3429395, 2015 U.S. App. LEXIS 8935 (9th Cir., May 29, 2015),  it reached that result even though Arizona has not adopted the efficient proximate cause rule, saying that it did not need to apply that doctrine to determine that the mudslide “could have been directly and proximately caused by the wildfire.” It also blithely ignored anti-concurrent causation (ACC) language, which is given effect in Arizona, as “inconsistent with Arizona’s standard fire insurance policy, which insures against all direct loss by fire.”

shutterstock_110845709The policyholders owned a home with a detached garage in Alpine, Arizona.  Beginning on May 29, 2011, eastern parts of the state and western New Mexico were devastated by a massive blaze known as the Wallow Fire – we published a post about an Arizona district court decision concerning business interruption loss that stemmed from that conflagration last month.  The fire consumed the detached garage and all of the vegetation on the nearby hillside, but it did not reach the house.  On August 6, 2011, however, one month after the Wallow Fire had been contained, there was a mudslide on the hillside, and mud and runoff water from flooding destroyed the home.

The insureds made claim under their homeowners policy.  The carrier paid for the loss to the garage, but it denied the claim for the house because the contract of insurance expressly excluded loss attributable to:

Water damage, meaning any loss caused by, resulting from, contributed to or aggravated by . . . flood [or] surface water flooding; and

Earth Movement, meaning any loss caused by, resulting from, contributed to or aggravated by events that include, but are not limited to . . . mudslide

These exclusions were prefaced by ACC language reciting that the carrier did not cover loss “which would not have happened in the absence” of the excluded event “regardless of . . . the cause of the excluded event; . . . other causes of the loss; or . . . whether such causes acted at the same time or in any other sequence with the excluded event to produce or contribute to the loss.” Read more ›

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Posted in Anti-Concurrent Causation, Causation, Direct Physical Loss or Damage, Efficient Proximate Cause, Exclusions, Flood, Mudslide, Wildfire

Georgia Court: Policy Does Not Require Insured to Produce Recordings of Her Conversations With the Carrier

On May 20th, a federal court in Georgia held that the standard “requirements in case of loss” language compelling the insured to turn over her books and records during the adjustment process did not require the production of recordings that she had secretly made of her telephone calls with the insurer’s representatives.  In Armstead v. Allstate Prop. & Cas. Ins. Co., 2015 WL 2408049, 2015 U.S. Dist. LEXIS 66030 (N.D. Ga., May 20, 2015), the court rejected arguments that the policyholder’s refusal to disgorge the tapes was a violation of the “no action” clause that precluded her breach of contract and bad faith action because it held that the carrier had not shown that they were material to the adjustment of the claim.

shutterstock_146114156Instead of contending that the “requirements in case of loss” language mandated the tapes’ production, of course, the insurer should have sought them through regular discovery and moved to compel if they weren’t forthcoming.  It is hard to see how the policyholder could have resisted that motion given her allegations of bad faith.

The policyholder owned a home in Powder Springs, Georgia that sustained fire and smoke damage from an accidental grease fire on December 7, 2011.  The insured submitted a proof of loss seeking $75,909.43, but her homeowners carrier contended that the repairs could be effected for far less, and it ultimately made payments totaling approximately $20,000. Read more ›

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Posted in Cooperation, Discovery, Examinations Under Oath, Fire, Homeowners Coverage, Investigation, Loss Adjustment
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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