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

Indiana Court Nixes Requests for Reinsurance and Reserves

shutterstock_182629457Early last month a federal court in Indianapolis barred a policyholder from seeking the claims and underwriting files of the defendant carrier’s reinsurer in Indianapolis Airport Auth. v. Travelers Property Cas. Co. of Amer., 2015 WL 1548959, 2015 U.S. Dist. LEXIS 45123 (S.D. Ind., Apr. 7 2015).  Several months ago, the same court also shot down the policyholder’s requests for the insurer’s reserves.

The insured operated the Indianapolis International Airport, and it began construction on the $1 billion Midfield Terminal Project in 2005 and secured a builder’s risk policy from Travelers to cover the work.  On January 24, 2007, temporary shoring towers collapsed, damaging the building, disrupting the original construction schedule, and generating claims by consultants and contractors.  The policyholder made claim for $13.4 million, but the carrier refused to pay more than $4.19 million.  The insured then brought suit, alleging breach of contract and seeking declaratory judgment.

During discovery, the policyholder issued a non-party subpoena to Travelers’ reinsurer, Gen Re, seeking Gen Re’s claims and underwriting files.  The insurer responded with a motion to quash and also requested a protective order barring the insured from discovery of any reinsurance documents from any source.  On April 7th, Magistrate Judge Tim Baker granted the motion. Read more ›

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Posted in Builders' Risk, Collapse, Discovery, Reinsurance, Reserves

Oklahoma Court Holds the Policyholder Can Also Be the Vandal

Earlier this week an Oklahoma federal court addressed a mortgagee’s claim for vandalism loss – a topic we also discussed in Wednesday’s post.  In American Modern Home Ins. Co. v. Tulsa Fed. Credit Union, 2015 WL 2372549, 2015 U.S. Dist. LEXIS 64491 (E.D.Okla., May 18, 2015), the court rejected an insurer’s argument that because the vandalism was done by the insured, it could not constitute the covered peril of “vandalism” in a situation in which the policy neglected to define that term.

shutterstock_118758637The insured owned a house and secured a homeowners policy that also extended coverage to his mortgagee.  The mortgage company instituted foreclosure proceedings and the policyholder vacated the dwelling, but only after removing fixtures and damaging property to the tune of $246,025.  The mortgagee’s subsequent insurance claim was denied, and litigation ensued.

The contract of insurance covered fire and also the perils of vandalism, malicious mischief, and burglary.  The terms “vandalism” and “malicious mischief” were not further defined, but the policy excluded burglary loss if it was “committed by an insured.”  In addition, there was an exclusion for “Intentional Loss” which was defined to mean “any loss arising out of any act committed . . . by or at the direction of an insured.”  Finally, there was a mortgage clause that informed the policyholder that “[i]f we deny your claim, that denial will not apply to a valid claim of the mortgagee” so long as the mortgage company has notified the insurer of any change in the ownership,  occupancy, or risk, paid any premium due, and submitted a sworn proof of loss in a timely manner. Read more ›

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Posted in Ambiguity, Homeowners Coverage, Loss Payees, Mortgagees, Theft or Dishonesty, Vandalism

Pennsylvania Joins Oklahoma, Bans Homeowners Insurers From Attributing Earthquakes to Fracking

Last month we reported that the Oklahoma Insurance Commissioner had issued a bulletin cautioning earthquake insurers against denying claims on the basis that the quake was attributable to a man-made cause, which is to say oil and gas production, rather than to a purely natural one.  Recently, Pennsylvania’s Acting Insurance Commissioner Teresa Miller followed suit, “instructing” homeowners carriers that earthquake endorsements “should cover all earthquakes, whether believed to be ‘naturally occurring’ or caused by ‘human activity.’ ”

shutterstock_248308744The Keystone State has not seen the dramatic uptick in earthquake activity that has shattered both nerves and property in Oklahoma in recent years.  Because of the hydrocarbon-rich Marcellus Shale formation, however, it remains a jurisdiction with more oil and gas drilling than all but a handful of other states, and many homeowners have purchased earthquake endorsements in view of the widely-publicized rise in seismic activity in many such places. Read more ›

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Posted in Causation, Earthquake, Homeowners Coverage, Regulation

Illinois Court Holds Vacancy Clause Does Not Bar Vandalism and Theft Claim by Mortgagee

In a case of first impression in Illinois, a unanimous panel of the state’s Appellate Court recently addressed the interplay between a vacancy clause and a mortgagee provision and held that the insured’s failure to comply with the former did not preclude recovery by the mortgage company after vandals did over $2 million in damage.  In Old Second Nat’l Bank v. Indiana Ins. Co., 2015 IL App. (1st) 140265, — N.E.3d –, 2015 WL 1283867, 2015 Ill. App. LEXIS 185 (Mar. 20, 2015), it held that the vacancy clause was a condition subsequent to coverage and that its violation therefore only operated to bar the policyholder’s claim even though the structure – unbeknownst to the insurer — had been vacant since the policy’s inception.

shutterstock_268384877The property at issue was a former slaughterhouse in Askum that had been vacant since 2005.  The policyholder (Brothers Future Holdings) acquired it in 2007 intending to use it for a contract cooking venture, but that business turned out to be stillborn.  Property insurance was duly procured, based on an application reciting the structure was “100% owner-occupied.”  The mortgagee came on board in August of 2007, and the insurer’s agent was contacted by the mortgage company and issued an “Evidence of Property Insurance” document to the mortgagee indicating that coverage was in place.

The insurer never inspected the facility and was unaware that it was vacant.  The mortgagee’s loan officer did inspect the building in 2007, however, and the mortgagee knew that the structure was unoccupied. Read more ›

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Posted in Conditions, Loss Payees, Mortgagees, Theft or Dishonesty, Vacant or Unoccupied, 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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