Inventory Computation Exclusion Bars Employee Theft Claim in Alabama

Employee theft claims are frequently problematic when the only evidence of shortage is a comparison between computer records and a physical inventory conducted after the malefactor has been discharged.  In W.L. Petrey Wholesale Co. v. Great American Ins. Co., 2015 WL 404523, 2015 U.S. Dist. LEXIS 10943 (N.D.Ala., Jan. 30, 2015), an Alabama federal court recently granted summary judgment to the carrier where the contract of insurance barred employee dishonesty claims based solely on “inventory computation” and such a comparison was the policyholder’s only evidence of the loss.

shutterstock_200562473Petrey was a wholesale distributor of goods supplied to convenience stores, one of which was a two ounce “energy shot” drink called “5-Hour Energy.”  It hired salespeople for delivery routes, and each of them leased a Petrey storage unit.  The salespeople ordered inventory from Petrey’s warehouse, and the insured then delivered the goods to the storage unit for distribution.

Justin Bree was a Petrey salesperson for six years before being terminated, and the insured made claim under its business income and crime prevention policy when a post-termination inventory showed a shortage of 82,510 bottles of 5-Hour Energy valued at $111,415.35.  The policy covered employee dishonesty, defined as “loss of, and loss from the damage to . . .  property resulting directly from dishonest acts committed by an employee, whether identified or not, acting alone or in collusion with other persons[.]”  There was also an exclusion for loss “the proof of which as to its existence or amount is dependent upon . . .  an inventory computation; or . . .  a profit and loss computation,” however, and Great American denied because the claim was based solely on a comparison between Petrey’s computer-generated inventory records and the physical inventory of Bree’s storage unit that was conducted after he was let go.  Litigation followed. Read more ›

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Posted in Conditions, Exclusions, Theft or Dishonesty

Virginia Court Nixes Claim Chinese Drywall Damage to HVAC Systems is Covered as Equipment Breakdown

In Travco Ins. Co. v. Ward, 284 Va. 547, 736 S.E.2d 321 (2012), the Virginia Supreme Court held that loss occasioned by the sulfuric gas released by defective Chinese drywall was excluded under the primary coverage grant of a property policy because of exclusions for corrosion and pollution.  Last month, a Virginia federal court shut down claims that such a loss might nonetheless be covered under a policy’s secondary coverage provisions extending coverage to equipment breakdown.  The matter was Nationwide Mut. Ins. Co. v. CG Stony Point Townhomes, LLC, 2015 WL 236826, 2015 U.S. Dist. LEXIS 5682 (E.D.Va., Jan. 15, 2015).

shutterstock_128300597The policyholder made claim after the heating, ventilating, and air-conditioning (HVAC) systems in five townhouses at its Creek’s Edge at Stoney Point Townhomes complex in Richmond broke down due to off-gassing from the drywall.  Its property insurance carrier, Nationwide Mutual, responded by filing a declaratory judgment action asking the court to hold that it had no obligation to cover the claims.  Stony Point conceded that it had no coverage under the main body of the contract of insurance in the wake of Travco, but it contended that the damage to the HVAC units was covered by an Additional Coverage for “Equipment Breakdown.”  This recited that Nationwide “will pay for loss caused by or resulting from an ‘accident’ to ‘covered equipment.’ “  The provision also afforded coverage for “the additional cost to repair or replace Covered Property because of contamination by a ‘hazardous substance.’ “ Read more ›

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Posted in Contamination, Corrosion, Mechanical Breakdown, Pollution

Late Notice Held to Bar a $6,000,000 Hurricane Wilma Claim in Florida

shutterstock_178930271In The Yacht Club on the Intracoastal Condo. Ass’n. v. Lexington Ins. Co., –  Fed.Appx. –, 2015 WL 106862, 2015 U.S. App. LEXIS 293 (11h Cir., Jan. 8, 2015), a unanimous panel of the Eleventh Circuit recently held that a Florida condominium association’s multi-million claim for extensive Hurricane Wilma damage was barred because the insured failed to give notice of loss for fully 55 months.  The policyholder’s arguments that it was initially unaware that the damage exceeded the deductible and that it had created an issue of fact with respect to whether the presumption of prejudice had been rebutted because both parties were ultimately able to put up expert evidence of causation were unavailing.

The Yacht Club had 380 units in some 16 buildings, and its property was damaged by Hurricane Wilma on October 24, 2005.  It had a $5,000,000 property policy with Lexington, but the Club’s board was initially of the opinion that the repairs would not exceed the policy’s $100,000 deductible and decided not to make a claim, though they subsequently imposed a $150,000 special assessment on residents to pay for the hurricane damage.  Over the next year, however, residents complained of a host of problems with roofs, stucco siding, windows, and sliding glass doors, and that led the Club to hire an engineer in late 2006; his report attributed the roof damage to Wilma.

In late 2009, the Club finally secured a public adjuster, and he advised that the property had suffered significant damage from the storm and recommended making an insurance claim.  Formal notice of loss was duly sent to Lexington on July 27, 2010, four years and seven months after the hurricane, and suit was filed three months later.  The Club sought $6,208,910 from its insurer. Read more ›

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Posted in Conditions, Hurricane, Hurricane Wilma, Investigation, Notice, Prejudice

If You Post It, Your Opponent Can Probably Discover It

In March we ran a post on how important videos, photographs, and statements on social media sites can be when investigating a property loss.  A picture is literally worth a thousand words.  Earlier this month, a Florida court explained that such material is also discoverable – even in situations where the policyholder employs privacy settings that prevent the general public from having access to his or her account – because the user’s privacy interest in such a site is “minimal, if any.”  Nucci v. Target Corp., – So.3d –, 2015 WL 71726, 2015 Fla. App. LEXIS 153 (Fla.Dist.Ct.App., Jan. 7, 2015) involved a slip-and-fall, but it applies with equal force to discovery in a first-party matter.

shutterstock_197845040Maria Nucci filed a personal injury action against Target, alleging that she fell on “a foreign substance” on the floor of one of the defendant’s stores.  Her complaint contended that she sustained permanent injuries, aggravated pre-existing ones, and also experienced lost earnings and emotional pain and suffering.  Prior to her deposition, Target’s attorneys reviewed her Facebook profile and found that it contained 1,285 photographs.  She was questioned about some of them at the deposition itself, and she promptly took three dozen of the pictures down.

Target moved to compel.  After a hearing, the trial court ordered production of “copies or screenshots of all photographs associated with” any social networking account that Ms. Nucci was currently registered with from two years prior to the date of loss until the present.  The plaintiff then sought certiorari review from Florida’s intermediate level appellate court. Read more ›

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Posted in Discovery, Investigation, Reasonable Expectations

Anti-Sequential Causation Clause Upheld in Hurricane Irene Case in New Jersey

In Ashrit Realty, LLC v. Tower National Ins. Co., 2015 WL 248490, 2015 N.J. Super. Unpub. LEXIS 107 (N.J.Super.Ct., App.Div., Jan. 20,  2015), New Jersey’s Appellate Division held that an anti-concurrent/anti-sequential causation clause precluded coverage for a Hurricane Irene loss.  A covered peril (hidden decay) led to an excluded peril (soil erosion), bringing down part of the insured’s structure.  As the court explained, such a provision “excludes coverage in situations where a covered event and an excluded event contribute, concurrently or sequentially, to a single loss.”  While the New Jersey Supreme Court has yet to weigh in on anti-concurrent/anti-sequential causation clauses, the case adds to growing body of lower court decisions holding or suggesting that such provisions are valid and enforceable.  See Assurance Co. of Am., Inc. v. Jay-Mar, Inc., 38 F.Supp.2d 349 (D.N.J. 1999); Simonetti v. Selective Ins. Co., 372 N.J.Super. 421 (N.J.App.Div. 2004); Petrick v. State Farm Fire and Cas. Co., 2010 WL 3257894, 2010 N.J. Super. Unpub. LEXIS 1964 (N.J.Super.Ct., App.Div. 2010).

shutterstock_548134The policyholders owned a gas station and convenience store in Cherry Hill, New Jersey.  The structure experienced moderate damage during a storm on August 14, 2011.  Two weeks later on August 28th, the rear portion of the building collapsed during Hurricane Irene.  There was a 72” corrugated metal culvert running underground near the rear of the structure, and this was corroded and decayed.  Experts for both sides agreed that the deteriorated culvert sustained damage during the first storm and then partially collapsed after Irene, leading to extensive soil erosion; when the insurer’s expert examined the property two days after the storm, there was a hole 60’ long, 20’ wide, and 8’ deep behind the building.

The insureds made claim against their property insurance carrier, Tower National Insurance Company, and they filed suit for breach of contract and breach of the duty of good faith after the insurer denied liability.  Tower moved for summary judgment, and that was granted by the trial court in October of 2013.  Last week, an appellate panel (Judges Marie Cimonelli and Michael A. Guadagno) affirmed. Read more ›

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Posted in Anti-Concurrent Causation, Causation, Collapse, Hurricane, Hurricane Irene, Seepage or Leakage

Website Names the Top Ten Most Ridiculous Lawsuits of 2014

December saw two posts about the depressing demise of TRIA, so we thought we’d end the year on a considerably lighter note.  FacesOfLawsuitAbuse.org is a U.S. Chamber of Commerce project that addresses this country’s litigation explosion, and it publishes a list of the ten most ridiculous lawsuits at the end of every year.  While none of this year’s finalists involve insurance coverage per se, we thought that we still would share them with our readership.  Some of last year’s – such as the man who sued Apple because he allegedly became addicted to pornography after “accidently” visiting an adult website on an Apple device or the criminal who sued eight brewers for not warning him that alcohol, which supposedly led to his life of crime, was “habit forming and addictive” – were arguably funnier.  This year’s crop nonetheless contains some howlers.  Read on – and may each and every one of you have a happy, healthy, and prosperous 2015!

shutterstock_167204078(1)  A man who fell asleep during Red Sox game at Yankee Stadium filed a lawsuit against ESPN and its announcers as well as Major League Baseball and the Yankees after he was shown napping on a live telecast of the game.  According to his complaint, he suffered “substantial injury” to his “character and reputation” and “mental anguish, loss of future income and loss of earning capacity” as a result of the incident.  His complaint seeks $10 million in damages.

(2)  Walt Disney Corporation’s new blockbuster movie Frozen, which is based on the Hans Christian Anderson fairytale The Snow Queen, has become the highest grossing animated film in history.  Disney has now been hit with a copyright infringement lawsuit by a woman who contends that the story is instead based on her autobiography about growing up in the mountains of Peru.  The pro se complaint points to the similarities such as the fact that the plaintiff, like the movie’s Elsa, grew up with a sister with different colored hair.  The complaint contends that the film caused “irreparable harm” to the plaintiff and calls for Disney to “cease and desist from any and all sales, distribution and marketing of Frozen in any media format” and to pay her $250 million in damages. Read more ›

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Posted in U.S. Legal System

Minnesota Holds “Comparable Material and Quality” Requires Wholesale Replacement Where Undamaged Siding Is Faded

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Matching issues are frequently problematic when storms damage only portions of an insured structure’s exterior and it proves impossible to replace the damaged sections with material that is an exact match for the rest of the building’s roof or siding.  Earlier this month, the Minnesota Supreme Court held that the phrase “comparable material and quality” means material that is suitable for matching; with respect to color, a reasonable match – not an identical match – is all that is required.  In Cedar Bluff Townhome Condominium Ass’n. v. American Family Mut. Ins. Co., – N.W.2d – , 2014 WL 7156914, 2014 Minn. LEXIS 661 (Minn., Dec. 17, 2014), however, the court held that that meant that all of the siding on 20 buildings had to be replaced to avoid a color mismatch even though less than 2% of it had actually sustained hail damage.

The insured, Cedar Bluff Townhome Condominium Association, owned a residential complex that sustained hail damage in October of 2011.  There was at least some siding damage to each building.  The siding panels were 15 square feet in size, and between one and ten panels were damaged on each structure.  Overall, however, less than 2% of the siding in the complex as a whole had actually been damaged by hail.

The policy issued by American Family Mutual Insurance Company afforded coverage for “direct physical loss of or damage to Covered Property,” and there was a Loss Payment clause that obligated the carrier to pay “the cost of repairing or replacing the lost or damaged property.”  The contract of insurance was also written on a replacement cost basis, and it recited that replacement cost was determined based on the cost to replace the lost or damaged property with other property “of comparable material and quality.”  The siding was 11 years old, and the color of the panels had faded.  The manufacturer had replacement panels that were identical in model name, size, texture, and installation methodology, but they were not available in a color that matched the faded siding.  American Family offered to pay $6,800 to replace those panels that had actually been damaged by hail, but Cedar Bluff sought over $361,000 to replace all of the 20 buildings’ siding. Read more ›

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

Our Dysfunctional Congress Skedaddles, Leaving TRIA to Die

Last Friday we reported that the House of Representatives had finally passed a bill reauthorizing the Terrorism Risk Insurance Act (TRIA) and sent it to the Senate.  The post included a picture of a cartoon bomb with a lit fuse because the statute was due to expire in only two weeks.  On Tuesday, in an epic act of irresponsibility, the Senate allowed that to happen, adjourning for the year without taking up the measure and leaving TRIA to sunset on December 31st.

shutterstock_121645444Congress has a bad habit of larding important legislation like TRIA with wholly-unrelated provisions, and it was one of those that doomed reauthorization.  When the Senate wrote its own reauthorization bill earlier this year, it proposed including a provision creating the National Association of Registered Agents and Brokers (NARAB), a non-profit clearinghouse made up of state insurance commissioners and insurance market representatives which would oversee and streamline the licensing of agents and brokers.  Senator Tom Coburn (R-Okla.) was opposed, believing that to be a federal infringement on authority traditionally reserved for the individual states, and the Senate bill that was sent to the House on July 17th sunset NARAB after two years.

When the House passed its own reauthorization bill and sent it back to the Senate on Friday, one of its changes was to eliminate NARAB’s sunset date.  That stuck in Senator Coburn’s craw, and he placed a hold on the bill, telling the Senate on Tuesday that the NARAB provision “takes away the 10th Amendment right of every state to control their own insurance agents and brokers.” Read more ›

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If It’s December, It Must Finally Be Time for Congress to Do Something About TRIA

It looks like Congress is finally turning its attention to reauthorizing the Terrorism Risk Insurance Act (TRIA).  The statute will sunset on December 31st unless action is taken before then.

Addressing our nation’s urgent problems at the last possible minute has become a Congressional hallmark in recent decades, and TRIA is no exception.  We ran a post explaining how the statute works in early May, and we optimistically titled it “Congress Moves Towards Reauthorization of TRIA.”  We should have known better.  TRIA was enacted in 2002 with a sunset date of December 31, 2005.  It has since been reauthorized twice – for two years by the Terrorism Risk Insurance Extension Act (TRIEA) in 2005 and then again for seven years by the Terrorism Risk Insurance Program Reauthorization Act (TRIPRA) in 2007.  TRIEA was sent to the President’s desk by Congress on December 22nd while TRIPRA was sent to the White House even closer to the wire, on December 26th.  Congress is at least consistent.

shutterstock_177862862The House of Representatives’ Financial Services Committee sent a reauthorization bill to the House floor on June 20th, but it was never voted on by the full chamber.  It had been passed out of the committee on a partisan 32-27 vote, and its sponsors evidently felt that it reduced the federal government’s backstop role too drastically to have any chance of passing the Senate.  The upper chamber then passed a reauthorization bill of its own on July 17th by a 93-4 vote and sent it to the House, but it languished there until recently as TRIA’s expiration date grew ever closer.

In recent weeks, extensive negotiations between Senator Charles Schumer (D.-N.Y.) and the Chairman of the House’s Financial Services Committee, Representative Jeb Hensarling (R.-Tex.), finally broke the bill free, and the House approved an amended version of the Senate’s TRIPRA of 2014 on Wednesday of this week.  The vote was an overwhelming 417-7, and the amended measure now heads back to the upper chamber. Read more ›

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Posted in Terrorism, Terrorism Insurance

Florida Court: Under All-Risk Policy, Insured Does Not Bear Burden of Showing Loss Was Caused by a Sinkhole

On November 26th, a unanimous panel of Florida’s Second District Court of Appeals held that a trial judge had erred in placing the burden of showing that loss was caused by covered sinkhole activity on the shoulders of the insured.  In Mejia v. Citizens Prop. Ins. Corp., 2014 WL 6675717, 2014 Fla. App. LEXIS 19526 (Fla.Dist.Ct.App., Nov. 26, 2014), the court stated that the policyholder under an all-risk contract of insurance has met his burden by showing that the insured property suffered a loss while the policy was in effect; the burden then shifts to the insurance carrier to prove that the cause of the loss was excluded from coverage.

shutterstock_3414932Alfredo Mejia owned a home that was insured by Citizens Property Insurance Corporation, and he made a claim for damage, contending that it was caused by sinkhole activity.  The insurer retained BCI, an engineering firm, and it denied liability after BCI concluded that the damage was not caused by a sinkhole.  A breach of contract action followed.

The policy was an all-risk contract of insurance that excluded earth movement, settlement, and loss caused by a sinkhole.  The insured had paid an additional premium for a Sinkhole Loss Coverage Endorsement, however; that added sinkhole loss as a covered peril and stated that the earth movement and sinkhole exclusions did not apply.

Prior to trial, the lower court ruled that Mejia had the burden of showing that the damage was, in fact, occasioned by sinkhole activity.  Instructed to that effect, the jury found that the policyholder had not established by the greater weight of the evidence that his home had suffered physical damage caused by a sinkhole.  Final judgment was entered in favor of the carrier. Read more ›

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Posted in All Risk, Burden of Proof, Experts, Homeowners Coverage, Sinkhole
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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