New Jersey Court: Loss of Use – Without More – Can Be “Direct Physical Loss or Damage”

Last month, a New Jersey federal court held that the term “direct physical loss of or damage to” property did not require that the property be physically altered in any permanent way.  In Gregory Packaging, Inc. v. Travelers Property Cas. Co., 2014 WL 6675934, 2014 U.S. Dist. LEXIS 165232 (D.N.J., Nov. 25, 2014), the court determined that an ammonia release that rendered the insured manufacturing plant unusable until the gas had been dissipated “physically transformed the air” within the facility and thereby inflicted direct physical loss or damage to the plant.

shutterstock_134470478Gregory Packaging manufactured and sold juice cups, and it was in the process of installing a refrigeration system at a new plant in Newman, Georgia when anhydrous ammonia was accidentally released into the facility, severely burning a subcontract worker.  The plant was evacuated, and a remediation company was retained to dissipate the gas.  That process took several days.

The facility was insured by Travelers Property Casualty Company under a contract of insurance that afforded coverage for “direct physical loss of or damage to Covered Property caused by or resulting from a Covered Cause of Loss.”  The insurer denied liability for Gregory Packaging’s property damage and business interruption claims, arguing that there had been no physical loss or damage because the term connoted a physical change or alteration to insured property requiring its repair or replacement.  The policyholder responded by placing the matter in suit in federal court in New Jersey, and it then sought partial summary judgment on the sole issue of whether the ammonia release constituted an instance of direct physical loss or damage to the property. Read more ›

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Posted in Direct Physical Loss or Damage, Explosion, Seepage or Leakage

With Respect to Discoverability, Indiana Federal Court Distinguishes Between Pre-Suit and Post-Suit Reserves

In May, we reported on a Third Circuit decision holding that loss reserve information was generally irrelevant and not discoverable.  In October, a federal court in Indiana came to the same conclusion with respect to post-suit reserves.  In G & S Metal Consultants, Inc. v. Continental Casualty Co., 2014 WL 5431223, 2014 U.S. Dist. LEXIS 151431 (N.D.Ind., Oct. 24, 2014), the court agreed that reserves established after litigation were irrelevant because of the multiplicity of factors that were necessarily considered in establishing them.  The opinion suggests that pre-suit reserves are discoverable unless they have been set in anticipation of litigation and consultation with counsel, however.

shutterstock_157718609G & S Metal Consultants filed suit for property damage and business interruption loss after a steam explosion at a Georgia facility.  After discovery was complete, the insurer, Continental Casualty, successfully sought permission to file an amended answer asserting additional affirmative defenses and a counterclaim based on alleged misconduct by G & S during the claim adjustment process that it had allegedly learned of during discovery, and the court reopened discovery to allow the policyholder to defend against the counterclaim.  The insured then sought to question the carrier’s 30(b)(6) designee about reserves, and it filed a motion to compel after Continental’s attorneys objected to that line of questioning.

On October 24th, the court denied the motion.  Judge Paul R. Cherry’s opinion distinguished between loss reserves set during the claim adjustment process and loss reserves set during litigation.  With respect to the latter, he held that such information was essentially irrelevant because there were simply too many factors involved in the carrier’s decisions.  As he explained: Read more ›

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Posted in Discovery, Explosion, Privilege, Reserves

Seventh Circuit: Under Wisconsin Law, “Continuous or Repeated Exposure” Language Means That a Continuous Trigger Theory Applies

Yesterday, in Strauss v. Chubb Indem. Ins. Co., – F.3d – , 2014 WL 6435314, 2014 U.S. App. LEXIS 21794 (7th Cir., Nov. 18, 2014), the Court of Appeals held that the use of the phrase “continuous or repeated exposure” in a Wisconsin first-party property policy’s definition of occurrence meant that the contract of insurance contemplated that the continuous trigger theory determined whether loss was covered.  As a result, a claim for 11 years of gradual water damage under a series of insurance policies was held to be timely even though it was first presented when the damage was initially discovered, five years after the last contract of insurance had expired.

shutterstock_124109527The Strausses had constructed a home in Mequon, Wisconsin in 1994, and they were insured by four separate Chubb carriers from then until October of 2005.  In October of 2010, Mr. and Mrs. Strauss discovered that a defect during construction in 1994 had been allowing water infiltration during every rainstorm over the past 16 years, causing damage to the building’s envelope.  They made claim under the 1994-2005 Chubb policies, but the insurers denied liability, and the Strausses brought suit in federal court in October of 2011, within one year of their discovery of the damage.

The policies covered “all risks of physical loss to [the] house” with coverage limited “only to occurrences that take place while this policy is in effect.”  The term “occurrence” was then defined as”

a loss or accident to which this insurance applies occurring during the policy period.  Continuous or repeated exposure to substantially the same general conditions unless excluded is considered to be one occurrence.

Finally, there was a “Legal Action Against Us” clause mandating that any action against the insurers be brought “within one year after a loss occurs.” Read more ›

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Posted in Ambiguity, Homeowners Coverage, Trigger, Water

New Jersey Court Holds $22 Million “Named Storm” Deductible Applicable to a Superstorm Sandy Loss

On October 29th, a New Jersey trial court held that a commercial policyholder’s Superstorm Sandy claims were subject to a $22 million “named storm” deductible equal to 2% of the total insurable values at risk at all of the loss locations for which the insured made claim.  In Wakefern Food Corp., et al. v. Lexington Ins. Co., Case No. L-6483-13 (N.J.Super.Ct., Middlesex Cty., Oct. 29, 2014), the court held that damage had begun to occur hours before Sandy was downgraded and no longer constituted a “named storm” as defined and that that fact “created a substantial nexus between the storm and Wakefern’s total losses” justifying application of the deductible.

shutterstock_197340095Plaintiff Wakefern was a buying cooperative consisting of the owners of ShopRite and PriceRite supermarkets, and it had a commercial property policy issued by Lexington Insurance Company.  After Superstorm Sandy struck on October 29, 2012, Wakefern made claim for over $50 million in damage at dozens of different locations.

The contract of insurance afforded wind and hail coverage up to a $150 million sub-limit.  It also stated that the wind and hail coverage was subject to either a $250,000 per occurrence deductible or a deductible of “2% of Total Insurable Values at the time of the loss at each location involved in the loss or damage arising out of a Named Storm.”  The phrase “total insurable values” (TIV) was not defined, but the policy recited that a “named storm” was “a storm that has been declared by the National Weather Service to be a Hurricane, Typhoon, Tropical Cyclone, Tropical Storm or Tropical Depression.”  Read more ›

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Posted in Deductible, Hurricane, Superstorm Sandy

Second Circuit Affirms a Southern District Decision Construing “Covered Location” Narrowly

In January, the Southern District rejected an insured’s $2 million claim for a generator destroyed by Superstorm Sandy.  The unit was in the basement of an office building in lower Manhattan, but the contract of insurance defined “covered location” to mean the 33rd floor of the structure.  The district court rejected the policyholder’s argument that language insuring personal property “in buildings or structures at a ‘covered location’ “ extended coverage to the entire building including its basement.  On October 16th, a panel of the Court of Appeals affirmed this carrier-friendly interpretation in Jane Street Holding, LLC v. Aspen American Ins. Co., — Fed.Appx. –, 2014 WL 5287051, 2014 U.S. App. LEXIS 19905 (2d. Cir., Oct. 16, 2014).

shutterstock_110443643Jane Street Holding, LLC was a trading company with offices in One New York Plaza in lower Manhattan.  On September 2, 2011, it purchased a commercial property policy from Aspen American Insurance Company for the 2011-2012 policy year.  Jane Street subsequently bought a $2.2 million generator and installed it in the basement of One New York Plaza.  The policy was renewed “as expiring” on September 2, 2012, and the generator was totally destroyed when Superstorm Sandy struck on October 29, 2012 and flooded Lower Manhattan.

The contract of insurance afforded $15 million in coverage for business personal property, $10 million in coverage for Electronic Data Processing Equipment, and $15 million in coverage for Equipment Breakdown,  and the generator was covered property as defined by all three coverage parts.  However, the governing policy language defined covered personal property as Jane Street’s “business personal property in buildings or structures at a ‘covered location’ or in the open (or in vehicles) on or within 1,000 feet of a ‘covered location.’ “  If the contract of insurance contained a Scheduled Locations Endorsement as Jane Street’s policy did, “covered location” was then defined to mean “a location that is described on the Location Schedule” of the endorsement.  In this case, the location schedule listed “One New York Plaza, 33rd Floor, New York, N.Y. 10004” as the “covered location.” Read more ›

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Posted in Flood, Insured Premises, Superstorm Sandy, Water

Oklahoma Supreme Court Reconciles Sewer Backup Exclusion With Accidental Discharge Coverage Grant

In May, we reported that a New York court had found that a policy containing both an exclusion for water that backs up through sewers and drains and a coverage grant for accidental discharge or overflow from a plumbing system was neither internally inconsistent nor ambiguous in nature.  The post can be found here.  On June 17th, Oklahoma’s highest court agreed, albeit without citing the New York case, and it held that the two provisions were fully reconcilable and enforceable.  The case in question is Porter v. Oklahoma Farm Bureau Mut. Ins. Co., 330 P.3rd 511, 2014 Okla. LEXIS 72 (Okla., June 17, 2014).

shutterstock_167733947Justin and Brandy Porter owned a home that was damaged when raw sewage entered the premises on November 14, 2009.  Their homeowners carrier was Oklahoma Farm Bureau Mutual Insurance Company, and the insurer denied.  Litigation followed.  After the district court granted Oklahoma Farm Bureau’s motion to dismiss and the state’s intermediate level appellate panel affirmed, the Oklahoma Supreme Court granted the Porters’ writ of certiorari.

The contract of insurance afforded all risk coverage for real property loss but covered loss to personal property on a specified perils basis.  One of the specified perils enumerated was:

Accidental Discharge or Overflow of Water or Steam from within a plumbing, heating, air conditioning or automatic fire protection sprinkler system[.]

With respect to both real and personal property, the policy also excluded loss caused by “water damage meaning . . .  water which backs up through sewers or drains[.]” Read more ›

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Posted in Ambiguity, Flood, Seepage or Leakage, Water

Pennsylvania Court: Inaction When Damage is Known to Be Likely is Enough to Render the Loss Non-Fortuitous

On September 19th, a federal court in Pennsylvania held that a wall collapse was not fortuitous because the insureds knew that the wall was unstable and likely to fall and yet took no steps to correct the problem.  No one could say the loss was certain to happen, but the court effectively held that the insureds’ inaction was enough to make the collapse non-fortuitous given the likelihood that the wall would fail if it wasn’t repaired or braced.  The decision is Fry v. Phoenix Ins. Co., 2014 WL 4662481, 2014 U.S. Dist. LEXIS 131504 (E.D.Pa., Sept. 19, 2014).

shutterstock_73062277 The Frys owned a home in Fleetwood, Pennsylvania.  The house was a wood-frame structure with a stone veneer, and they noticed that the veneer was bulging in 2003.  An engineering report that they commissioned at the time attributed the problem to “an insufficient number of veneer wall ties and fasteners,” and the Frys paid $22,000 to have the exterior wall repaired.

As of 2011, the policyholders were insured by Phoenix Insurance Company, and the contract of insurance extended coverage to the peril of collapse, which was defined as “an abrupt falling down or caving in” of a portion of the structure.  In July of that year, the Frys made claim for bulging of the veneer’s exterior after a storm, and both the policyholders and Phoenix then secured expert reports.  The insured’s expert attributed the movement to the fact that “there is not a good connection between the stone veneer and the framed wall,” and he recommended repair and temporary bracing from outside if repairs could not be done “within the next couple months.”  The carrier’s expert ascribed the problem to “inadequate anchorage to the wood-framing” as well and also recommended repair and temporary bracing until that could be accomplished.  The insurer denied liability because the bulging was “not sudden and accidental” in nature. Read more ›

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Posted in Collapse, Fortuity, Water, Wear and Tear

Florida Court: Your Own Attorney is Simply Not a “Disinterested” Appraiser

As noted yesterday, last month saw an intermediate level appellate panel in Florida address whether the attorney for the policyholder could serve as that party’s appraiser.  It was a case of first impression in the Sunshine State.  In Florida Ins. Guar. Assn. v. Branco, 2014 WL 4648208, 2014 Fla. App. LEXIS 14602 (Fla.Dist.Ct.App., Sept. 19, 2014), the panel held that it was impermissible to select one’s own lawyer to act in that capacity when the contract of insurance called for a “disinterested” appraiser.

shutterstock_122066239The Brancos’ home was damaged by a sinkhole in April of 2010, and they made claim under a homeowner’s policy issued by Homewise Preferred Insurance Company.  The insurer denied liability, asserting that what had happened did not qualify as a “sinkhole loss” as defined, and the Brancos brought suit.  Homewise was subsequently declared insolvent, and Mr. and Mrs. Branco filed an amended complaint substituting the Florida Insurance Guaranty Association as defendant.

FIGA then conducted its own investigation, and it admitted in its answer that the sinkhole activity was a contributing cause of loss and that the Brancos were entitled to recover.  Mr. and Mrs. Branco demanded appraisal three weeks later and filed a motion to compel such a proceeding which was granted by the trial judge.  FIGA then took an appeal, making three arguments in opposition to the order to compel appraisal. Read more ›

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Posted in Arbitration and Appraisal, Loss Adjustment, Sinkhole

Florida Court Holds “Retained Rights” Provision Does Not Render an Appraisal Clause Unenforceable

In a pair of sinkhole cases, different panels of Florida’s intermediate level appellate court recently compelled appraisal, and the decisions are instructive because they address both challenges to the procedure and also the question of who is qualified to serve as an appraiser.  Today’s post will discuss Cincinnati Ins. Co. v. Cannon Ranch Partners, Inc., – So.3rd –, 2014 WL 5286519, 2014 Fla. App. LEXIS 17033 (Fla.Dist.Ct.App., Oct. 17, 2014) where the panel rejected arguments that the appraisal clause was unenforceable because it permitted the carrier to deny the claim even after an appraisal had taken place.  Tomorrow’s post will then address who constitutes a “disinterested” appraiser.

shutterstock_126855290The case involved sinkhole damage to a piece of property owned by Cannon Ranch Partners, Inc.  The property was insured by Cincinnati Insurance Company, and the contract of insurance included coverage for sinkholes.  The dispute involved the necessary scope of repair.  Cincinnati’s two consultants determined that grouting was all that was needed to restore the structure to its pre-sinkhole state, but Cannon Ranch’s consultant opined that underpinning was also needed, and the policyholder entered into a contract to have that done.  Cincinnati refused to sign off on the work, however, and it made a demand for appraisal instead.

Cannon Ranch refused to participate, and it filed a breach of contract suit.  The insurer responded by moving to abate the litigation and to compel appraisal, but the district court denied the motion.  On appeal, a panel of Florida’s Second District Court of Appeal reversed, and it remanded for the entry of an order compelling the appraisal proceeding. Read more ›

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Posted in Arbitration and Appraisal, Loss Adjustment, Sinkhole

Iowa Decision Underscores the Danger of Sharing Privileged Material with Reinsurers

Last month, a federal court in Iowa handed down a decision holding that neither work product nor attorney-client nor the common interest doctrine shield legal advice and analysis from production in  discovery once it has been shared with a carrier’s reinsurers.  The case – Progressive Cas. Ins. Co. v. F.D.I.C., — F.R.D.— , 2014 WL 4168577, 2014 U.S. Dist. LEXIS 116909 (W.D. Iowa, Aug. 22, 2014) – involved a directors & officers (“D&O”) liability policy rather than a first party property insurance policy, but it nonetheless sounds a cautionary note about the potential consequences of such disclosures.

shutterstock_216347893The case arose after the Office of Thrift Supervision closed Vantus Bank and appointed the FDIC as its receiver.  The FDIC then filed suit against the bank’s former officers and directors, alleging gross negligence and breach of fiduciary duties.  Progressive Casualty Insurance Company, which had issued a D&O policy to the bank, responded by filing a declaratory judgment action of its own, asserting that there was no coverage for the FDIC’s claims under its contract of insurance.

On March 10th, Magistrate Judge Leonard T. Strand ordered Progressive to produce copies of all communications with its reinsurers concerning either the D&O policy or the FDIC’s claims against the former officers and directors.  The insurer did so, but it redacted those portions containing legal advice and analysis, contending that these were shielded from disclosure by the work product doctrine, the attorney-client privilege, and/or the common interest doctrine. Read more ›

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Posted in Privilege, Reinsurance
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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