Texas Limits Scope of Anti-Technicality Statute and Material Breach Doctrine in Vacancy Clause Case

Last week, the Texas Supreme Court handed down an opinion that involved two unique (and somewhat troublesome) creatures of state law – the so-called “anti-technicality” statute and the material breach doctrine – and in Greene v. Farmer’s Ins. Exc., 2014 WL 4252271, 2014 Tex. LEXIS 758 (Tex., Aug. 29, 2014), it effectively limited the scope of both.  The court thereby gave effect to a provision in a homeowners policy that suspended coverage if a dwelling was allowed to remain vacant for more than sixty days.

shutterstock_94651420The case arose after Lewayne Greene moved into a retirement community, vacating her home in Irving, Texas and placing the structure on the market.  She notified her insurer of the move, but she did not purchase an endorsement offered by the carrier, Farmers Insurance Exchange, that would covered an extended vacancy.  Four months later, fire from a neighboring house spread to her home and damaged it.  Farmers denied the subsequent insurance claim because the structure had been vacant for over sixty days, and the policyholder brought suit.  She prevailed in the trial court, but the Court of Appeals reversed and rendered judgment for Farmers. On appeal,  a unanimous Texas Supreme Court affirmed.

The policyholder sought to invoke Sec. 862.054 of the Texas Insurance Code, the anti-technicality statute.  That provision recited that unless a breach or violation of “a warranty, condition, or provision of a fire insurance policy or contract of insurance on personal property . . . contributed to cause the destruction of the property,” the insurer could not raise it as “a defense to a suit for loss.”  The parties had stipulated that the vacancy did not cause or contribute to the fire damage.  The insured therefore argued that the statute precluded Farmers from denying the claim based upon the vacancy clause. Read more ›

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Posted in Causation, Fire, Prejudice, Vacant or Unoccupied

Current Florida Sinkhole Statute Held to Apply Even Though Policy Used Prior Statute’s Formulation

Florida adopted a stringent, five-part definition of what constitutes a covered sinkhole loss in 2011, but many policies continue to employ the 2005 statutory formulation which merely defined “sinkhole loss” as “structural damage to the building, including a foundation, caused by sinkhole activity” and importantly left the term “structural damage” undefined.  The result was that Florida courts split into conflicting camps with respect to how such a contract of insurance should be read; the Middle District for example, held for policyholders in two cases and for the carrier in a third, as reported in a prior post that can found here.  When one of the former decisions recently reached the Eleventh Circuit, the Court of Appeals determined that the language was to be construed in accordance with the narrow 2011 requirement, and it reversed and remanded.

shutterstock_111260423Shelton v. Liberty Mutual Fire Ins. Co., 2014 WL 4100426, 2014 U.S. App. LEXIS 16120 (11th Cir., Aug. 21, 2014) arose when the insureds made a claim for sinkhole loss to their home.  Their homeowner’s carrier, Liberty Mutual, denied after its experts found only cosmetic damage that did not fall within the 2011 statute’s five-part definition.  Litigation followed.  As noted above, the district court granted summary judgment to the policyholders, finding that the new statutory definition of structural damage was inapplicable because the policy neither referenced the 2011 statute expressly nor incorporated its language.  It then read “structural damage” to mean any damage to the building. Read more ›

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Posted in Homeowners Coverage, Sinkhole

Texas Court Lays Out a Useful Roadmap of the Defenses to a Hailstorm Claim

Hailstorm claims for damage to roofs often involve belated notification that an already old or damaged structure has been further compromised.  In a recent Texas case, the court provided a primer for carriers confronting such claims, addressing a trifecta of defenses available – lack of causation, late notice, and prejudice.  The case is Hamilton Properties v. American Insurance Company, 2014 WL 3055801, 2014 U.S. Dist. LEXIS 91882  (N.D.Tex., July 7, 2014).

shutterstock_108416048Plaintiff Hamilton Properties acquired the Dallas Plaza Hotel in 2006 and mothballed the structure in February of 2009.  The hotel was insured by American Insurance Company (AIC) from February through September of 2009.  In 2012, the policyholder notified AIC that it was making claim for roof and water damage allegedly sustained during a July 8, 2009 storm that dumped ping-pong sized hailstones on the city.  After investigating the loss, the insured denied liability, and Hamilton Properties brought suit.

AIC promptly moved for summary judgment, and Judge Jane J. Boyle granted the motion on July 7, 2014 in an opinion that contains a thoughtful discussion of three of the principal defenses that insurers have to the all-too-frequent claims for hail damage to roofs. Read more ›

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Posted in Causation, Hailstorm, Notice, Prejudice

South Carolina: Admission of Cause & Origin Testimony by Fire Chief Was Prejudicial Error

In James D. Fowler v. Nationwide Mutual Fire Ins. Co., 2014 WL 3844215, 2014 S.C. App. LEXIS 209 (S.C. App., Aug. 6, 2014), South Carolina’s Court of Appeals recently held that it was prejudicial error to allow the jury to consider either the report of a volunteer fire chief or his testimony on the issue of cause and origin if he does not qualify as an expert.  The take away is that if a firefighter can’t testify as an expert, any opinion he or she has on causation is simply not a datum that the fact-finder is entitled to know about.

shutterstock_208404577The insured’s home was destroyed by fire in January of 2007.  His homeowner’s carrier, Nationwide Mutual Fire Insurance Company, denied liability after a fire investigator hired by the carrier determined that the blaze was incendiary, and the insured brought suit.  The fire was extinguished by the local volunteer fire department, after which its Chief, David Wright, completed a mandatory form known as a “Truck Report.”  This stated that the fire originated in a kerosene heater in the living room and that the “Cause of Ignition” was “unintentional.”

Prior to trial, Nationwide moved successfully to exclude any testimony by Chief Wright as to cause and origin.  At the trial itself, however, the circuit court judge both admitted the Truck Report into evidence and also allowed the fire chief to testify about his rationale in completing it.  Chief Wright stated that he determined that the living room heater was the point of origin because there was a V-shaped burn pattern on the living room wall and the heater was at the base of it.  With respect to the report’s statement that the blaze was “unintentional,” the fire chief testified that he “didn’t see or smell anything that made him think [the fire] was intentional.”  The jury returned a verdict in favor the policyholder in the amount of $504,444. Read more ›

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Posted in Arson, Arson and Fraud, Experts, Fire, Investigation

Vermont: There is No Cause of Action for Negligence in Adjusting a Property Loss

Last week, the Vermont Supreme Court firmly rejected the notion that an insured can bring a cognizable claim for negligence against his or her carrier in connection with the inspection and handling of a first-party property insurance claim.  In Helena G. Murphy v. Patriot Ins. Co., 2014 VT 96, 2014 WL 3965639, 2014 Vt. LEXIS 101 (Vt., Aug. 14, 2014), the court recognized that the relationship was “fundamentally contractual” in nature and that a policyholder’s rights flowed solely from the insurance policy and the covenant of good faith and fair dealing implied in that instrument.

shutterstock_95374945In July of 2007, the insured, Helena Murphy, reported damage to the roof of her house and interior water damage to her homeowner’s carrier, Patriot Insurance Company.  The insurer promptly had the structure inspected by a claims adjuster, and it paid $3,553.05 for the loss.  The policyholder then proceeded to make a series of additional claims over the course of the next few months, and Patriot ultimately tendered over $30,000 to Ms. Murphy, including the full policy limit of $10,000 for damage from mold and rot.

The insured contended, however, that it would cost in excess of $56,000 to remediate the remaining mold and rot, and she brought suit for breach of contract in June of 2008.  An amended complaint was then filed adding, inter alia, claims against Patriot for negligence.  Ms. Murphy alleged that Patriot had an independent tort duty to handle her claim in a reasonable manner and had violated that duty by negligently inspecting and processing the claim, with the result that she suffered additional property damage and also health problems associated with the mold infestation. Read more ›

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Posted in Homeowners Coverage, Investigation, Loss Adjustment, Mold, Water

Florida Insurer Waives Two-Year Requirement by Waiting That Long to First Raise It

In Axis Surplus Ins. Co. v. Caribbean Beach Club Assn., 2014 WL 2900930 (Fla.Dist.Ct.App., June 27, 2014), a Florida court recently held that the insurer could not rely on a policy requirement that conditioned recovery of the cost of complying with current building codes during reconstruction on having completed the work within two years of the loss.  The insurer waived the two-year requirement by failing to raise it until the entire two years had elapsed and choosing to spend that time cooperating with the policyholder’s efforts to determine the necessary scope of repair instead.

shutterstock_44054The insured, Caribbean Beach Club Association, owned a time-share condominium building in Fort Myers that was heavily damaged by fire in April 2003.  It had property insurance coverage with Axis Surplus Insurance Company, and it had paid an additional premium for an Ordinance or Law Coverage Endorsement that provided up to $2.5 million for any increased cost of reconstruction incurred as a result of the enforcement of local ordinances or laws.  The endorsement recited that the insured could not recover, however, until after the property was actually repaired or replaced and that reconstruction had to take place within two years’ time.

The county building authorities had a “50% rule” mandating that if a building was more than 50% damaged, any reconstruction or repair had to comply with all current building codes.  In this case, the parties stipulated that that would add $1.8 million to the repair bill because it would require that the entire building be demolished and rebuilt at a higher elevation from the ground. Read more ›

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Posted in Fire, Ordinance or Law, Waiver

In Iowa, Rain is What Gene Kelly Sang In – Not Water From a Burst Drain Pipe

Earlier this year, an Iowa court recognized that rain becomes rainwater once it has fallen, and it held that policy language excluding loss caused by “rain” – without more – will not operate to bar coverage for water from a burst drain pipe that ruptured during a rainstorm.  The decision is reported at Amish Connection, Inc. v. State Farm Fire & Cas. Co., 847 N.W.2d 237, 2014 WL 1234161 (Iowa Ct. App., March 26, 2014).

shutterstock_170611241The insured, Amish Connection, Inc., leased space in a mall in Waterloo, Iowa, and its merchandise was damaged after a 4” cast iron drain pipe above the ceiling burst during a rainstorm.  The pipe carried water from the roof drains to a storm sewer.  The policyholder reported the loss on the day after the storm, and its commercial property insurer, State Farm Fire & Casualty Company, denied by letter on the same afternoon, stating that the loss was “caused by rain.”  The contract of insurance excluded loss “to the interior of any building or structure, or the property inside any building or structure, caused by rain, snow, sleet, ice, sand or dust, whether driven by wind or not[.]”  Rain itself was not a defined term.

Amish Connection brought suit.  The district court granted summary judgment to State Farm, ruling that the exclusion applied because the water that cascaded from the burst pipe was “rainwater.”  On appeal, a unanimous panel of the state’s intermediate level appellate court reversed, and they did so for exactly that reason – the loss was caused by rainwater and not the excluded peril of rain. Read more ›

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Posted in Flood, Water

Insurers Say “Over My Dead Body” to Claims for Damage From Decomposition

Last April saw decisions handed down in Pennsylvania and Florida that addressed the ghoulish question of whether first-party policies cover property damage from a decomposing body, and the courts in both jurisdictions held that the answer in no.  A word of warning – the balance of this post is not for the squeamish.

shutterstock_10128775The first decision was Certain Underwriters at Lloyds of London v. Creagh, — Fed.Appx. —, 2014 WL 1408868 (3rd Cir. , April 14, 2014).  The insured owned a building in Philadelphia where a tenant died in the bathroom of a second floor apartment.  The body went undiscovered for two weeks, by which time bodily fluids had seeped through the floor, contaminating both the apartment itself and parts of the first floor unit below, and there was “a powerful foul odor” in the entire structure.  The policyholder spent $180,000 to sanitize, remediate, and even rebuild portions of the building, and he then sought coverage from his property insurance carrier, Certain Underwriters at Lloyds of London.

Lloyds denied, and the matter went into suit.  The Eastern District of Pennsylvania granted summary judgment to the insurer, and the Third Circuit affirmed earlier this year, holding that coverage was barred by two exclusions in the Lloyds policy.  The first was a “Microorganism Exclusion” that recited as follows: Read more ›

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Posted in Decomposition, Explosion, Microorganisms, Seepage or Leakage

Sixth Circuit Holds That Declines in Market Value are Not a Factor in Determining Actual Cash Value

In a case of first impression in Michigan, the federal Court of Appeals determined last month that general market conditions could not be considered when calculating actual cash value.  In Whitehouse Condominium Group, LLC v. Cincinnati Ins. Co., — Fed.Appx. —, 2014 WL 2743480 (6th Cir., June 17, 2014), the contract of insurance defined ACV as replacement cost less a number of factors including “obsolescence .”  The Sixth Circuit held that the word connoted only functional obsolescence as opposed to both functional and economic obsolescence.

shutterstock_179118050The policyholder owned a condominium building in Flint, Michigan that was heavily damaged by fire in November of 2010.  The policy afforded coverage for ACV, which was defined in the contract of insurance to mean “replacement cost less a deduction that reflects depreciation, age, condition and obsolescence.”  The insurance carrier, Cincinnati Insurance Company, determined that the value of the structure was $1,187,660.38, and it paid that amount to the insured.  The policyholder contended that the building was actually worth $1.6 million more, however, and it demanded appraisal.

The sole issue was the meaning of the word “obsolescence.”  The insured contended that it meant only functional obsolescence, which the Court of Appeals defined as “a loss in value due to something inherent in the building itself such as old technology (think an electric panel that is no longer acceptable under current codes) or bad design (think a five bedroom house that only has one bathroom).”  Cincinnati, on the other hand, argued that it meant both functional and economic obsolescence – “a reduction in value due to market factors entirely external to the building, such as neighborhood factors (this might occur if the neighborhood were suddenly under a noisy flight path) or the general market (the real estate market crash appears to be the factor in this case);”  The decline in property values in Flint was the reason for the difference between the two parties’ ACV numbers. Read more ›

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Posted in Actual Cash Value, Depreciation, Fire, Loss Adjustment

Argument That Rain Alone Can’t Cause a Flood “Would be News to Noah” Says a California Court

Last month an appellate court in California looked to the Bible, citing the Book of Genesis when rejecting the argument that an inundation caused solely by heavy rain was not an excluded flood.  The opinion was handed down in Horvath v. State Farm General Ins. Co., 2014 WL 2931049 (Cal.App., June 30, 2014).

shutterstock_25651162The insureds, Peter and Susan Horvath, owned a home at the end of a cul-de-sac at the bottom of Bell Canyon Drive.  On December 22, 2010, severe rainstorms led to what the husband described as a “river of water coming down the street.”  The town’s drainage systems were overwhelmed, and the cul-de-sac quickly filled up, ultimately inundating the first floor of the insureds’ home with 18” of water.  The couple were evacuated by firefighters, and the local municipality yellow-tagged the structure as unfit to live in.

The policyholders made claim under a homeowners policy issued by State Farm General Insurance Company.  The carrier denied liability because “flood” was an excluded peril under the contract of insurance.  Specifically, the language at issue recited as follows:

We do not insure under any coverage for any loss which is caused by . . . Water Damage, meaning flood, surface water, waves, tidal water, tsunami[.]

The term “flood” was not further defined in the policy. Read more ›

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Posted in Ambiguity, Flood, Water
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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