Blog Archives

Eleventh Circuit Confirms Cleaning is not Direct Physical Loss

Posted on August 20, 2020 by Alycen A. Moss, Elliot Kerzner

The Eleventh Circuit has provided some clarity to Florida businesses and their insurers dealing with COVID-19 claims. In Mama Jo’s Inc., d.b.a. Berries v. Sparta Ins. Co., No. 18-12887 (11th Cir. March 18, 2020), the Court held that a restaurant’s lost income and extra cleaning costs due to nearby roadwork did not trigger coverage because it did not involve direct physical loss or damage. In the underlying case pending in the Southern District of Florida, Mama Jo’s, Inc. v. Sparta Ins. Co., 17-CV-23362-KMM, 2018 WL 3412974, at *9 (S.D. Fla. June 11, 2018), the Court considered whether there was a direct physical loss when construction debris and dust from road work required the insured to clean its floors, walls, tables,…

JPML Will Not Allow Centralization of MDL Covid-19 Lawsuits

Posted on August 13, 2020 by Alycen A. Moss, Denise Bessellieu

On April 20, 2020, two policyholders involved in Covid-19 class action suits filed the first motion with the Judicial Panel on Multidistrict Litigation (MDL) asking for the transfer and coordination or consolidation of two class actions suits filed in the U.S. District Court for the Eastern District of Pennsylvania with nine so-called “related actions” filed in federal courts in Illinois, Florida, New York, Wisconsin, Ohio, California, Oregon, and Texas and “subsequent tag-along actions.”[1] Others followed suit in attempting to transfer, coordinate, and/or consolidate actions into several MDLs. There are currently more than 100 insurance companies named as defendants in the cases proposed for transfer. About The Authors

Tagged with: business interruption, coronavirus, Coverage, covid, covid-19, Insurance, multidistrict litigation, physical loss, property insurance, United States Judicial Panel on Multidistrict Litigation
Posted in Business Interuption, Direct Physical Loss or Damage

New Hurricane Harvey Opinion Provides a Roadmap to Defeating Common Policyholder Attorney Tactics

Posted on April 29, 2020 by Karl A. Schulz

Policyholders attorneys often try to skip the threshold steps of bringing their client’s claim within coverage and allocating between covered and non-covered causes of loss. Instead, the policyholder attorney would have the insurer first disprove coverage, or at least first justify its coverage position. These tactics unfold in a familiar way. The policyholder attorney will engage a consultant to write up an Xactimate estimate. Or, perhaps a public adjuster already wrote up the estimate and then brought the claim to the attorney. Everything that is wrong with the structure will go into the estimate. Every water-stained ceiling tile, bent AC condenser fin, and dent on the siding will go into the estimate regardless of causation. The bigger estimate, the better…

Tagged with: Allocation, Coverage, Hurricane Harvey, Investigation, Policy Interpretation
Posted in Catastrophes, Coverage, Hurricane

Coronavirus: Is There Coverage Under Property Insurance Policies?

Posted on March 18, 2020 by Alycen A. Moss, Paul Ferland

Coronavirus (“COVID-19”) has disrupted events, supply chains, sales, and entire industries. As a result, businesses are going to look to their property insurers to recuperate lost business income, as well as expenses related to cleaning, sanitizing and decontamination. The first lawsuit alleging a business interruption loss was filed yesterday in Louisiana, and there are most likely others that will be filed in the coming days and weeks. Almost all property policies require direct, physical loss or damage to property to trigger coverage. Whether claims related to COVID-19 can meet this threshold requirement largely depends on whether the case law in a given jurisdiction construes the phrase “direct physical loss or damage” narrowly or broadly. In addition, an analysis of the…

Tagged with: Coverage, damage, exclusion, physical loss
Posted in Coverage

Failure of Insured to Provide Requested Documents Triggers Appraisal Under First Party Insurance Policy

Posted on October 14, 2019 by Paul Ferland

Those familiar with first party insurance policies have undoubtedly encountered a recurring issue with the interpretation of appraisal provisions – what does it mean to disagree on the amount of loss? In Valvano Realty Co. v. American Fire and Casualty Co., the United States District Court for the Middle District of Pennsylvania recently held that a disagreement on the amount of loss encompasses situations where an insurer claims it needs additional documentation before it can determine whether a disagreement exists. Valvano involved a December 18, 2015 fire at the Plaintiff’s property in Dickson City, Pennsylvania, which was insured by American. American’s adjuster, working with a retained construction consultant and structural engineer, determined the replacement cost value of the loss to…

Collapse Coverage: Second Circuit Holds That Cracking Walls Do Not Constitute “Collapse”

Posted on May 6, 2019 by Dina R. Richman

Most homeowners’ policies – and property insurance policies in general – contain a limited coverage extension for “collapse.” The interpretation of that collapse coverage has been litigated around the country for decades, with different jurisdictions reaching considerably different results. The latest of these decisions, Valls v. Allstate Insurance Company, No. 17-3495-cv (2d Cir. 2019), comes out of the Second Circuit, deciding the case under Connecticut law. The case presented a single substantive question: does the “collapse” provision afford coverage for basement walls which had significant cracking but remain standing? Both the district court (D. Conn.) and the Second Circuit Court of Appeal concluded that it does not. In Valls, the plaintiffs owned a home in Connecticut which was insured by…

Tagged with: Collapse, Coverage, Homeowners policy
Posted in Collapse