Archives: Property Insurance

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Misrepresentation Results in Loss of Coverage

One of the best ways for a policyholder to lose its insurance coverage is to conceal or misrepresent material facts and circumstances about the claim.  In a recent case, the Sixth Circuit Court of Appeals affirmed summary judgment in favor of the insurance company dismissing a policyholder’s claims against its insurance carrier for not paying … Continue Reading

Does Physical Loss or Damage Include Loss of Use, Reliability or Impaired Functionality?

Cyber attacks on computer systems have spawned myriad coverage disputes over whether the data stored on the computer system tangible property that comes within property insurance coverage or whether the computer system has to be rendered unusable.  As cyber attacks have grown and morphed from hacking to ransomware to other types of intrusions, and as … Continue Reading

Binding Arbitration Award In Coverage Dispute Ends Later Coverage Litigation

Many insurance policies have binding arbitration clauses along with other provisions that address whether a lawsuit may be brought against the insurance company.  What happens when the arbitration goes against the policyholder?  Can the policyholder then sue the insurance company over the same coverage dispute even if the arbitrator ruled against the policyholder?… Continue Reading

It’s Always a Good Idea to Read Your Insurance Policy

Among the basic rules of insurance are these two:  (a) always read your policy and (b) courts will construe clear and unambiguous insurance policy language by giving it its ordinary and plain meaning. This is the lesson that a policyholder learned after filing a claim for windstorm damage to his roof.  The question was whether … Continue Reading

No Coverage to Builder for Beetle-Infested Logs

Nearly all construction jobs require that the contractor purchase insurance.  Commercial general liability insurance (“CGL”) is often what is purchased.  CGL policies also typically have an exclusion for property damage to “your work.” In a recent case, the Ninth Circuit Court of Appeals addressed this exclusion in a case of damage caused by beetle-infested logs … Continue Reading

Policyholder Denied Discovery Into Handling of Other Insureds’ Superstorm Sandy Losses

Superstorm Sandy was a complicated loss because of its unique nature and the controversy over when it was a hurricane and whether damage caused by it was while it was a hurricane.  Many property policies have sublimits and deductibles specific to hurricanes or “named storms” or for flood losses.  How these sublimits or deductibles apply … Continue Reading

Strict Conditions Doom Flood Insurance Claim

The National Flood Insurance Program has been controversial to say the least.  Part of the program allows commercial insurance companies to act as agents for the federal government in producing Standard Flood Insurance policies and managing claims under a write your own program (“WYO”).  The program, under its enabling law, the National Flood Insurance Act, … Continue Reading

Foundations, Basement Walls and Collapse — Connecticut Supreme Court Rules Against Coverage

Homeowners in Connecticut (and other states) have had issues with crumbling foundations and basement walls of their homes due to defective concrete manufactured by a specific supplier.  They have turned to their homeowners insurance policies for coverage and coverage has been denied.  Multiple lawsuits have been brought.  In a series of recent cases, the Connecticut … Continue Reading

Appraisal Award Ends Property Damage Dispute

Property insurance policies contain provisions to resolve disputes between the policyholder and the insurer over damage claims.  These provisions provide for an independent appraisal of the alleged damaged property with the appraiser’s final award binding the parties.  An appraisal award is akin to an arbitration award in many respects.  In a recent case, a policyholder … Continue Reading

Contra Proferentem and Ambiguity Preclude Subrogation Recovery

Here’s a typical scenario.  The general contractor or owner takes out a all-risk builder’s policy to cover a construction project.  Subcontractors are included as additional insureds where required by their subcontracts, but only “as their respective interests may appear.”  The policy has a subrogation clause, but the clause includes a provision precluding subrogation against additional … Continue Reading

The 5th Amendment and Insurance Coverage

When a property is destroyed by fire, the property owner’s property insurance likely will cover the loss all things being equal.  But if the fire was intentionally set, coverage likely will be denied.  In the case of a residential property, policies often condition coverage on occupation of the premises.  In a recent case before the … Continue Reading

No Point in “Wining” About It — No Coverage for Missing Wine

In an interesting case about wine and wine collectors, purchasers of fine wines sought coverage for wine they ordered from a seller but never received.  Turns out the seller was running a wine Ponzi scheme and hundreds of customers never received thousands of bottles of wine ordered.  The case reached the Tenth Circuit Court of … Continue Reading

Forum Selection Clause in Excess Policy Overrides Appraisal Clause in Primary Policy

When primary and excess polices cover the same property many assume that the excess policy will follow the form of the primary policy.  That is not always the case, which is a good reason why reading the actual terms of both policies is important.  In a recent case involving hurricane damage to a Florida development, … Continue Reading

To Match or Not to Match, That Is the Question

After Hurricane Sandy, I found some shingles missing off my roof.  My contractor said the entire roof should be replaced.  My insurer would only pay for replacing the missing shingles.  The type of shingle was readily available.  But what happens if the damage to the roof, siding, facade, floor occurs to only parts of those … Continue Reading

War (Exclusions), What Is It Good For?

Back in the day, policyholders and insurers (and maybe everyone) understood what war was.  War was a military action between government forces of sovereign nations.  Today, not so much.  With the proliferation of terrorism and armed groups controlling various jurisdictions like pseudo-governments, it is often difficult to know when an attack is war or terrorism.  … Continue Reading

Faulty Excavation Support Not Covered By Contractor Controlled Insurance Plan

Construction projects are often subject to myriad claims.  Subcontractors can cause damage to third-parties and their property, the project can be delayed by municipal inspections or citations, workers can get injured, and property can be damaged by fire, collapse or weather.  To organize construction projects, sometimes insurance is purchased through a plan.  A contractor controlled … Continue Reading

Breach of Cooperation Clause Shields Carrier From Duty to Indemnify

The cooperation clause in an insurance policy is an essential part of the insurance bargain.  If the policyholder does not cooperate in the reporting or investigation of a claim, the coverage the policyholder paid for may be lost.  In a recent case, a policyholder whose employees lied to investigators was found to have breached the … Continue Reading

When a Loss Falls Within Policy Exclusions as a Matter of Law the Complaint Cannot Survive

The policyholder bears the burden of demonstrating that a loss suffered falls within the terms of the insurance policy.  In other words, the existence of coverage is an essential part of a policyholder’s claim.  Where the insurance company raises an exclusion, the initial burden is on the insurer to show that all the allegations within … Continue Reading

Late-Notice Defense for Insurance Coverage Is Still a Thing

Notice provisions in insurance policies are there to inform an insurer of a claim in a timely manner so that the insurance company can properly investigate and address the claim.  Most notice provisions are conditions precedent to an insurer’s liability. While there has been some erosion to the defense of late-notice to coverage, a recent … Continue Reading

Crumbling and Cracking Is Not a Collapse Under an All-Risks Policy

Intuitively, an all-risks policy is supposed to cover all risks.  But we know that even all-risks policies have exclusions.  Sometimes, however, an exclusion is reinstated in part to provide coverage for a limited species of the excluded item.  For example, an all-risks policy may exclude “collapse,” but may write back that coverage to a limited … Continue Reading
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