Tag Archives: Exclusion

Although Many Policies Exclude Sewer Line Backups from Coverage, What Is A Government Entity’s Liability Under Inverse Condemnation?

Most homeowners are surprised to learn that almost all homeowners’ policies include exclusions for damage caused by sewage water originating outside their home. For example, if your city or county’s sewer main line backs up because of tree roots or debris and the sewage water backs up into your home, the resulting damage will not … Continue Reading

Arson of Vacant House: Covered Fire Loss or Excluded Vandalism?

In a recent case,1 a federal appeals court addressed the issue of whether fire damage to a vacant dwelling from an arsonist was considered distinct from vandalism, so as to not implicate an exclusion within a homeowners insurance policy. In that case, Wells Fargo Bank owned an insurance policy on an abandoned house that an … Continue Reading

Gator Coverage?

Chomp, Chomp! Insurance Policies are designed to cover sudden and accidental loss and damage. Mary Wischusen, 77, believed that she had a suffered a sudden and accidental act of nature and that coverage would be afforded when a gator came crashing into her kitchen. This 11-foot alligator was not her domestic pet or a planned … Continue Reading

When Can My Property Insurance Claim Be Denied Due to War or Other Undefined Terms?

I often receive calls from policyholders asking how an insurance company can deny their claim based on an exclusion that isn’t defined in the policy. One of these terms is “surface water,” a common exclusion found in most policies. Recently, I had a client whose home’s gutter system malfunctioned during a rainstorm. Rather than channeling … Continue Reading

Why is the Carrier so Quick to Argue the Wear and Tear Exclusion?

Chip Merlin posted about the Wear and Tear Exclusion just last month in Wear and Tear Exclusions Versus Depreciation For Resulting Damage To Worn and Torn Older Parts of a Structure. Explaining about wear and tear, Chip gave this example: The judge made up his own example of ten old bolts giving way and then … Continue Reading

Property Insurer Wrongly Denies You Coverage? Victor Jacobellis and Chip Merlin Discuss How Exceptions to Exclusions Win Coverage

Victor Jacobellis left his job in San Francisco representing insurance companies to join Merlin Law Group and help policyholders obtain insurance coverage benefits. He asked me to speak with him about exceptions to exclusions of coverage which are often overlooked and lead to wrongful denials of coverage. The photo above shows yours truly speaking with Victor … Continue Reading

My House Has Suffered Water Damage, Am I Covered?

Lately, much of the United States have seen wild swings of severe weather. From the mid 70’s on Saturday to 47 degrees and an inch of rain on Monday, severe weather can wreak havoc on your home. With torrential rains and flash flood in most parts of the Northeast recently, many find themselves asking: my … Continue Reading

Broken Water Main Damage: Flood or Not Flood Under Homeowner’s Insurance Policy?

In a recent court opinion,1 the New Jersey Appellate Division interpreted a homeowner’s insurance policy’s water damage exclusion and determined whether damage from a broken municipal water main under a public street was covered under the policy. In that case, a homeowner brought an action against his insurer for breach of contract after the insurer … Continue Reading

Collapse Loss Ambiguity Determined With Dictionary Help

Feenix Parkside LLC owed a commercial building that incurred a partial collapse to their ceiling. When Feenix sought coverage for the collapse, the insurer—Berkley North Pacific—denied coverage for the loss. When Feenix reported the loss, they stated the collapse was due to decay, which was a gradual decline in strength and soundness.… Continue Reading

Where There Is Smoke, There Is… A Denial

An Illinois Public Insurance Adjuster recently contacted me regarding an insurer’s denial of a smoke damage claim. The facts were as follows. While a condominium unit owner was using the fireplace in the unit (“unit 1”), smoke began to fill up in the condominium unit above (“unit 2”). The condominium association made a claim to … Continue Reading

Freezing Exclusions: One Size Does Not Fit All

“One size fits all” is a phrase used to describe pieces of clothing or accessories designed to fit all people. Over time, it has been used to refer to anything meant to apply in all circumstances. Obviously, one size cannot fit all people. The same holds true when it comes to “freezing” exclusions in homeowner’s … Continue Reading

Case Highlights How Writing and Interpreting Policies Can Be Challenging in Today’s Technological World

In the recent case of Rainforest Chocolate, LLC v. Sentinel Insurance Company, Ltd.,1 the Supreme Court of Vermont found coverage for Rainforest where Sentinel’s “false pretense” exclusion turned out to be ambiguous as there were at least two reasonable interpretations of what constituted “physical loss or physical damages.”2… Continue Reading

A CATastrophe! Is Damage Caused By Pets Covered?

Are you covered if your pet cat causes a CATastrophe to your property? I was posed this question after being referred to an article on celebrity Frankie Muniz who found his home “flooded with 3 feet of water because his cat had accidentally turned on the faucet while he was away at his uncle’s funeral.” … Continue Reading

It’s Rain, Not Flood, Why Isn’t My Water Damage Covered?

The photos from Hurricane Michael show catastrophic loss from not only the storm surge, up to fourteen feet in some areas, but from winds and rain as well. For those that live far enough inland where surge and flood was not an issue, but still sustained water damage from rain, you may think your homeowners … Continue Reading

Follow-Up: My Insurance Claim Was Denied Because My Water Leak Lasted Over a Period of 14 Days or More – Was the Denial Proper?

In March, I posted a blog on the Hicks v. American Integrity Insurance Company opinion,1 in which a Florida court ruled that policy language stating: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days,” did not preclude coverage for damage caused during the first … Continue Reading
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