Tag Archives: FC&S Bulletin

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

Few Judges and Insurance Regulators Worked in Property Claims: Understanding New Depreciation Rulings

Most judges and insurance regulators have never worked in property insurance claims departments. For that matter, few insurance attorneys have either (Merlin Law Group’s Javier Delgado worked his way through school as an independent adjuster). But, when I was starting out, an older and experienced GAB adjuster told me they never depreciated labor and the … Continue Reading

Cracks Caused by Construction Operations May Be Covered

Judges often make erroneous decisions based on the information presented and argued to them by the attorneys selected by the parties. I was thinking about this while writing my post, Experts Regarding Causation Can Be More Important Than Witnesses — or, Don’t Believe Your Lying Eyes When Your Insurance Company Hires an Expert.… Continue Reading

Defective Construction and Ensuing Loss Provisions

A public adjuster called with a common situation—a property loss occurred during repair and the insurance company had initially denied the claim, saying that the loss was from defective construction. The smart public adjuster thought the property damage caused in part by defective construction could lead to coverage under an ensuing loss provision. The policyholder … Continue Reading

Property Damage Caused by a Dead Body: Court Says Clean-up Company can be Paid and Assignment of Benefits Valid

Borrowing a quote from Chip Merlin’s post, Dead Bodies–Are They a Covered Peril?: Some of the most unnerving claims an adjuster experiences are those concerning dead bodies, and we have had many recent questions regarding the deceased and what to do with them. Particularly, is there coverage under the homeowner’s policy for clean up for … Continue Reading

Insurance Coverage in a Winter Wonderland, Part I

Cold and snowy weather during the winter of 2013-2014 set numerous records in many parts of our country. Before the cold and snowy arctic weather could fade out as a distant memory, Mother Nature was back at it—treating some regions to extreme cold and snowy conditions since early fall/ late summer.… Continue Reading

Insurance Industry Knows Chipped Tile Case Wrongly Decided

Insurance defense attorneys often argue coverage does not exist for losses the insurance industry routinely pays and recognizes as covered. I believe Ergas v. Universal Property and Casualty Insurance Company,1 which I discussed yesterday in Chipped Tile Claims Get Marred, misconstrues longstanding insurance contract interpretation. Hopefully, the policyholders’ attorneys file a motion for rehearing, because … Continue Reading

Hurricane Sandy Claim Denials and the Value of FC&S

Hurricane Sandy claim denials are starting to be issued. This is typical; hurricane claim denials usually start four to six weeks after the catastrophe. I cannot overemphasize the value of FC&S materials and other insurance industry reference sources when researching whether Hurricane Sandy denials can stand up to challenge.… Continue Reading

Hurricane Sandy’s Supply Chain Disruptions Will Be Significant and Complicated

The 2011 losses Japan and Thailand rippled through the oceans as many realized that our global economy had become highly interdependent and supply chain disruptions were costlier than ever anticipated. A few months ago, global insurers revamped their Contingent Business Income questionnaires and applications in an effort to understand how deeply interrelated and exposed their … Continue Reading

Are Tenants Covered For Landlord’s Repairs to The Property- Understanding Business Interruption Claims

A recently published FC&S Bulletin answered a nuanced coverage question for a situation that is all too common in landlord tenant relationships. In the scenario, the tenant purchased a Business Owner Policy form (BP 00 03). The landlord was required to remove underground tanks from his property and the removal process suspended the tenants’ business … Continue Reading

Ordinary Payroll Coverage Can Be Extraordinarily Tricky- Understanding Business Interruption Claims

When measuring a business income loss, a company can treat all payroll and benefits (if directly related to payroll, i.e., FICA, worker’s compensation, etc.) as “continuing expenses” in its accounting worksheet as defined in CP 00 30 10 (Business Income and Extra Expense Coverage Form). If the policy has an Ordinary Payroll Exclusion or Limitation, … Continue Reading

Avoiding the Anti-concurrent Causation Trap — Understanding Business Interruption Claims, Part 59

Relying on anti-concurrent causation clauses, several insurers have adopted a method of claims adjusting where business income claims are denied in whole if the property suffered damage attributed in part to an excluded cause of loss. In most states, this type of business practice is wrong and contrary to public policy. For an in depth … Continue Reading

A Business Income Deductible is a Concept of Time – Understanding Business Interruption Claims, Part 54

Many clients and claim professionals often have questions about their deductible responsibility toward their business income claim. Typically, if the property has sustained physical loss or damage, the insured will be required satisfy the applicable peril-deductible to receive benefits to repair or replace the damaged property and trigger the business income coverage. However, insureds should … Continue Reading

Are Property Manager’s Fees Recoverable? – Understanding Business Interruption Claims – Part 52

Property manager’s fees are normally considered “continuing expenses” in business income claims. The standard Business Income (And Extra Expense) Coverage Form CP 00 30 04 02 says, "We will pay for the actual loss of Business Income you sustain due to the necessary ‘suspension’ of your ‘operations’ during the ‘period of restoration.’" Business Income is … Continue Reading

Considerations Regarding Ordinary Payroll – Understanding Business Interruption Claims, Part 43

A recent IRMI article titled “Limiting the Interruption in Business Interruption” discussed the importance of considering payroll during the risk assessment phase of obtaining business insurance coverage. The forms regarding business income and ordinary payroll are hyperlinked for ease of use and understanding.… Continue Reading

Can Insurance Companies Demand Multiple Proofs of Loss?

Proof of loss requirements are becoming a more frequent topic of conversation, and questions regarding proofs of loss are frequently asked of members in our law firm. Proofs of loss are conditions precedent to recovery under virtually all property insurance policies. Unless waived or not demanded under some forms, proofs of loss should be filed.… Continue Reading

The Value of an Extended Business Income Provision – Understanding Business Interruption Claims, Part 38

After non-catastrophic losses, most insureds are able to restore operations in a fairly short period of time. In those cases, the measure of recovery will be limited to any business income loss and incurred normal operating expenses during the period of restoration. However, in many cases, businesses are not able to return to their pre-loss … Continue Reading

Does an Insurance Policy Cover Only “Loss” or “Damage” to Property?

Property insurance policies are written in complex language. The fact that there are so many different interpretations and disputes about the language by some very bright people is probably enough evidence to prove that point. David Rossmiller wrote a post, Corban v. USAA: A few (more) words about anti-concurrent causation, which had me thinking about words … Continue Reading