Comply with your Insurance Policy's Conditions Precedent (Post-Loss Obligations)
May 31, 2021 —
David Adelstein - Florida Construction Legal UpdatesI am of the opinion that if your property insurer requests a sworn proof of loss, furnish one with the assistance of counsel (preferably). Ignoring the insurer’s request or refusing to comply with insurer’s request is NOT value-added; it is simply placing you at a disadvantage based on the insurer’s argument that you, as the insured, materially breached the policy. I generally find no value having to confront this expected argument. Instead, I find value making an effort to comply with post-loss obligations including the insurer’s request to submit a sworn proof of loss. Working with counsel can help you comply with post-loss obligations (conditions precedent) while not weakening the value or merits of your claim.
By way of example, in Edwards v. Safepoint Ins. Co., 46 Fla. L. Weekly D1086a (Fla. 4th DCA 2021), the insured did not provide its property insurer with the requested sworn proof of loss. The insurer moved for summary judgment that the insured’s failure to submit the sworn proof of loss was a material breach of the policy that rendered the policy ineffective. The trial court agreed and granted summary judgment. The Fourth District Court of Appeal affirmed explaining “[a] total failure to comply with policy provisions made a prerequisite to suit under the policy may constitute a breach precluding recovery from the insurer as a matter of law. If, however, the insured cooperates to some degree or provides an explanation for its noncompliance, a fact question is presented for resolution by a jury.” Edwards, supra, quoting Haiman v. Federal Ins. Co., 798 So.2d 811, 812 (Fla. 4th DCA 2001).
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David Adelstein, Kirwin Norris, P.A.Mr. Adelstein may be contacted at
dma@kirwinnorris.com
Tetra Tech-U.S. Cleanup Dispute in San Francisco Grows
July 15, 2019 —
Mary B. Powers - Engineering News-RecordThe U.S. Justice Dept. and consultant Tetra Tech are ramping up a battle over alleged false claims for payment the firm submitted to the U.S. Navy under $261 million in contracts for radiological tests and cleanup at San Francisco’s former Hunters Point base, a Superfund site being developed for up to 12,000 residential units.
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Mary B. Powers, ENRENR may be contacted at
ENR.com@bnpmedia.com
Stair Collapse Points to Need for Structural Inspections
November 27, 2013 —
CDJ STAFFThe exterior stairways at the Nutmeg Woods apartments in New London, Connecticut have lead to injuries three times in the last three years, with the most recent failure causing fatal injuries. Despite the annual injuries, the city has not been inspecting the stairways on an annual basis. Calvin Darrow, New London’s fire marshal, told The Day, a New London newspaper, that these inspections are supposed to occur annually, but tend to come about once every five years. Mr. Darrow ascribed the matter to staffing issues.
The stairways have now received a preliminary inspection by a structural engineer, and building and fire officials. Kirk Kripas told the paper that the Building Department was still attempting to determine when the stairs were built.
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Court Rules that Damage From Squatter’s Fire is Not Excluded as Vandalism or Malicious Mischief
April 15, 2015 —
Valerie A. Moore, Christopher Kendrick, and Colin T. Murphy – Haight Brown & Bonesteel LLPIn Ong v. Fire Insurance Exchange (No. B252773, filed 4/3/15), a California appeals court ruled that a vacancy exclusion limited to damage caused by “vandalism or malicious mischief” did not bar coverage for damage to a vacant property caused by a warming fire purposely started by a transient that got out of control and spread to other parts of the property.
In Ong, the insured’s rental premises had been vacated by tenants and the utilities turned off. Nearly two years later, the insured submitted a claim for fire damage that had just occurred. An investigator reported finding signs that a squatter had been living in the building, stating that: “[I]t appears the fire may have been initiated as the result of an uncontrolled warming fire started by an unauthorized inhabitant.” The investigator found firewood and a mattress, and concluded that holes burned in the floor were the result of the squatter attempting to throw burning wood out the door when the fire got out of control.
The policy excluded vandalism as follows: “We do not cover direct or indirect loss from: . . . 4. Vandalism or Malicious Mischief, breakage of glass and safety glazing materials if the dwelling has been vacant for more than 30 consecutive days . . . just before the loss. A dwelling under construction is not considered vacant.” The term “Vandalism” was not defined in the policy. The insurer denied coverage based on the exclusion, stating: “Our investigation indicates that this loss was the result of vandalism. A trespasser entered the vacant dwelling and intentionally set a fire on the kitchen floor.”
Reprinted courtesy of Haight Brown & Bonesteel LLP attorneys
Valerie A. Moore,
Christopher Kendrick and
Colin T. Murphy
Ms. Moore may be contacted at vmoore@hbblaw.com.
Mr. Kendrick may be contacted at ckendrick@hbblaw.com
Mr. Murphy may be contacted at cmurphy@hbblaw.com
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Colorado Defective Construction is Not Considered "Property Damage"
September 12, 2022 —
Saxe Doernberger & Vita, P.C.In the July 5, 2022, case of Indian Harbor Ins. Co. v. Houston Casualty Co., the United States District Court for Colorado addressed the issue of whether damage to defectively installed balconies is considered “property damage” under Colorado law, requiring payment by a commercial general liability policy.
Facts of the Case
The case stems from a construction project where a subcontractor improperly installed balconies on an apartment complex. The owner of the project secured commercial general liability (CGL) coverage through an OCIP insured by Houston Casualty Company (HHC). The OCIP insured the general contractor and subcontractors. The general contractor also purchased a subcontractor default insurance policy insured by Indian Harbor.
All parties agreed that the subcontractor improperly installed portions of various balconies, including flashing, water-proof sealing, and water-resistant barriers, among other defects with the installation process. The parties also agreed that other portions of the balconies were properly installed. However, in order to repair the defects in the installations, every bit of each balcony had to be torn off and re-constructed.
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Saxe Doernberger & Vita, P.C.
Conn. Appellate Court Overturns Jury Verdict, Holding Plaintiff’s Sole Remedy for Injuries Arising From Open Manhole Was State’s Highway Defect Statute
June 14, 2021 —
Christy Jachimowski - Lewis BrisboisSection 13a-149 of the Connecticut General Statutes, commonly known as Connecticut’s highway defect statute, provides that claims arising from injuries or damages to people or property resulting from a defective road or bridge can be asserted against a party responsible for maintaining that road or bridge. Conn. Gen. Stat. §13a-149. The statute also extends to sidewalks and further provides that written notice of an alleged injury must be given to a defendant municipality within ninety days of the injury.
Recently, in Dobie v. City of New Haven, 2021 Conn. App. LEXIS 162 (App. Ct. May 1, 2021), the Connecticut Appellate Court overturned the trial court’s denial of a municipal defendant’s post-trial motion to dismiss. The court held that even though the plaintiff attempted to assert allegations of negligence against the defendant municipality, Connecticut’s highway defect statute was the plaintiff’s exclusive remedy. Since the plaintiff failed to meet the requisite notice requirements, pursuant to the statute, the Appellate Court held that the trial court erred in denying the municipality’s motion to dismiss for lack of subject matter jurisdiction.
The Underlying Case
In February of 2013, Plaintiff William Dobie filed suit against the City of New Haven alleging injuries and damages as a result of the negligence of a City of New Haven snowplow operator. Dobie’s claims arose from an incident that occurred on January 21, 2011, in which he was driving behind the City snowplow driver, who was in the process of plowing snow from a municipal street located in New Haven, Connecticut. As the defendant employee was operating his snowplow, he knocked off a manhole cover, causing Dobie’s vehicle to drive over the open manhole. Dobie claimed personal injuries as a result of his vehicle dropping into the open manhole, including injuries to his jaw.
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Christy Jachimowski, Lewis BrisboisMs. Jachimowski may be contacted at
Christy.Jachimowski@lewisbrisbois.com
Key Amendments to Insurance Claims-Handling Regulations in Puerto Rico
September 23, 2019 —
Andres Avila & Richard W. Brown - SDV InsightsPolicyholders in Puerto Rico should be aware of significant benefits provided by recent amendments to the Insurance Code. New rules establish an expedited method of property insurance dispute resolution, mandatory expedited partial payments in the event of catastrophic events, and protection against bad faith claims handling by insurers.
Appraisal Process with a Puerto Rican Twist
A key amendment is the establishment of an appraisal process, widely used for many years in the United States and now adopted in Puerto Rico. Commercial and personal property insurers in Puerto Rico shall include, in their policies, a clause for an appraisal process according to Article 11.150 of the Insurance Code of Puerto Rico, 26 L.P.R.A. § 101 et seq. (“the Code”).
The appraisal process provides both policyholders and insurers the option to submit insurance claims to an impartial umpire if a dispute arises over the value of covered damages or losses. The umpire and appraisers do not have authority to resolve coverage or legal issues. They can only resolve disputes over the quantum claimed for losses already determined to be covered by the insurer. Id. Each party is required to pay its own appraiser’s fees and split equally the fees of the umpire. Id.
Reprinted courtesy of
Andres Avila, Saxe Doernberger & Vita, P.C. and
Richard W. Brown, Saxe Doernberger & Vita, P.C.
Mr. Avila may be contacted at ara@sdvlaw.com
Mr. Brown may be contacted at rwb@sdvlaw.com
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Pennsylvania Federal Court Finds No Coverage For Hacking Claim Under E&O Policy
July 25, 2022 —
Celestine Montague & Paul A. Briganti - White and Williams LLPOn June 9, 2022, the U.S. District Court for the Eastern District of Pennsylvania held, on summary judgment, that an insured was not entitled to coverage under a Professional Errors and Omissions (E&O) policy for loss allegedly resulting from a hacking incident. See Construction Fin. Admin. Servs., Inc. v. Federal Ins. Co., No. 19-0020, 2022 U.S. Dist. LEXIS 103042 (E.D. Pa. June 9, 2022). Applying North Carolina and Pennsylvania law, the court reasoned that: (1) coverage was barred by the policy’s unauthorized computer access, or “breach,” exclusions; and (2) the insured violated a condition in the policy that required the insurer’s consent to settlements and the violation prejudiced the insurer.
The insured, Construction Financial Administration Services, Inc. (CFAS), was a third-party fund administrator for construction contractors. In April 2018, the CFAS received email requests from what it believed to be one of its clients, SWF Constructors (SWF), to disburse $1.3 million from an SWF account to a foreign company. CFAS authorized the payments, despite not having received a copy of any executed agreement between SWF and the foreign company. After the funds were disbursed, SWF advised that it had not authorized or requested the payments to the foreign company. In response, CFAS placed approximately $1.2 million of recovered and borrowed funds into the SWF disbursement account. SWF then sent a letter advising CFAS that the requests from the foreign company did not include documentation required under the contract between SWF and CFAS. It was later determined that the emails had been initiated by a fraudster who had gained unauthorized access to the sender’s email account.
Reprinted courtesy of
Celestine Montague, White and Williams LLP and
Paul A. Briganti, White and Williams LLP
Ms. Montague may be contacted at montaguec@whiteandwilliams.com
Mr. Briganti may be contacted at brigantip@whiteandwilliams.com
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