Chip Merlin | Property Insurance Coverage Law Blog | May 30, 2016
Insurance companies insure all kinds of buildings in all sorts of conditions. Insurers that decide to insure older structures and buildings with older roofs in various states of wear and tear love to recite exclusionary clauses when those roofs and older structures suffer damage.
The Arizona Supreme Court put an end to this type of “accept the premium and deny the claim and coverage” practice of insurers who deny windstorm claims which caused new or additional damage finding the following:
We reject the proposition that windstorm coverage extends only to buildings in objectively reasonable condition. Insurers are free to expressly limit coverage to buildings meeting certain structural qualifications or to inspect buildings before issuing windstorm coverage. Absent such limitations, however, a windstorm is a wind of sufficient force to proximately cause damage to the “ordinary condition of the things insured….1
We are constantly being asked to review denied claims where older roofs with wear and tear are damaged by subsequent windstorm or hail. Those claims and types of losses are covered. There should be no question about that. The problem is some insurance company expert consulting firms fail to note the additional damage trying to help insurers deny payment for the loss by wrongfully claiming that the windstorm or hail caused no additional damage.
Those with this type of issue should read my post from last week, Hail Storms, Wear and Tear, and Inadequate Maintenance.