Property Insurance Coverage Law Blog : Florida Insurance Lawyer & Attorney : Merlin Law Group Law Firm : Tampa, Houston, Coral Gables, Gulfport

Anita Lee of the Sun-Herald first reported about the camera system in 2007. This week, Lee provided an update on the camera system that Jones calls the “Eye of the Storm.”

Why did Jones develop the camera system? After Hurricane Katrina's unprecedented tidal surge and the following wind versus water debate, Jones understood how valuable it would be to know what damages were caused by the wind.

After Katrina, policyholders filed hundreds of wind vs. water disputes against insurance companies that denied coverage, maintaining damage was from storm surge. Policyholders and insurers went to great expense to hire experts asked to determine the cause of losses. The cameras might not pinpoint damage at every location, but they would give insurance companies and homeowners more information about forces at work during a storm.

In windstorm cases where the carrier denies coverage based on the flood exclusion, meteorologists are often retained to try to explain what the weather data shows happened at a loss location during the hurricane. Having the video cameras rolling during a storm could be powerful evidence showing what actually happened at a specific location.

Many people seem to be interested in and fascinated by catastrophic weather. And, many times, people take risks during times of bad weather just to see what is going on. The storm chaser curiosity and property owners’ concern could be remedied by viewing the weather event from a safe location. The 24-hour surveillance camera has recording components that are waterproof, shatterproof and run on batteries for up to seven days.

Darrell Jones, of Ocean Springs, is selling the cameras and looking to set up cameras in coastal Mississippi. As a public adjuster, Jones saw had firsthand how difficult it can be to separate wind damage from tidal surge.

The biggest problem we've faced is the insurance company comes in, sees a slab and says, 'Water did it,' when we know that is not always the case," Jones said. "The camera takes real-time video footage of your property as a hurricane comes through.

The cameras are built to withstand winds of 300 miles per hour and are encased in 1/4-inch stainless steel with special mountings. Herbert Saffir, the engineer who helped develop the Saffir-Simpson Scale was intrigued by “Eye of the Storm” and thinks the camera’s data could be very helpful to understanding the dynamics of the storm. "That's one of the problems in most hurricanes," Saffir said. "Very little visual data is available.”

How "Eye of the Storm" will impact future hurricane insurance claims is yet to be determined, but any policyholder who has visual proof will likely make a strong claim presentation.

In Katrina Cases Came ‘Fast and Furious,’ but Judge has no Regrets, Anita Lee wrote more in depth about Judge Senter:

The judge also became a hero to beleaguered policyholders when he ruled wind damage is covered even if storm surge contributes to a loss. Insurance companies, he said, had the burden to prove flood caused a loss in order to deny coverage.

The local and national media reported on those early cases, with reporters dashing from the courtroom to file their stories first.

“I just didn’t dream there would be that much (news coverage),” Senter said. “Frankly, I just worried also because of the danger that the jury panel would be influenced.”

The courtroom crowd swelled to its largest size in February 2007, when Senter held a hearing to consider a massive settlement agreement proposed by a group of policyholder attorneys, led by famed lawyer Dickie Scruggs, and State Farm Fire & Casualty Co. Sheila Birnbaum, considered in legal circles to be the world’s leading product-liability attorney, headed State Farm’s team.

Senter wanted to know how the Scruggs legal team intended to earn up to $20 million in legal fees outlined in the settlement agreement. The lawyers were unable to answer this and other questions to Senter’s satisfaction. He rejected the settlement. Senter ruled it failed to protect policyholders. Scruggs, used to getting his way, was livid.

Judge Senter asked me to speak against the class settlement that day. I had previously spoken in favor of the mandatory mediations and settlement conferences he ordered. I felt his heart and legal rulings were just in both instances. I argued against the Scruggs lead class that parties should always be encouraged to resolve differences as quickly as possible but should never be forced to accept an unfair settlement.

Again, as reported by Anita Lee, his impression of the timing of decisions and the impact it had on cases was the same as mine:

The tide was running in policyholders’ favor at the time. But the 5th U.S. Circuit Court of Appeals changed all that. The appellate court in September 2007 overturned Senter’s decision in a Nationwide insurance case, finding wind damage was not covered when water contributed to a loss. Policyholders near the waterfront were left to wonder what hurricane protection their policies did offer.

Insurance policies are governed by state law, so the Mississippi Supreme Court is the final authority in this area. The 5th Circuit could have sent the wind vs. water question to the state Supreme Court instead of reaching its own decision.

Instead, a test case did not reach the state’s high court until April 2008. The Supreme Court settled the issue in October 2009, more than four years after the hurricane. Justices drew the same conclusions Senter had reached less than a year after Katrina: Wind and water cause separate losses. Once the policyholder establishes a direct physical loss under an all-perils policy, the burden shifts to an insurance company to prove water caused the loss in order to deny coverage.

The delay, Senter said Wednesday, was “tragic.” “When (the 5th Circuit) reversed my decision,” he said, “it had a really demoralizing effect on a lot of policyholders who had lawsuits filed, as I was told by plaintiff’s lawyers, so they settled for substantially less than they should have received.”

He might not have known what he was getting into with the insurance cases, Senter said, but he would do it again. “Once you see the devastation, as I saw it, and all the people struggling, it just seems like a small, small part for me to try these cases,” he said. “They deserved a forum to have their cases tried.”

I noted the same and applauded Judge Senter's reasoning in Fifth Circuit Got it WRONG!!:

In the adjustment field, where the rubber meets the road, adjusters warn policyholders that interpretations could give a zero result where a coverage "problem" may exist in return for the policyholder being thankful for even an underpaid claim. This is exactly the situation now facing the public because of this overly broad interpretation of the clause given by the Fifth Circuit. Judge Senter had it right when he wrote:

Read literally, this provision would exclude all coverage when a windstorm did damage to both an insured dwelling (a covered loss) and adjacent "screens, including their supports, around a pool, patio, or other areas." (an excluded loss). I do not believe this is a reasonable interpretation of the policy. A windstorm is a weather condition that is specifically included in the coverage of this policy. When the policy is read as a whole, I find that this exclusionary provision is ambiguous -- the policy as a whole providing explicitly for windstorm coverage in one section and purportedly excluding the same coverage on the grounds that a windstorm, a "weather condition," and an excluded peril, a flood, ; occurred at approximately the same time. The most reasonable interpretation for these conflicting policy provisions is that this policy provides coverage for windstorm damage, in accordance with its terms, and that coverage is not negated merely because an excluded peril (in this case storm surge flooding) occurs at or near the same time. If this second provision were read to exclude wind damage that occurs at or near the time that any excluded water damage occurs, the result would be contrary to well-established Mississippi law...... This reading of the policy would make the windstorm protection illusory for those who live in areas where the risk of flooding is greatest. Nationwide seems to recognize this to be the reasonable interpretation of its policy. Nationwide has not invoked this policy provision to deny coverage to the Leonards for what everyone recognizes to be wind damage. (emphasis added)

Senter made the point that the Fifth Circuit missed, the insurance industry has heretofore no problem with paying for what damage wind does, despite a literal reading possibly giving rise to an absurd result. The example provided by Judge Edith Jones is an absurd result.

Eventually, I wrote about why the Fifth Circuit’s reasoning was wrong and Judge Senter’s was correct in Slabbed Gets It and So Do I: What About All the Other More Brilliant People Regarding Concepts of Concurrent Causation? But, the decision was far too late to correct the wrongs resulted from the Fifth Circuit’s erroneous decision to overrule Judge Senter.

This very humble and capable judge lead the most difficult insurance quagmire into a fair resolution, as I indicated in a post that I want you to read twice--once in the entirety and second for the bold emphasis if you want to understand how I felt about the matter-- I noted in a post from two years ago, A Judge That Gets It:

It is very, very hard to be a good judge. Of all the human endeavors, making decisions that directly impact people, their lives, and dreams on a wide variety of intensely disputed controversies is an awesome responsibility. To be a good judge, you have to be very smart, patient, understanding, intellectually and factually honest, have common sense, be experienced in life, energetic, restrained, detached from undue influence, noble, hard working, and intensely dedicated to seeing that people have a chance for justice. It is impossible to find all of these traits in one person, I know my best talents are found somewhere other than as a referee in a trial courtroom.

A federal judge is appointed for life. Like Admirals and Generals of our military and Cabinet-level Secretaries and their Deputies, they are on the Board of Directors of the United States of America. They voluntarily take on the job of making certain that this Land of the Free and Home of the Brave is more than just an ideal we have ingrained into our souls. They are the keepers of a governmental system of the best and longest running democracy to ever exist.

Two of my very good friends became federal judges. As I get older, more of my colleagues are getting tapped for these positions. They change once appointed. The federal judiciary demands that the avoidance of conflicts and appearances of conflicts of interest become paramount. I no longer see my federal judge friends regularly. As an advocate, I can understand and appreciate the need for my friends and judicial colleagues to distance themselves from the lawyers and other friends that may come before them seeking results favorable to our interests.
I guess it comes with the job, but there are personal sacrifices made by those accepting these responsibilities.

One of the aspects of practicing law all over the country is that I practice in front of a lot of different judges in various venues. Virtually all truly want justice in each case. Some are better at it than others. The worst and most dangerous to our society are those who are dishonest or who have closed their hearts to fairness or justice because they have a predetermined agenda. Once in a while, a particular judge makes rulings that show wisdom and leadership. Sometimes, you find these judges in places where people are surprised to find stellar and academic legal opinions, but we are often wrong to stereotype individuals based upon where they come from or live.

For instance, my mother cried the day she learned the Coast Guard was transferring our family to the Mississippi Coast. She grew up in Philadelphia and was afraid her children would never receive a proper education. However, the best academic and life lessons I learned were during the two years I spent with the Brothers of the Sacred Heart at St. Stanislaus in Bay St. Louis, Mississippi. My mother cried when we had to leave for my father's next tour of duty in California. The Brothers are very different from most modern people. They devote themselves to the improvement of people through the teachings of Jesus Christ. They have no other interests; they represent higher ideals. They inspire us to think about the welfare of others over ourselves. I owe them so much and am so unworthy a student of them.

Good judges are very much the same; they become judges to make justice and law based upon higher ideals. Who wants a dumb judge? Who wants an unsuccessful lawyer who just wants a raise as their judge? Nobody. How many successful attorneys, after working harder and better at it than others, want to take a cut in pay to be a judge? Not many. Those good attorneys who do, and truly desire to make this country a better place, without agenda, and with nothing more than a desire to do so, are what we need in our country.

It is truly rare when judges properly understand the practical and academic issues facing them. Either they lack the practical experience, or the very best attorneys are simply taking advantage of their academic abilities, resulting in poor decisions. This problem has not happened in the Southern District of Mississippi since Hurricane Katrina. Judge Senter has repeatedly called the balls and strikes of the ensuing insurance litigation with a reserved attitude and a voice of experience, trying to get the litigation resolved.

I will always remember Judge Senter and Magistrate Judge Walker for the important role they played in providing swift and effective justice. I noted in Tina Nicholson Gets a Well Deserved Note in Slabbed:

The Hurricane Katrina insurance coverage litigation along the Mississippi Coast was a once in a lifetime event for most attorneys. For me, it was obvious from the first day we landed at Stennis airport that this was where the Super Bowl of insurance coverage litigation was going to be waged for the next several years. With a lot of help from Florida panhandle trial attorneys Larry Keefe and Sparky Lovelace (Sparky quickly left our venture and started work with his long time friend, Dickie Scruggs), we decided to build two law offices--one in Bay St. Louis and the other in Gulfport. Teenage friends of mine who were local attorneys without law offices as a result of Katrina, Randy SantaCruz and William Weatherly, agreed to sign on with our efforts after Cindy Cady recruited them. With insurance claim denials and low payments running rampant, we were overworked with cases and clients. We already had transferred Jason Ciofalo from Tampa to work full time in Mississippi, and Deborah Trotter was working full time with Randy Santa Cruz out of the Bay St. Louis office.

But without Judge Senter taking leadership and moving the cases towards resolution, this would never have happened so that the rest of us could do our part. We need more judges with the character, attitude and nobleness of Judge Senter. To him I say, "Cheers" and God's Blessings.

In Bill Adding Wind To NFIP Introduced, May Be Discussed This Week, the National Underwriter addressed this recent development:

The House will likely consider legislation on Thursday that would add wind coverage to the National Flood Insurance Program, a plan opposed by the insurance industry.

The bill, H.R. 1264—“the Multiple Peril Insurance Act”—is sponsored by Rep. Gene Taylor, D-Miss. In discussions leading up to the House’s passage of a five-year NFIP extension last week, Rep. Taylor sought to attach an amendment adding wind coverage to the NFIP. But the House Rules Committee ruled it “non-germane” to the main bill, H.R. 5114, the “Flood Insurance Reform and Priorities Act of 2010.”

In a note to colleagues sent today urging their support, Rep. Taylor argued that the bill would save taxpayers billions of dollars by reducing future disaster assistance costs after hurricanes and tropical storms. “As long as wind and flood coverage are in separate policies, there will be gaps in coverage and lengthy disputes over causation after hurricanes,” he said. Rep. Taylor contended that almost all companies in the private property insurance market would benefit from adding wind to the program.

“The NFIP relies on insurance companies to sell federal flood insurance policies,” he said. “The companies keep about 30 percent off the top for agent commissions, administrative expenses and profits, yet bear none of the risk.” This arrangement would continue under his legislation, Rep. Taylor said.

Reflecting the property and casualty industry’s position, Blaine Rethmeier, a spokesman for the American Insurance Association, said, “The entire industry opposes the bill, and no one thinks adding wind exposure to a program that is already $19 billon in debt is a good idea.” (emphasis added)

The strong insurance industry opposition to this legislation was also echoed by the Insurance Networking News in "Insurers’ Wild Week." The article included speculation by one insurance industry lobbyist that Taylor's language was included because of the upcoming election and had little chance of ever becoming law:

"While the Senate ratification of regulatory reform was largely perfunctory, the passage of H.R. 5114, the Flood Insurance Reform Priorities Act of 2010, was replete with last-second drama.

To the consternation of insurers, one of three amendments offered by Rep. Gene Taylor (D. –Miss.), passed by a voice vote and was included in the final bill. The amendment would require private insurers participating in the NFIP “Write Your Own” (WYO) program to remove anti-current causation clauses from their policies. Taylor, whose home was destroyed during Hurricane Katrina and later reached a settlement with State Farm, says the clauses enable participating insurers to shift damage caused by wind to the NFIP.

To be sure, the issue of whether to include coverage for wind damage has been one of the primary issues blocking a long term funding resolution for the NFIP. With the defeat of two of his amendments, a multi-peril insurance bill sponsored by Taylor may come up on the floor as a standalone bill this week. “It’s never over,” jokes Ben McKay, SVP, federal government relations for the Property Casualty Insurers Association of America. Surprisingly, given the number of Republicans representing coastal districts, the vote for H.R. 5114 fell largely along party lines. “There’s a lot of extra stuff in the bill, so if you wanted to find something to love or hate, it’s in there,” McKay tells INN.

[An insurance lobbyist] says that Taylor’s efforts may be largely quixotic, noting that when a bill that included wind coverage appeared in the Senate, there was 85 votes against it. “The Senate won’t pass a bill with wind and [even if they did] the president has said he’ll veto it,” he says. “This may a bit of political gift in a tough election year for Gene Taylor—at our expense.”

Yet, in his remarks on the House floor last week, Taylor’s ardor to include wind coverage seemed genuine as he challenged his colleagues to take up the cause. "Quite honestly, I would like to see which shill for the insurance companies wants to defend what they did to individuals in the Gulf Coast and what they have done to the taxpayers as a whole," he said." (emphasis added)

In April, Slabbed updated everybody on Gene Taylor's efforts in "Let’s talk multi peril insurance and NFIP reauthorization as Slabbed updates the Washington front." That post contained a link to Gene Taylor's testimony on the issue and Anita Lee's coverage of the topic.

Having met with Taylor on this issue and other claims conduct issues following Katrina, I am glad to see he has not given up on finding a way to prevent the insanity of this coverage issue in the future. On his website, Taylor made the following observation regarding what this bill would accomplish:

Another focus of this hearing is H.R. 1264, “the Multiple Peril Insurance Act” which has been introduced by Rep. Gene Taylor (D-MS). After Hurricane Katrina, property owners with an insurance policy expected to be reimbursed for the full damage suffered. However, insurers declined to cover wind damage under the homeowner’s policy if some of the damage was deemed due to flooding, and the NFIP supplement to the policy would only cover flood-related damage. In effect, property owners who had been paying for years for this insurance were caught in the middle of a legal dispute between insurers and the NFIP.

The Multiple Peril Insurance Act would allow homeowners to buy comprehensive insurance and know that hurricane damage would be covered without lengthy legal disputes over how much damage was caused by wind and how much was caused by flooding. Premiums for the wind coverage would be risk-based and actuarially sound. Coverage would be limited. The CBO has scored the bill as budget neutral.

The bill would also reduce future property damage by requiring participating communities to adopt International Building Codes. Windstorm insurance would be available only where the local governments adopt and enforce the International Building Code or equivalent building standards. Thus the bill would not only prevent insurers from shifting liability back to the federal government, it would also save taxpayers money by increasing the number of properties that are mitigated against future wind damage and paid for by insurance premiums rather than post-disaster federal assistance.

In the long run, we will have to pay for the losses we incur. We can do this privately, through the social product of insurance which spreads losses among geographic and time parameters. Similar to the debate about the investment in an energy efficient infrastructure not dependent on carbon, we need promote investment in buildings better hardened against perils of loss. Many of these steps will help reduce the severity of loss risk to private insurers doing business in coastal states.

I hate to sound pessimistic, but I cannot imagine that many insurers would remove a fairly standard clause found in most property insurance policies just to write insurance under the National Flood Insurance Program. I would expect that any final legislation extending the National Flood Program will not require the anti-concurrent clause to be removed from Write-Your-Own policies. And that may be a shame because Taylor's bill would stop the problem many devastated coastal policyholders are forced to resolve following a significant hurricane storm surge.

Robert Hartwig, who heads the Insurance Information Institute, said the ruling could affect the cost and availability of homeowner policies on the Mississippi Coast.

“What this basically suggests is that the cost of claims is going to be higher than insurers anticipated,” Hartwig said, “so there are direct consequences for the price of insurance in Mississippi and potentially for the availability as well.

If the state of Mississippi is going to take a different tack from the federal courts, the policies will have to be priced and underwritten appropriately. It makes selling policies in Mississippi risky and, on average, more expensive. There’s just no other way around that."

The propaganda threat and point is obvious—suggest to those who interpret policies against the insurance industry’s version (judges) that the case is wrongly decided and that those venues with a similar view will have unaffordable insurance, if any at all. This has been the mantra of his propaganda and that of the insurance industry wherever repeated catastrophes have occurred.
 

My response is:

How affordable is insurance that does not pay fully and promptly after a catastrophic loss?

And

Why does the insurance industry find that “good” judicial decisions only happen when denials of coverage are upheld and customers get nothing, unless the insurance industry is more interested in its own profits than caring for its customer and providing a product that serves a purpose after a catastrophe?

Many of my retail corporate clients and their general counsel have told me that if they advertised and then performed in the manner of their insurer, the federal and state trade commissions would be holding “bait and switch” hearings. But, this is exactly the type of treatment insurance executives are calling for when they support the propaganda against their own customers through spokespersons such as Hartwig.

I am not the only one to have noticed this. Slabbed had two posts on the topic, The Push Back on Corban – “You’re gonna pay for this” and Da Corban spin continues: AIA prefers denial while the National Underwriter carries III press release calling it news. The editors of Slabbed were pretty blunt about what they think about Hartwig:

The ink was still wet on that post when 2 days ago the Mississippi Supreme Court ruled that the ACC clause as interpreted by the notorious, corporation loving 5th Circuit ain’t the law in Mississippi. The tragedy is that hundreds of thousands of claims were illegally mishandled for 4 years before we got word. Anyway, State Farm, Allstate, Nationwide and USAA got bitch slapped, and they’re some kinda pissed. I knew there’d be press statements coming, all calculated to terrorize homeowners as soon as the shills got their poison pens loaded. We all know who they are: Robert Hartwig being foremost among them….
…
You see how this sick SOB thinks nothing of threatening us? What he’s saying is “you’re gonna pay for this . . . we’re gonna jerk policies if we have to, or raise rates on you . . . but one way or the other, you’re gonna pay for this!”

In other words, if policyholders dare invoke the rule of law to reign in these monolpolies, they come back with “You’re gonna pay for this!” See how this is just like “whipsawing” rate increases? I’ve said it over and over, big insurance is openly engaged in racketeering…
…
I think it is time we put such intellectually dishonest drivel to bed. Long standing legal principles were restored with the Corban decision which overturned the flawed anti concurrent causation analysis contained in Leonard as well as firmly setting out well established legal principle that insurers have the burden of proof to establish a non covered peril caused a loss on a all perils policy. Insurers, knowing full well the meaning of their policy language were no doubt overjoyed at the gift Edith Jones gave them in Leonard overturning literally hundreds of years of case law but make no mistake they knew the risk they were taking in Mississippi and Louisiana way before Katrina ever struck. To assume these highly paid execs were ignorant of their own policy langauage or that Corban somehow changes the coverage equation is wacky.

I agree completely with the highlighted portion of the quote from Slabbed. However, the equally important aspect of its post should be how insurance customers and regulators throughout the country should start to view most of the property and casualty insurance companies—they are purely interested in their own profits and self interest and do not look at the historical role of insurance as a social product. Insurance companies advertise peace of mind and all kinds of emotional messages. The truth is that many are engaged in a social propaganda campaign to make it appear as if their own customers are wrong to get fully and promptly paid after a disaster strikes. It is almost as if the intended message is that customers suffering a catastrophe are “bad” and getting their benefits is wrong because the poor insurance companies will leave markets or raise rates for the customers that did not suffer a loss in that catastrophe. The message is clear—try to pit the customers that did not suffer a loss that day against those that did to gain additional allies to the insurance industry agenda.

We need political, regulatory and thought leaders, like Slabbed, to make certain that the insurance industry propagandists are called out when they engage in a war against their customers. Until insurance industry executives accept the ethical obligations they have to their customers, there is an ever increased need for strong regulations and legislation mandating honest and fair conduct by this industry. We cannot trust insurance companies to be honorable or do the right thing when the moment of truth is at hand.

I live in a world where words, and the subtle understanding of them, mean much financially to everybody involved, including myself. I personally had millions of dollars on the line advancing the costs of lawsuits in Mississippi. I was very much a partner with my clients advocating for coverage.

Corban is a big decision in my world. As I read the decision, most of my thoughts were upon others that have been through this huge legal mess. Unless you have lost everything and have had your insurance denied, it is hard to comprehend how frustrating being embroiled in a sea of insurance lawyers can be—it is a curse at best.

When I first started reading the case, I was silently cursing our firm’s knowledge manager for not indicating which side won the decision. Since some of the award was for the insurance company regarding the flood issue, maybe he could not figure it out. I am certain that some insurance company claims executives and their counsel will feign that this is “a win” because the storm surge and flood exclusions were found to be valid and applicable. I have never shared much hope for that legal position. I think my view regarding that issue prevented me and others with me from joining Dickie Scruggs’ group and his attempts for a class action lawsuit on that issue.

Yet, I knew that Judy Guice always advocated that view of flood being covered. When I read Anita Lee’s article this afternoon quoting from Judy Guice’s class action attorney, Richard “Flip” Phillips, I kept thinking about Judy advocating that flood was not excluded for a number of reasons. Judy Guice is a noble person and a worthy advocate. I am happy she uses her talents for policyholders and people rather than corporate and insurance company interests. She should be proud of the result. She has worked very hard for the people along the Mississippi Coast.

I also thought about my argument against Flip and Judy Guice about making the cases a class action. The federal courtroom was filled with journalists and I was pretty punishing about my views of how a class would hurt most policyholders. Honestly, class action status would have been a windfall for the attorneys, but a lopsided loss for the policyholders. I know Dickie Scruggs and I disagreed about that, but all you need to do is watch our clients, the Lees, to understand why I say that.

Slabbed was also on my mind while reading the decision. Their post, Insurance is a big think – Have you ever tried to think?, is something I can appreciate and strongly urge others to read and gain a better intellectual knowledge of the legal discussion in Corban.

There was an entire causation discussion in this decision where I was thinking about an attorney, David Rossmiller, who had nothing personally involved with the outcome of any of these cases. Rossmiller is a former journalist turned lawyer. I thought of Rossmiller teaching that many concurrent cases were truly not concurrent situations when the Corban court wrote:

No reasonable person can seriously dispute that if a loss occurs, caused by either a covered peril (wind) or an excluded peril (water), that particular loss is not changed by any subsequent cause or event. Nor can the loss be excluded after it has been suffered, as the right to be indemnified for a loss caused by a covered peril attaches at that point in time when the insured suffers deprivation of, physical damage to, or destruction of the property insured. An insurer cannot avoid its obligation to indemnify the insured based upon an event which occurs subsequent to the covered loss. The insured’s right to be indemnified for a covered loss vests at time of loss. Once the duty to indemnify arises, it cannot be extinguished by a successive cause or event…. The same principle applies in reverse. In the case of a loss caused by an excluded peril, that particular loss is not changed by any subsequent covered peril or event. Nor can that excluded loss become a covered loss, after it has been suffered.

…

Loss to property can consist of many losses because property can consist of many
elements, and ‘loss’ need not refer only to the totality of the damage and in fact should not when different forces have caused different damage.” Appleman on Insurance § 192.03[H] (2009) (emphasis added). The subject homeowner’s policy insures “for direct, physical loss” to property.

Rossmiller wrote this about the Corban case long before this decision in his post, Mississippi Supreme Court Asked to Interpret Anti-concurrent Cause in Interlocutory Appeal:

When I see something like this, I call it a "yeah but" moment. Yeah, but where's the analysis showing exactly how you think wind and water acted either concurrently or sequentially to cause the same damage? Those words, concurrently or sequentially, can have meaning only within the context of the clause's overarching purpose – to address multiple causes of the same loss. And if there ain't no same loss, they ain't no good.

So "concurrent" and "in sequence" have to have some specialized meaning within this context, or they make no sense -- they can't be used in a colloquial sense. Merely because one thing follows another does not give it the meaning of sequentially within this context, nor are two things concurrent in this context merely because the forces act at roughly the same time or act on the same physical element of property. You have to understand the purpose of those words, and once you do, it is relatively easy to see that Katrina wind and water were neither concurrent nor sequential. They can't be, because they didn't cause the same loss at the same time, they caused different losses to property at different times. It is not important that the same element of property was damaged by different forces twice -- they are still distinct and so any form of causation analysis used to sort out what is responsible for the same loss is irrelevant. I am still waiting for anyone to show me even one instance of Katrina wind and water acting concurrently or sequentially as I explain those terms. No one has yet, and I doubt anyone ever will.

The Corban Court obviously followed Rossmiller’s causation analysis. While he is not blogging any longer, his analysis is still respected among those of us that do this law day to day.

Thank God the Mississippi Supreme Court did not follow Nationwide’s analysis or nobody would have coverage for just about any cause of loss. Nationwide is not on Your Side unless you have an ownership interest in its profits. Beware if this is your insurance company. Their public claims of limited coverage in courts and lawsuits are very different than what that company advertises and leads customers to think is covered. The executives of Nationwide should be ashamed to have allowed their attorneys to argue what they did. The Mississippi justices singularly pointed out how harsh Nationwide’s interpretation was against the policyholder. This company obviously has an anti-customer attitude when it comes to claims. Buyer beware.

I wish this case came out two years ago. The Fifth Circuit should have allowed the Mississippi Supreme Court to decide these issues in the Leonard case, but it refused to place a certified question before the Mississippi Supreme Court at that time.

The bottom line is that this case is so long in the tooth that most Mississippi policyholders cannot benefit from it because most cases are finished. It is a rule of law that benefits a few and hurts a few because the vast majority of Katrina cases are settled, for better or worse.

Still, I keep wondering what I, and my clients, would have done had this case come out three years ago and followed Nationwide’s argument. We would have been in a world of hurt and true despair.

Ed Rust Jr. is very capable and bright, but is he earning the position or does he just get to keep it because of his dad and long standing family ownership of State Farm's management?

For example, in the 2001 case of Campbell v. State Farm Mut. Automobile Ins. Co., the Utah Supreme Court in 2001 found:

"2. The Nature of State Farm's Misconduct

This factor specifically analyzes the nature of the defendant's conduct in terms of its maliciousness, reprehensibility, and wrongfulness. It mirrors the "reprehensibility" factor described by the United States Supreme Court in BMW of North America, Inc. v. Gore, 517 U.S. 559, 134 L. Ed. 2d 809, 116 S. Ct. 1589 (1996). There, the Supreme Court stated that the defendant's misconduct is "perhaps the most important indicium of the reasonableness of a punitive damages award." ...Repeated "trickery and deceit" targeted at people who are "financially vulnerable" is especially reprehensible and worthy of greater sanctions. ... Moreover, "deliberate false statements, acts of affirmative misconduct, or concealment of evidence of improper motive" also warrant larger awards. ...

With these standards clearly in mind, the trial court made nearly twenty-eight pages of extensive findings concerning State Farm 's reprehensible conduct. We summarize here three examples from those findings of State Farm 's most egregious and malicious behavior.

First, State Farm repeatedly and deliberately deceived and cheated its customers via the PP&R scheme. See Court's Findings, Conclusions and Order Regarding Punitive Damages and Evidentiary Rulings, Campbell, at 17-27. For over two decades, State Farm set monthly payment caps and individually rewarded those insurance adjusters who paid less than the market value for claims... Agents changed the contents of files, lied to customers, and committed other dishonest and fraudulent acts in order to meet financial goals...For example, a State Farm official in the underlying lawsuit in Logan instructed the claim adjuster to change the report in State Farm's file by writing that Ospital was "speeding to visit his pregnant girlfriend." ...There was no evidence at all to support that assertion. Ospital was not speeding, nor did he have a pregnant girlfriend. Id. The only purpose for the change was to distort the assessment of the value of Ospital's claims against State Farm's insured. As the trial court found, State Farm's fraudulent practices were consistently directed to persons--poor racial or ethnic minorities, women, and elderly individuals--who State Farm believed would be less likely to object or take legal action.

Second, State Farm engaged in deliberate concealment and destruction of all documents related to this profit scheme....State Farm's own witnesses testified that documents were routinely destroyed so as to avoid their potential disclosure through discovery requests....Such destruction even occurred while this litigation was pending... Additionally, State Farm, as a matter of policy, keeps no corporate records related to lawsuits against it, thus shielding itself from having to disclose information related to the number and scope of bad faith actions in which it has been involved.

Third, State Farm has systematically harassed and intimidated opposing claimants, witnesses, and attorneys... For example, State Farm published an instruction manual for its attorneys mandating them to "ask personal questions" as part of the investigation and examination of claimant in order to deter litigation... Several witnesses at trial, including Gary Fye and Ina DeLong, testified that these practices had been used against them... Specifically, the record contains an eighty-eight page report prepared by State Farm regarding DeLong's personal life, including information obtained by paying a hotel maid to disclose whether DeLong had overnight guests in her room...There was also evidence that State Farm actually instructs its attorneys and claim superintendents to employ "mad dog defense tactics"--using the company's large resources to "wear out" opposing attorneys by prolonging litigation, making meritless objections, claiming false privileges, destroying documents, and abusing the law and motion process...

Taken together, these three examples show that State Farm engaged in a pattern of "trickery and deceit," "false statements," and other "acts of affirmative misconduct" targeted at "financially vulnerable" persons.... Moreover, State Farm has strategically concealed "evidence of [its] improper motive" to shield itself from liability, which was furthered by State Farm's treatment of opposing witnesses and counsel.... Such conduct is malicious, reprehensible, and wrong.

State Farm responds by arguing in its brief that even if its conduct was wrong, it does not "after all, involve murder, torture, or deliberate poisoning of the environment," and thus cannot warrant millions of dollars in punitive damages. Additionally, State Farm argues that under Crookston II, willful calculated fraud was not sufficient to justify a higher than ordinary ratio of punitive to compensatory damages...

State Farm fails to realize that, while Crookston II held that fraudulent conduct alone was insufficient to justify a large punitive damage award, it also observed that fraud combined with other factors justifies a higher award....the company's 'calculated and calloused attitude' toward settling valid claims." ...In this case, the jury was convinced, and the evidence shows, that State Farm engaged in a widespread pattern of fraud. Moreover, the evidence of its PP&R scheme demonstrates that State Farm specifically calculated and planned to avoid full payment of claims, regardless of their validity. Thus, the nature of State Farm's conduct supports the imposition of a higher than normal punitive damage award."

The United States Supreme Court reversed the amount of punitive damages and sent the case back further review of State Farms's claims culture. This occurred in 2004, before Hurricane Katrina, and the conservative Utah court held:

" In insurance each party must take a risk. But it is inaccurate to assert that if the insured event does not occur then the insured receives nothing in return for the premium payment made. Each insured receives at the time of contract formation present assurance of compensation if the loss occurs which is a valuable peace-of-mind protection.

....

Insureds buy financial protection and peace of mind against fortuitous losses. They pay the requisite premiums and put their faith and trust in their insurers to pay policy benefits promptly and fairly when the insured event occurs. Good faith and fair dealing is their expectation. It is the very essence of the insurer-insured relationship. In some instances, however, insurance companies refuse to pay the promised benefits when the underwritten harm occurs. When an insurer decides to delay or to deny paying benefits, the policyholder can suffer injury not only to his economic well-being but to his emotional and physical health as well. Moreover, the holder of a policy with low monetary limits may see his whole claim virtually wiped out by expenses if the insurance company compels him to resort to court action.

....As the facts of this case make clear, misconduct which occurs in the insurance sector of the economic realm is likely to cause injury more closely akin to physical assault or trauma than to mere economic loss....When an insurer callously betrays the insured's expectation of peace of mind, as State Farm did to the Campbells, its conduct is substantially more reprehensible than, for example, the undisclosed repainting of an automobile which spawned the punitive damages award in Gore....

...

This deceitful conduct can only be explained as part of a scheme to reduce State Farm 's economic exposure. The possibility that its dissembling would expose the Campbells to an excess judgment must have been apparent to State Farm . To react as it did when the excess judgment became a reality only confirms the toxicity of State Farm 's behavior.

...

When considered in light of all of the Gore reprehensibility factors, we conclude that a 9-to-1 ratio between compensatory and punitive damages, yielding a $ 9,018,780.75 punitive damages award, serves Utah's legitimate goals of deterrence and retribution within the limits of due process."

Unlike the vast majority of American corporations whose boards and regulatory audit committees would have cast out a CEO after such findings, State Farm's board of directors and audit committees did nothing. This financial and independent giant thumbed its nose at regulators and the courts. It made no change. I would be more than happy to share anything that anybody has to offer to explain how such a small amount of punitive damages changed one of America's largest corporations (allegedly non-profit).

Utah has Mormon conservatives, but what about Florida, where people from the north and south, liberal and conservative, must agree upon ethics? Is State Farm honest in Florida? How about this finding, which I reported in "State Farm's Freakoutnomics:"

"The recommended Order from the Judge who reviewed the rate increase explains how State Farm’s theory of loss is sham economics. Starting at page 15:

"...State Farm Florida also paid State Farm Mutual $12.8 million for a credit risk provision....
...
Of the total $700 million paid to private re-insurers, State Farm Florida paid approximately $151 million to private re-insurers other than State Farm Mutual. State Farm Florida paid $549 million to its parent company, State Farm Mutual.
...
Payments to unrelated private re-insurers represent arms-length transactions between a willing buyer and willing seller of reinsurance coverage. However, the fact-finder is unable to determine from a preponderance of the evidence whether either the cost of reinsurance purchased from State Farm Mutual or the cost of the credit risk provision purchased from State Farm Mutual is excessive or reasonable....

The economic reality is that State Farm Florida is merely the legal form in which State Farm Mutual chooses to do business in Florida. State Farm Mutual and its wholly-owned subsidiaries, including State Farm Florida, comprise a "group or combination" that the Legislature defines as a "person" ...

Transactions between State Farm Mutual and State Farm Florida for reinsurance and credit risk provisions totaling approximately $561.8 million, when viewed in the light of economic reality... may be transactions which State Farm Mutual engages in with itself and which lack any independent economic significance. Transactions with no independent economic significance would be sham transactions which may distort the economic costs... Such economic distortions may enable the group to derive a rate advantage from the legal form in which State Farm Mutual chooses to do business in Florida."

That is what the judge said and this is what I said:

"The above findings cannot be overstated. The judge made these findings after State Farm and Florida's Office of Insurance Regulation fought over the details of State Farm's request for a rate increase. The bottom line is that what State Farm Florida wishes to report as expense, is largely payments made to its parent company. Essentially, it is moving income from one pocket to another, while claiming it as an expense.

If the media would report on this finding with headlines such as, "Judge Rules State Farm Engages in Sham Transactions," I do not think that State Farm's explanation of financial loss and threats to leave Florida would have such an impact. If people knew the whole story, they would know State Farm’s tales of financial loss in Florida are nothing more than propaganda."

In Mississippi, so many clients had altered engineering reports that it was obvious the problem was not just a mistake. Every time the change was made, it was to lessen the amount owed. Who in any position of leadership would allow this to wrongfully happen without picking up the phone and asking to quietly resolve the matters? I have never spoken to Ed Rust Jr. Other insurers have been understanding enough to have their officers call their policyholders who have catastrophic claims. Slabbed and Anita Lee are reporting events necessary for an understanding of State Farm's litigation culture.

This week, the Florida Appellate Court decided the issue against State Farm and for Florida policyholders and for Kevin McCarty. The important thing is that a "sham" transaction and argument has been made to Florida Regulators and judges. Why should State Farm be able to hold a license in any state given the findings here and in Campbell? Because they have a tremendous amount of money and lots of really nice and friendly local agents? Maybe to keep the license throughout the rest of the country, State Farm should have to change culture at the very top. Do any of you think that you should run your family's business by birthright? Why should Ed Rust, Jr.?

What do you think?