A business interruption claim does not always end up in litigation. There are basic techniques that an insured may consider expediting and presenting a claim that may result in a fair resolution of a business interruption claim. The Business Interruption Book: Coverage, Claims, and Recovery,1 is a great source for information on business interruption issues and it provides a non-exclusive checklist to facilitate claims handling.
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Business Interruption coverage protects the potential earnings of the insured business while its operations are suspended as a result of damage caused by a covered peril. The period of restoration has a direct effect on the actual loss suffered. A typical definition in most ISO forms of the “period of restoration” is:
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On January 30, 2019, New Jersey residents suffered a tremendous loss. Marcal Paper, in Elmwood Park, New Jersey on the edge of Route 80, burned to the ground. Along with it, 80 years of a family owned business, jobs, community, and an iconic sign that lit up Route 80 were lost.
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We see many commercial insurance claims denied because the insured did not maintain a particular “protective safeguard” required by the policy. For example, a policy may require burglar alarms, and exclude coverage for theft if alarms are not working at the time of a loss. Or, a policy may require fire sprinklers, and exclude coverage for fire loss if the property does not have any. Some provisions may even allow the insurer to deny coverage if the insured failed to have a contract in place for regular service of the protective safeguard, something often seen for Ansul systems in restaurants. Courts across the country have almost uniformly upheld the validity of these endorsements.1
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A very insightful reader posted this comment to my blog post, Period of Restoration-Valuing Business Interruption Claims, Part I:
When adjusting business interruption claims, I find that the biggest disagreements I have with carriers are not with the length of the restoration period. They’re with my projected revenues had no loss occurred.
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The effort to mitigate the damage, gather supporting documents, and present an insurance claim, can for many policyholders prove to be the toughest part of the recovery process. After suffering a loss or business interruption, the main priority of most business owners is restoring their businesses or premises as soon as possible – not preparing an insurance claim. While their goal is to achieve the utmost recovery in the shortest period of time, the loss adjustment process can be long and grueling.
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After every major flood event, I am contacted by at least one business owner and/or condominium owner who suffered flood damage, filed their claim with their NFIP1 Flood Insurance Company (Allstate, Hartford, Wright Flood, Farmers, FEMA, etc.), and was then told by either the flood insurance company or adjuster that the flood insurance policy did not cover all of the buildings or structures on the property. The business owners are enraged because they were under the impression that all buildings on the property were covered.
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Business interruption coverage is very valuable to many policyholders in the wake of Hurricane Michael. Florida business owners may seek coverage under their commercial insurance policies for business interruption, which indemnifies them for lost earnings and expenses if their businesses are partially or totally interrupted as a result of Hurricane Michael. Business interruption coverage is intended to protect the potential earnings of the insured business. Its purpose is “to do for the insured…just what the business itself would have done if no interruption had occurred—no more.”1
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On June 12, 2018, the Office of the Commissioner of Insurance of Puerto Rico (OCI) issued Ruling Letter No. CN-2018-241-D, Appraisal Procedures for Insurance Claims for Commercial Property Related to Catastrophic Events.
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It’s the stuff that dreams are made of. Humphrey Bogart delivers this memorable line at the end of The Maltese Falcon, summing up the allure of the shady characters’ search for the eponymous, elusive relic. Pro-policyholder case law can be equally elusive, especially when unsettled areas of insurance law, like coverage for cyber losses, are at issue.
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