Tag Archives: Exclusion

Gator Coverage?

Chomp, Chomp! Insurance Policies are designed to cover sudden and accidental loss and damage. Mary Wischusen, 77, believed that she had a suffered a sudden and accidental act of nature and that coverage would be afforded when a gator came crashing into her kitchen. This 11-foot alligator was not her domestic pet or a planned … Continue Reading

When Can My Property Insurance Claim Be Denied Due to War or Other Undefined Terms?

I often receive calls from policyholders asking how an insurance company can deny their claim based on an exclusion that isn’t defined in the policy. One of these terms is “surface water,” a common exclusion found in most policies. Recently, I had a client whose home’s gutter system malfunctioned during a rainstorm. Rather than channeling … Continue Reading

Property Insurer Wrongly Denies You Coverage? Victor Jacobellis and Chip Merlin Discuss How Exceptions to Exclusions Win Coverage

Victor Jacobellis left his job in San Francisco representing insurance companies to join Merlin Law Group and help policyholders obtain insurance coverage benefits. He asked me to speak with him about exceptions to exclusions of coverage which are often overlooked and lead to wrongful denials of coverage. The photo above shows yours truly speaking with Victor … Continue Reading

Broken Water Main Damage: Flood or Not Flood Under Homeowner’s Insurance Policy?

In a recent court opinion,1 the New Jersey Appellate Division interpreted a homeowner’s insurance policy’s water damage exclusion and determined whether damage from a broken municipal water main under a public street was covered under the policy. In that case, a homeowner brought an action against his insurer for breach of contract after the insurer … Continue Reading

Collapse Loss Ambiguity Determined With Dictionary Help

Feenix Parkside LLC owed a commercial building that incurred a partial collapse to their ceiling. When Feenix sought coverage for the collapse, the insurer—Berkley North Pacific—denied coverage for the loss. When Feenix reported the loss, they stated the collapse was due to decay, which was a gradual decline in strength and soundness.… Continue Reading

Where There Is Smoke, There Is… A Denial

An Illinois Public Insurance Adjuster recently contacted me regarding an insurer’s denial of a smoke damage claim. The facts were as follows. While a condominium unit owner was using the fireplace in the unit (“unit 1”), smoke began to fill up in the condominium unit above (“unit 2”). The condominium association made a claim to … Continue Reading

Freezing Exclusions: One Size Does Not Fit All

“One size fits all” is a phrase used to describe pieces of clothing or accessories designed to fit all people. Over time, it has been used to refer to anything meant to apply in all circumstances. Obviously, one size cannot fit all people. The same holds true when it comes to “freezing” exclusions in homeowner’s … Continue Reading

Case Highlights How Writing and Interpreting Policies Can Be Challenging in Today’s Technological World

In the recent case of Rainforest Chocolate, LLC v. Sentinel Insurance Company, Ltd.,1 the Supreme Court of Vermont found coverage for Rainforest where Sentinel’s “false pretense” exclusion turned out to be ambiguous as there were at least two reasonable interpretations of what constituted “physical loss or physical damages.”2… Continue Reading

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

Follow-Up: My Insurance Claim Was Denied Because My Water Leak Lasted Over a Period of 14 Days or More – Was the Denial Proper?

In March, I posted a blog on the Hicks v. American Integrity Insurance Company opinion,1 in which a Florida court ruled that policy language stating: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days,” did not preclude coverage for damage caused during the first … Continue Reading
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