Showing posts with label insurance law. Show all posts
Showing posts with label insurance law. Show all posts

Monday, 24 June 2013

Insurance for Flood Damage to Your Home

    Pumping flood water back into the river

Standard homeowner's policies issued by Canadian insurance companies contain an exclusion for damage caused by flood.  Here is a typical flood damage exclusion:


"This policy does not insure … loss or damage caused directly or indirectly by flood, and the word "flood" means waves, tides, tidal waves, and the rising of, the breaking out or the overflow of, any body of water, whether natural or man-made…"


The exclusion clause is carefully drafted so as to provide the insurance company with the widest possible protection against this type of claim.

The language employed is quite comprehensive.  Damage arising "directly or indirectly" from flood is excluded from coverage, and the word "flood" is defined broadly so as to include things that people would not normally think of as flooding, such as tides and waves.  Flooding from any body of water, including man-made sources such as reservoirs, is excluded.

Courts in a number of Canadian provinces have upheld this form of exclusion clause.  In Catalano v. Canadian Northern Shield Insurance Company, 2000 BCCA 133, municipal workers diverted water from overflowing culverts so that it inundated the plaintiff's business.  The B.C. Court of Appeal held that the diversion was not a separate intervening cause of the damage, and that since the original source of the water was overflow arising from heavy rainfall and melting snow pack, the loss came within the policy definition of "flood" and was excluded.

In the recent emergency in Alberta, work crews in certain locations have erected berms and other barriers to divert overflow from rivers.  Although these actions are intended to protect residential areas from flooding, some property owners have probably found that the diverted water increased the flow over their land.  Assuming that the Alberta courts adopt the B.C. interpretation, the ensuing flood damage would be excluded under the typical home insurance policy.

In an Alberta case, the Court of Queen's Bench also accepted the insurer's interpretation of this clause.  In MacNichol v. Insurance Unlimited (Calgary) Ltd., 1992 CanLII 6185 rising water in the Peace River breached a dam, causing blocks of ice to go over the dam and crash into a pump-house that was under construction.  Although the immediate cause of the damage to the pump-house was the action of the ice blocks pounding against it, the court concluded that the direct cause was the rise and overflow of the river, which triggered the exclusion clause.

In another B.C. case, however, the Court of Appeal adopted an interpretation more favourable to the insured.  In B.C. Ferry Corp. v. Commonwealth Insurance Co. (1987), 40 D.L.R.(4th)  766, the insured owned a ferry terminal which was damaged by heavy waves during a severe storm.  Since the evidence showed no abnormal rise in the water levels, however, the appellate court concluded that the event did not come within the extended definition of "flood" in the policy, which encompasses waves, tides, and tidal waves.  Although it was wave action that damaged the terminal, there was no rising of, breaking out, or overflow of any  body of water - the flood exclusion did not apply.

Although the Insurance Bureau of Canada has said that there is no coverage for "overland flooding" in Canadian home insurance policies, there is an alternative point of view.  If the original source of the water is overflow from a river, the damage comes within the standard flood exclusion and is not covered.  The exclusion does not use the word "overland", however, so the wording does not extend to any water that enters a home from outside regardless of the source.

There has been heavy rainfall in many areas of the province over the last week, and water that seeps or leaks into a home due to excess precipitation, and that does not originate in an overflowing river, stream, or reservoir, would not trigger the flood exclusion.  Such water damage would come within the coverage provided in an "all risks" policy, and would likely be covered as "storm" damage in a specified perils policy.

Here are some other kinds of losses that might be covered, even if the home policy contains a standard flood exclusion:
  • Sewer backup - many home insurers provide sewer backup coverage as an add on for an extra premium.  If your home policy has a sewer backup endorsement, you are covered where waste water from storm or sanitary sewers has entered the basement through floor drains, tubs, shower stalls, or toilets.  You may also have coverage where some of the water entering your home is backup from sewers and some is overland flow from river flooding.
  • Electrical disruption - electrical failure or interruption that is not caused by flood damage could be covered.  It seems that municipal authorities decided to cut power to certain areas once an evacuation order had been issued.  The spoiled contents of a fridge or freezer could be covered in this situation.  If the power loss was due to flood damage to a transformer, however, it would likely come within the flood exclusion.  The contrary argument is that the authorities cut power as a precautionary measure in areas that might be flooded, so the power disruption is analogous to the water diversion in the Catalano case.
  • Evacuation costs - if you were evacuated, but your property was not in fact flooded, it is arguable that your accommodation costs such as hotel, restaurants, and parking could be covered.  Such losses would likely not be covered under a specified perils policy, but they should fall within the coverage of an all risks policy in the absence of an exclusion for government orders or actions.  Losses due to electrical disruption could be covered under the same argument.
  • Theft, vandalism, arson - whether your property was flooded or not, damage caused by third parties while you were ordered to evacuate and unable to protect your home should be covered.
  • Vehicle damage - cars are insured separately, and flood damage to a vehicle should be paid if the insured purchased comprehensive coverage.
All of the above applies to insurance for residential premises.  Business insurance is in an entirely different category.

Although standard business policies contain a flood exclusion similar to the one in home policies, business owners can purchase flood coverage for an extra premium.  This option is not available to home owners.

Even if a business policy does not have a flood endorsement, the flood exclusion often contains language stating that the exclusion does not apply to "resulting damage".  Under this exclusion to the exclusion, direct flood damage is not covered, but if building systems such as fire alarm and suppression, refrigeration, or security are damaged by flood waters, and then there is additional damage caused by the failure of one of those systems, this is "resulting damage" and it is covered.  An example might be the loss of the contents of an industrial freezer to spoilage where water shorts out electrical systems, causing the freezer to shut down.

If you are a business owner you should look at the specific terms of your policy and consult your broker, public adjuster, or legal counsel for assistance in determining what is and is not covered.


Contact Richard Hayles at Billington Barristers:
(403) 930-4106

View my profile on LinkedIn: http://www.linkedin.com/profile/view?id=50396098&trk=nav_responsive_tab_profile

Any legal information provided is general in nature and may not apply to particular situations. It does not constitute legal opinion or advice. Please consult your lawyer regarding your specific legal issue.

Friday, 14 June 2013

Insurance Company Must Defend Condo Developer

    Condominium Construction

Builders and developers involved in the construction or conversion of condominiums often face lawsuits over alleged deficiencies, sometimes long after the project is completed.  The builders are typically covered under Comprehensive General Liability ("CGL") policies that limit coverage to damage that occurs during the policy period, and which contain exclusions for liability arising out of contract.
The coverage provided by a CGL policy includes an obligation to indemnify the builder for legal liability to others resulting from the builder's negligence, and an additional, separate obligation to defend any actions claiming damages for such negligence.  The duty to defend includes an obligation to retain counsel and pay the legal costs involved in dealing with litigation.  Since defence costs in major construction litigation can easily run into the hundreds of thousands of dollars, and since most actions will settle before trial, the duty to defend is often as important as the obligation to indemnify.
Does the insurance company have an obligation to provide a defence where the condominium corporation sues the developer/builder for damage that didn't appear until long after the project is completed? What about damage that happens after the CGL policy has expired? In Alberta, the Court of Queen's Bench dealt with both these issues in a recent case involving Canalta Construction Co.
The Condominium Project
Canalta was the developer and general contractor for a condo conversion in Edmonton.  During the construction, Canalta obtained a CGL policy from Dominion of Canada.  Canalta registered the condominium plan in 2003, the work was completed in 2005, and all of the condo units had been sold by September of 2006.
The Dominion policy was renewed through to January 1, 2008.  A water main failed some seven months later, and the Condominium Corporation sued Canalta in July of 2010, claiming damages for the design and construction of the water main and the failure of the roof system to repel water vapour and insulate the premises.  The water main and the roof system were both common elements, and all of the damages were located in common areas rather than in individual condo units.
The Dominion Policy
The Dominion CGL policy covered liability for "'property damage' which occurs during the policy period."  There was an exclusion for compensation that Canalta had to pay "by reason of the assumption of liability in a contract or agreement", but this exclusion was subject to an exception for liability that Canalta "would have in the absence of the contract or agreement".
There were also exclusions for property that Canalta owned, rented, or occupied, and for damage to premises that Canalta has sold.  The latter exclusion contained an exception where the premises are "your work", and were "never occupied, rented or held for rental by you."

The coverage provisions and exclusions in the Dominion policy are common in CGL policy forms used in the construction industry in Canada.  Interpretative difficulties arise when damage outside the policy period is caused by deficiencies in design or construction that took place while the policy was in force: on those facts, did the property damage "occur" during the policy period?

The exclusion for liability assumed under a contract can also be problematic.  Since all the builder's work on a project is done pursuant to a contract, does this mean there is no coverage for defects in any of the work? Faulty construction is usually the result of negligence, however, and the builder would be liable for negligent construction in the absence of a contract.  Does the exception to the exclusion mean that all the defects are covered, and if so, what is the purpose of the exclusion for contractual liability?

Legal Test for Insurer's Duty to Defend

If the duty to defend is to be of any use, the insurer has to take on its defence obligations during the litigation process; otherwise the insured could incur substantial legal costs defending an action when those costs are covered under the policy.  From the insurer's point of view, early involvement in the litigation is also beneficial, as the insurer is then in a position to monitor litigation costs and make decisions regarding tactics and settlement.  Deferring the duty to defend decision until after the trial would not be in the interests of either insurer or insured, and would defeat the purpose of this type of coverage.

Since any issues regarding the duty to defend have to be resolved before all the evidence in the action against the builder is available, this question is decided on the basis of the allegations against the builder set out in the statement of claim in that action.  According to the Supreme Court of Canada, the duty to defend is triggered if there is a "mere possibility" that the claim is covered: Progressive Homes Ltd. v. Lombard General Insurance Co. of Canada, [2010] 2 S.C.R. 245.  This is the test that was applied by the Alberta Court of Queen's Bench in the Canalta case.

Damage Outside the Policy Period

Since the water main didn't fail until some seven months after the expiration of the policy, Dominion argued that any ensuing liability was outside the policy period.

In duty to defend cases, the courts have entertained four different theories as to when damage occurs: (1) damage does not occur "until it manifests itself"; (2) damage that is undetected during the policy term is covered if it commences while the policy is in force; (3) exposure to a harmful condition constitutes damage; and (4) developing damage constitutes a continuous series of covered occurrences, starting when the property is first exposed to damage and ongoing until it is discovered.

Canalta argued that since all the work was completed by January, 2005, it was open to the trial court to decide that there was ongoing damage so that the second and fourth theories would apply.  Since the statement of claim issued against Canalta by the Condominium Corporation alleged negligence in design, installation, and construction, it was arguable that damage occurred before the end of 2005.

Liability Assumed Under Contract

Although the statement of claim contained allegations of negligence, Dominion argued that these were essentially allegations that the contract was breached by negligent design and construction.

The court mentioned the exception to the exclusion.  The allegations of negligent design and construction could be viewed as instances of breach of contract, or as negligence which would give rise to liability outside the contract.  It was not clear that the allegations of negligence were just repetitions of the allegations of breach of contract, so the exclusion for contractual liability did not assist Dominion.

Property Owned or Occupied by the Insured

Since both the defects and the damage were limited to the common elements in the building, the question here was whether or not the developer "occupied" the common property during the period in question.  Although duty to defend cases are normally limited to a review of the pleadings in the action against the insured, in this case an officer of Canalta testified that Canalta controlled access to the common property and hired a property manager until the condo board was in place.  Since it was unclear whether or not these acts amounted to occupation of the common property, there was a possibility that the exclusion did not apply.

Property Sold by the Insured

Canalta argued that even if the "alienated property exclusion" was applicable, there was a possibility that the exception for property that constitutes the work of the insured and that the insured never occupied would come into play.  The court seemed to agree: it was unclear whether or not the acts of Canalta prior to the takeover of the building amounted to occupation, so the exception to the exclusion could apply.

Conclusion

It was arguable that the damage occurred when the design and construction work was done, which was during the policy term and prior to the sale of the condo units or the transfer of the common elements to the Condominium Corporation.  The judge held that the claim of negligent design and construction was a "stand alone claim", and not merely derivative of the breach of contract claim.  Since there was a possibility that the claim was covered under the CGL policy and that none of the exclusions applied, Dominion had a duty to defend Canalta in the litigation.

The case illustrates how difficult it can be for an insurer to avoid its obligation to defend under a CGL policy.  A duty to defend application is only interim, and the insured could still be ordered to reimburse the insurer after trial if it appears that the claim is not covered or that one of the exclusions is applicable.  As a practical matter, however, a favourable decision on the duty to defend issue means that the insurer will defend and settle the action, and that the insured is unlikely to be called upon to contribute substantially to defence and settlement costs.



Canalta Construction Co. Ltd. v. Dominion of Canada General Insurance Company, 2013 ABQB 325, http://www.albertacourts.ab.ca/jdb_new/public/qb/2003-NewTemplate/qb/Civil/2013/2013abqb0325.pdf


Contact Richard Hayles at Billington Barristers:
(403) 930-4106
View my profile on LinkedIn: http://www.linkedin.com/profile/view?id=50396098&trk=nav_responsive_tab_profile



Any legal information provided is general in nature and may not apply to particular situations. It does not constitute legal opinion or advice. Please consult your lawyer regarding your specific legal issue.