Wildfire Took Your Home? Don’t Count on Insurance: Viewpoint

Liam Denning | Claims Journal | April 12, 2019

Own a home? No doubt you’ve insured it. Very sensible of you. But if that home were, say, burned to the ground, then your insurance company probably wouldn’t cover the cost of rebuilding it.

Don’t feel too bad, though. It’s only partly your fault.

Two-thirds of California wildfire victims are under-insured, according to Amy Bach, executive director of consumer advocacy group United Policyholders, speaking at a recent meeting of governor Gavin Newsom’s wildfire commission, held in Santa Rosa. Shocking as that figure seems, it comports with anecdotes I picked up reporting on the aftermath of the recent wildfires earlier this year. Meanwhile, Sarah Paulson of Kevin Paulson Insurance Agency Inc. in San Diego, estimates maybe 60 percent of policyholders are under-insured.

Now a new study titled “Minding the Protection Gap,” just published in the Connecticut Insurance Law Journal, concludes the prevalence of under-insurance among American homeowners might be closer to 80 percent. Kenneth Klein, a professor at California Western School of Law, bases that estimate partly on a report from the California Department of Insurance, prepared in the wake of the 2007 wildfires, that recently became public record. Remarkably, this found that even when homeowners had purchased extended coverage, 57 percent of such policies fell short.

Summing up his study over the phone, Klein calls homeowner insurance “a really weird market; people think they bought a Cadillac when they really bought a Yugo.”

By and large, homeowners think they do have adequate coverage in the event of a catastrophe – and that’s where they take a share of the blame. Standard policies haven’t offered “guaranteed replacement coverage” for several decades. But unless the homeowner takes the time to read the mind-numbing policy documents or ask the right questions, they generally assume they’re good if the sky falls.

Before piling onto this feckless homeowner, though, ask yourself a question: Do you know how much it would cost to rebuild your home? Didn’t think so.

Most likely, you’re relying on an estimate from your insurance agent. Typically, those are derived from sophisticated software tools such as Verisk Analytics Inc.’s 360Value or CoreLogic Inc.’s RCT. Insurance is the original big-data business, compiling myriad items of information to judge probabilities and costs; these tools are immense databases of such things as local labor rates, materials prices, storage costs and many other line items.

No software can accurately predict every contingency, though; especially if, for example, a wildfire burns down a whole neighborhood and surge pricing kicks in. More importantly, software doesn’t write insurance, companies do. And the incentives in homeowner insurance tend to skew one way.

Only a small proportion of homes are sold each year, capping the size of the market for policies. Customers tend to be ignorant of the true cost of reconstruction. And when disputes arise, courts tend to effectively side with the insurance provider – after all, the homeowner signed up for the coverage stipulated in their contract. In short, the homeowner tends to bear all the risk of under-insurance while usually being ignorant of that risk. Plus, thinking catastrophe a very remote possibility, they’re more motivated to keep their monthly insurance bill low than to cure their ignorance.

So there can be little incentive for an insurance provider to invest time and money in a more-thorough assessment of a home’s particular risks. It’s tempting to instead enter fewer parameters to the software tools to estimate coverage and simply quote the most competitive premium they can. Klein ran an experiment on his own home, getting replacement-cost estimates from six insurers and two software tools, involving different levels of detail. They ranged from $512,000 to more than $1.1 million.

One way of addressing this problem is better-educating the customer, such as with tools alerting them to potential under-insurance. Meanwhile, Klein recommends requiring insurers to quote a price for guaranteed replacement coverage. Would those premiums be higher? Probably much higher, although providers could also compete on them. More importantly, they would signal to homeowners the true cost of protecting their home – and they could then choose to accept it or go with a lower quote for standard insurance, with the clear understanding they bear the risk of less-than-adequate coverage. “This will reconnect risk creation and risk allocation,” Klein writes.

California’s wildfires didn’t create this market failure; just revealed it. The enormous claims arising from the past two wildfire seasons – some $25 billion – are having an impact on pricing and availability already. At that same commission meeting in Santa Rosa, Joel Laucher, chief deputy commissioner of the California Department of Insurance, said complaints about higher premiums or difficulty renewing coverage in the highest-risk counties have jumped by 224 percent and 573 percent, respectively, since 2010. Meanwhile, over the past five years, there has been a 51 percent increase in policies written for homes in wildfire-prone areas under California’s FAIR program – insurance so bare-bones the website states up top it should only be used as “a last resort.”

In many respects, the wildfires expose the true costs of climate change and how they intersect with people’s choices about where and how they live; choices often made out of necessity or made at a time when phrases like “global warming” seemed utterly abstract. Mitigating wildfire risk is, of course, central to addressing this, but so is reform of insurance, society’s ingenious method of pooling risk. Pushing the industry to provide better incentives for, say, hardening homes and communities must be a priority for California – and, indeed, any other state facing rising risks from a changing climate. Making those risks, and their costs, crystal clear to consumers would be a good start.


Wildfire Considered One Occurrence Despite Damaging Numerous Properties

Christina Phillips | Property Insurance Coverage Law Blog | November 29, 2018

A recent decision by the Supreme Court of Wisconsin1 might predict how other courts would analyze coverage under commercial general liability insurance policies for wildfires. In May 2013, a fire broke out on forest land owned by Lyme St. Croix Forest Company. The fire burned nearly 7,500 acres over the course of three days and damaged real and personal property owned by various individuals and businesses.

The fire was alleged to have begun within a piece of logging equipment owned by Ray Duerr Logging, LLC (“Duerr”). At the time of the fire, Duerr was insured by Secura under a commercial general liability policy with a $2 million aggregate limitation. The policy also contained a logging endorsement, the per-occurrence limit was reduced to $500,000 for property damage due to fire arising from logging or lumbering operations. Secura believed that the $500,000 policy limit applied, rather than the $2 million aggregate limit and filed a declaratory judgment action.

The Supreme Court of Wisconsin was presented with determining whether the fire was a single occurrence for purposes of the CGL policy, or whether there was a new occurrence each time the fire crossed a property line. The court began by looking at the policy language, which defined “occurrence” as “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” The court then looked to the “cause theory” which provides “where a single uninterrupted cause results in all of the injuries and damage, there is but one ‘accident’ or ‘occurrence.’ ” If the cause and results are so simultaneous or closely linked in time and space as to be considered by the average person as one event, then only a single event has taken place.

In concluding that the fire was a single occurrence, the court noted that the fire burned continuously for three uninterrupted days in a discrete area caused by a single precipitating event. The court believed that the average person would consider this one event regardless of how many properties lines the fire crossed. In that regard, the Supreme Court of Wisconsin believed that the number of properties damaged by the fire was irrelevant – whether one person, or multiple persons owned the 7,500 acres did not determine the number of occurrences.

Additionally, the Wisconsin Supreme Court disagreed with the court of appeals determination that there was an occurrence each time the fire – fueled and expanded by the consumption of new materials – spread to a new piece of real property and caused damage. The Wisconsin Supreme Court held that such a conclusion would result in an unfathomably large number of occurrences, an interpretation which would cause an unreasonable result under the policy. As such, the Wisconsin Supreme Court concluded there was a single occurrence, subject to the $500,000 policy limit.
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1 Secura Ins. v. Lyme St. Croix Forest Co., LLC, 918 N.W. 2d 885 (WI. Oct. 30, 2018).

Northern California Wildfires — Important Insurance Coverage Considerations

Edward P. Sangster and Paul C. Fuener | K&L Gates | October 20, 2017

The ongoing Northern California wildfires are already the most destructive in the state’s history. In addition to the tragic loss of dozens of lives, California officials have reported that at least 5,700 structures have been destroyed. The economic impact is enormous, and many businesses, particularly in California’s Wine Country, have suffered major losses. Affected businesses likely may have insurance coverage in place to assist with rebuilding and repair of damaged structures, lost production and business income, extra expenses incurred as a result of the wildfire’s impact, and potentially lost income as a result of damage to suppliers and customer locations, including “attraction properties” that draw business to the area.

It is important that businesses impacted by the wildfires understand their potential insurance rights to maximize an insurance recovery in the event a business makes a claim. The wildfires will give rise to a variety of individualized issues, which will vary depending on each insured business’s particular circumstances. The following checklist provides a general overview of selected issues that may be relevant to such claims.

IDENTIFYING POSSIBLE COVERAGE

The most common source of responsive coverage for most businesses is likely to be the first-party coverage insuring the assets of the business. While there are standard insurance industry forms for the coverage, some insurers have issued tailored policies to meet an insured’s particular risk scenarios. Evaluation of specific policy language by reference to relevant law is critical.

Businesses may have first-party coverage that includes the following specific elements:

• “Property damage” coverage for damage or complete destruction of any property resulting from fire or another insured peril that may be classified as “insured property” under the policy, including buildings and other structures, equipment, supplies, and other personal property.

• “Business interruption” coverage, which generally covers the insured’s loss of earnings or revenue resulting from property damage caused by an insured peril but often leads to significant disputes regarding the proper quantification of the insured loss.

• “Contingent business interruption” coverage, which generally covers the insured with respect to losses, including lost earnings or revenue as a result of damage to property of a supplier, customer, or some other business partner or entity — even where the insured’s own property is not itself damaged.

• “Attraction property” coverage, which is a sub-category of contingent business interruption coverage that may apply where an insured business — such as a hotel or restaurant — suffers loss of income as a result of damage to a designated “attraction property,” such as a nearby sports venue, theme park, or convention center.

• “Extra expense” coverage, which generally covers the insured for certain extra expenses incurred by the insured as a result of an insured event — e.g., fire damage to the insured’s property or to a contingent business interruption property — and in order to resume normal operations and mitigate other losses.

• “Ingress and egress” coverage, which generally covers the insured when access to a business premises or location is blocked for a time.

• “Civil authority” coverage, which generally covers the insured for losses arising from an order of a governmental authority that interferes with normal business operations. Similar to contingent business interruption coverage, civil authority coverage may apply even when there is no damage to the insured’s property.

• “Service interruption” coverage, which generally covers the insured for losses related to electric or other power supply interruption.

• “Advance payments” may be expressly required under the terms of a commercial property policy, even if the full extent of the insured loss is still being adjusted by the insurance company. Such advance payments can be important where a business cannot afford a protracted adjustment period.

• “Claim preparation” coverage, which generally covers the insured for the costs associated with compiling and certifying a claim.

COMMON INSURER RESPONSES

In response to insurance claims resulting from the California wildfires, insurers may raise a number of potential limitations or restrictions on coverage for a business’s claims. Here are just a few common issues raised by insurers, particularly when faced with large claims:

• There was no covered business interruption. Insurers will often take a very narrow view of what constitutes a business interruption, sometimes arguing that a complete cessation of operations is necessary to support a claim. The insurer may also dispute the necessity or cause of the interruption. For example, the insurer may argue that at least some part of the interruption or reduction in an insured business was the result of an unrelated business decision by the company, or the consequence of an economic downturn, and it was not caused solely by fire damage to insured property.

• The claim is for losses beyond the allowed recovery period. Policies sometime include provisions specifying that it only covers loss of income and related expenses for a specified period of time after an insured event occurs. If the policy does not define that period, it may be tied to the time it would take your company, employing reasonable mitigation efforts, to resume normal business operations under the circumstances. In view of the magnitude of the California wildfires and the number of properties affected, the length of time it will take to repair property and resume normal business operations may be longer than the length of time had the claim been from an isolated event affecting a single facility.

• The claim is subject to a per-occurrence deductible. Many policies have a per-occurrence deductible or other self-insurance features that may reduce the amount of coverage available, depending on how the number of occurrences issue is addressed. For example, there may be disputes about whether each fire constituted a separate occurrence. This issue can also impact the amount of per-occurrence policy limits that may be available to an insured business.

CLAIM PRESENTATION

Most policies include specific provisions for presenting a claim. The manner in which a claim is presented can have a significant impact upon recovery. This cannot be understated. Policyholders should be proactive in assembling an insurance recovery team, including working with accountants and claim professionals as well as insurance coverage counsel. At a minimum, a policyholder should consider the following common policy provisions:

• Notice of Loss. Most policies require the insurer be notified as soon as practicable or within a specified time frame after circumstances that may lead to a claim. Policyholders should seek to notify all potential insurers.

• Proof of Loss. Property policies generally require a sworn proof of loss summarizing the amount and extent of the damage or loss. The insurer may require this proof of loss within a specified timeframe, though it is not uncommon for insurers to agree to extend this deadline. A policyholder should consider requesting a written agreement extending the time for submission of a proof of loss (and potentially other policy conditions) depending on the nature of the loss.

• Suit Limitation. Policies may include “suit limitation” provisions, which provide that an action to recover under a policy is barred if not initiated by a certain timeframe. In some states, these provisions are not enforceable, while in other states, they are enforceable. Therefore, businesses should consult counsel to determine the limitations period that may be applicable to their claim.

CONCLUSION

Businesses that have suffered losses because of the California wildfires should not overlook the significant financial protection that may be provided through their insurance policies. Businesses should act carefully and proactively to maximize coverage. Experienced insurance coverage counsel is often needed to assess the viability and strength of a policyholder’s claim, in dealing with the insurers’ loss adjusters, and in maximizing the policyholder’s potential insurance recovery. K&L Gates has represented clients in dealing with claims arising from many types of natural disasters and perils, including fires, hurricanes, and floods, as well in other complex insurance claims for over 30 years. The firm maintains a group dedicated to assisting policyholders in assessing and prosecuting insurance coverage claims.

New Report Gives Insight into Increased Fire Claim Figures

Nicole Vinson | Property Insurance Coverage Law Blog | March 22, 2017

One of the most terrifying and devastating perils insured against is fire. A wildfire outbreak is one news alert that can have a massive impact on our property and lives. A new research study has exposed some of the data on the insurance claim side of this catastrophe.

For many years, the amount of claim dollars that carriers were spending on wildfire losses accounted for only 1.8 percent of total dollars.

Research coming from a CoreLogic study shows that the danger and the quantity of these claims is on the rise- with Colorado, California, and Texas having the most risk. However, the report cautions that 38 states should be on high alert for wildfire damage.

What is causing the increase in wildfire devastation? Sadly, the Department of Interior linked as many as 90% of the wildfires to a human starting the fire in some fashion. Now, this calculation includes intentionally set fires that are considered arson, but also includes unattended campfires, debris burns, and improperly discarded cigarettes. Other causes of wildfire include lightning strikes and even lava flow.

What was interesting from the report was that the link has been made that another familiar phenomenon, wind, is the culprit. Wind-blown embers can allow for significant fire spread impacting surrounding buildings and residences. Homes in close proximity are more likely to burn in clusters, especially if there is only 15 feet between the residences with combustible forces. This data was supplied by the Institute for Business & Home Safety.

The hot-off-the-presses data from January 1, 2017, to February 3, 2017, reported 2,459 wildfires, an increase compared to the 723 wildfires counted in the same period in 2016. With the increase in the number of fires already counted this year, the area impacted is almost three times the land mass from last year.

But 2015 and 2016 also had incredibly devastating fires, and a wildfire that originated in Alberta, Canada, impacted homeowners as far south as Iowa.

Harvard School of Engineering and Applied Science has forecast that by the year 2050, the number of the wildfires in the West could rise by 50%.

As policyholder advocates, our concern is that the data collected and included in the research may not have contemplated some covered damages that policyholders did not fully collect. Insured property owners in the path of the fires filed claims with their carriers. Fire and wildfire losses should not be a heavily contested peril but even when coverage and causation is clear, that does not always mean every claim is paid in full. Issues with wildfire claims can include inadequate scopes, failure of the insurance company to indemnify for all the covered losses—including dwelling extensions and ordinance and law issues—and rejection of loss of rents or additional living expenses claims.

The insurance claim dollars and number of claims also doesn’t account for the damages that are not paid—or not claimed because the policyholder assumed because the fire did not catch their home on fire, there was no damage. However, many times homes and properties in the vicinity may have been damaged by smoke or heat. The damages may be more subtle on the property but can be submitted as direct, physical loss caused by the wildfire. Some insurance companies try to also dodge paying these claims arguing the lack of damage, or below the deductible damages. It is worth having a second opinion on these smoke claims because damage evaluations by an expert may show intense impact on building components and carcinogens may have seeped into your home and the damage needs to be properly remediated.

United Policyholders has some great resources for wildfire survivors. United Policyholders is an incredible non-profit organization that helps insureds across the country in a major way. The resource materials and amicus briefs by United Policyholders can make an enormous difference for those experiencing property loss.