{"id":894213,"date":"2018-05-17T11:29:43","date_gmt":"2018-05-17T17:29:43","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=894213"},"modified":"2018-05-17T11:29:43","modified_gmt":"2018-05-17T17:29:43","slug":"policy-exclusions-must-narrowly-applied","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/","title":{"rendered":"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available"},"content":{"rendered":"<p>Tamara Chen-See | <a href=\"https:\/\/www.propertyinsurancecoveragelaw.com\/2018\/05\/articles\/court-opinion\/policy-exclusions-must-be-narrowly-applied-to-assure-policyholders-receive-all-benefits-available\/\" target=\"_blank\" rel=\"noopener\">Property Insurance Coverage Law Blog<\/a> | May 10, 2018<\/p>\n<p>In a recent post,\u00a0<em>Policyholders May Benefit From All Their Coverages<\/em>, I discussed the importance of carefully evaluating all the insurance benefits potentially available to policyholders if a catastrophic loss occurs. That blog examined the decision in\u00a0<em>Citizens Property Insurance Corp. v. Hamilton<\/em>,<sup>1<\/sup>\u00a0which allowed recovery of benefits for a total loss due to flood and due to wind damage under both a flood and a separate specified-peril wind insurance policy.<\/p>\n<p>The First District Court of Appeal in Florida held that the wind-only insurance carrier, Citizens, was not entitled to set off against benefits available for wind damage under its policy the amount already paid by the flood carrier under the National Flood Insurance Program. The insured was able to recover full policy limits under both policies since the flood policy had determined total loss when the property was classified by the county building department as \u201csubstantially damaged.\u201d That classification meant that the structure was damaged beyond 50% of its pre-loss value, and if rebuilt would be required to meet all current buildings code requirements. Since that level of code compliance would be cost prohibitive, the county\u2019s determination essentially required demolition. Citizens was not allowed to inform the jury of the amount of recovery under the flood policy, and the jury was allowed to consider whether wind had substantially damaged the structure to the point of being a total loss\u00a0<em><strong>before<\/strong><\/em>\u00a0the storm surge. When the jury decided that wind had caused a total loss, the court applied Florida\u2019s Valued Policy Law<sup>2<\/sup>\u00a0requiring payment for the structure as a total loss.<\/p>\n<p><strong>Multiple Causes of Loss.<\/strong>\u00a0The\u00a0<em>Hamilton<\/em>\u00a0case dealt with several other issues important to full compensation for policyholders. The Citizens wind-only policy excluded payment for damage caused by flood, and used \u201canti-concurrent cause\u201d language (\u201cACC\u201d) as part of its exclusion. The ACC language denied \u201ccoverage for a loss caused\u00a0<strong><em>directly or indirectly<\/em><\/strong>\u00a0by an excluded peril.\u201d<sup>3<\/sup>Citizens argued on appeal that the policy\u2019s use of ACC language should have required the trial court to instruct the jury that the policyholder had the burden to prove that wind was the sole cause of the losses claimed to the Hamilton\u2019s home. The court of appeals decided that the jury had been adequately instructed when the trial court instructed: \u201c(1) that appellees shouldered the burden to prove losses \u2018sustained \u2026 as a result of wind\u2019 and (2) that Citizens would not be liable for \u2018loss caused by excluded perils such as water damage. . . .\u2019\u201d<sup>4<\/sup>\u00a0The Hamilton\u2019s met this burden through testimony from their engineering expert:<\/p>\n<blockquote><p>[T]he majority of the damage was caused by the high winds and the storm surge just washed away what was left of the house. The house would have been substantially damaged well before the storm surge would have washed away the debris or toppled over what was left if it hadn\u2019t been toppled over already.<\/p><\/blockquote>\n<p>Although Citizens presented opposing opinions from its expert, the jury accepted the opinions of the policyholder\u2019s forensic expert to find in their favor. As a result, the Hamilton\u2019s received full benefits under their wind policy.<\/p>\n<p>The\u00a0<em>Hamilton<\/em>\u00a0case is not new, but its holdings show the value of capable legal representation. The recent catastrophic hurricanes in Florida, the Caribbean, and Texas present similar challenges for policyholder advocates. Insurance policies need to be carefully analyzed and carrier arguments attempting to apply exclusions broadly to limit coverage benefits must be applied narrowly, as normal rules of policy interpretation hold. Policyholder advocates need to be aware of all the state laws that may operate in unison to secure insurance benefits for policyholders, supplementing the insurance policy like the collateral source rule of evidence, local building codes that apply when replacement cost benefits are triggered, and the Valued Policy Law used in\u00a0<em>Hamilton<\/em>. Florida law has relatively robust protections for policyholders, but other states may have similar protections that capable legal counsel can use to turn an insurance policy into the asset\u2014as it is meant to be\u2014when a catastrophic risk strikes.<br \/>\n__________________<br \/>\n<sup>1<\/sup>\u00a0<em>Citizens Property Ins. Corp. v. Hamilton<\/em>, 43 So.3d 746, 751-52 (Fla. 1st DCA 2010).<br \/>\n<sup>2<\/sup>\u00a0Fla. Stat. 627.702.<br \/>\n<sup>3<\/sup>\u00a0In December 2016, the Florida Supreme Court resolved disagreement between the state\u2019s Third and Second District Courts of Appeals by its decision in\u00a0<em>Sebo v. American Home Assurance Co., Inc.<\/em>, 208 So.3d 694 (Fla. 2016). The\u00a0<em>Sebo<\/em>\u00a0decision determined that where a sole cause of a loss is not undisputed, Florida courts will follow the doctrine of concurrent causation in applying policy exclusions, where if one of several concurrent causes of loss is covered, and another excluded, the policy will cover the loss. In most property insurance policies, two classes of excluded causes of loss are stated, with only one group using anti-concurrent cause language that would prevent application of the concurrent cause doctrine. Common exclusions such as for damage caused by \u201cwear and tear,\u201d \u201cdefective construction\u201d and so on generally are grouped in the class of exclusions that are not preceded by anti-concurrent cause language.<br \/>\n<sup>4<\/sup>\u00a0<em>Hamilton<\/em>, 43 So.2d at p. 754.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tamara Chen-See | Property Insurance Coverage Law Blog | May 10, 2018 In a recent post,\u00a0Policyholders May Benefit From All Their Coverages, I discussed the importance of carefully evaluating all the insurance benefits potentially available to policyholders if a catastrophic loss occurs. That blog examined the decision in\u00a0Citizens Property Insurance Corp. v. Hamilton,1\u00a0which allowed recovery&hellip; <a class=\"more-link\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\">Continue reading <span class=\"screen-reader-text\">Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[9914],"tags":[9895,94,23,469],"class_list":["post-894213","post","type-post","status-publish","format-standard","hentry","category-insurance-coverage","tag-advise-consult","tag-florida","tag-insurance-coverage","tag-policy-exclusion","entry"],"jetpack_publicize_connections":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available - Advise &amp; Consult, Inc.<\/title>\n<meta name=\"description\" content=\"Florida has robust policyholders protections, but other states may have similar protections that legal counsel can turn an insurance policy into the asset\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available - Advise &amp; Consult, Inc.\" \/>\n<meta property=\"og:description\" content=\"Florida has robust policyholders protections, but other states may have similar protections that legal counsel can turn an insurance policy into the asset\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\" \/>\n<meta property=\"og:site_name\" content=\"Advise &amp; Consult, Inc.\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Advise-Consult-Inc-126949043996790\/\" \/>\n<meta property=\"article:published_time\" content=\"2018-05-17T17:29:43+00:00\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@adviseconsult\" \/>\n<meta name=\"twitter:site\" content=\"@adviseconsult\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/person\/0a11abe008083d5fb19c2b0feefe7bd7\"},\"headline\":\"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available\",\"datePublished\":\"2018-05-17T17:29:43+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\"},\"wordCount\":855,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#organization\"},\"keywords\":[\"Advise &amp; Consult\",\"Florida\",\"insurance coverage\",\"Policy Exclusion\"],\"articleSection\":[\"Insurance Coverage\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\",\"url\":\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\",\"name\":\"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available - Advise &amp; Consult, Inc.\",\"isPartOf\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#website\"},\"datePublished\":\"2018-05-17T17:29:43+00:00\",\"description\":\"Florida has robust policyholders protections, but other states may have similar protections that legal counsel can turn an insurance policy into the asset\",\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/\"]}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#website\",\"url\":\"https:\/\/www.myconstructionexpert.com\/blog\/\",\"name\":\"Advise &amp; Consult, Inc.\",\"description\":\"Construction Expert Witnesses\",\"publisher\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.myconstructionexpert.com\/blog\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#organization\",\"name\":\"Advise & Consult\",\"url\":\"https:\/\/www.myconstructionexpert.com\/blog\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.myconstructionexpert.com\/blog\/wp-content\/uploads\/2015\/11\/AC-Red-Logo.png\",\"contentUrl\":\"https:\/\/www.myconstructionexpert.com\/blog\/wp-content\/uploads\/2015\/11\/AC-Red-Logo.png\",\"width\":162,\"height\":75,\"caption\":\"Advise & Consult\"},\"image\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/Advise-Consult-Inc-126949043996790\/\",\"https:\/\/x.com\/adviseconsult\",\"https:\/\/www.linkedin.com\/company-beta\/204526\/\",\"https:\/\/www.youtube.com\/user\/MrConstructionExpert\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/person\/0a11abe008083d5fb19c2b0feefe7bd7\",\"name\":\"admin\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/b01e71b7acadd7657af782b7ad1a30cc?s=96&d=mm&r=pg\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/b01e71b7acadd7657af782b7ad1a30cc?s=96&d=mm&r=pg\",\"caption\":\"admin\"},\"sameAs\":[\"http:\/\/www.expertwitnessinconstruction.com\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available - Advise &amp; Consult, Inc.","description":"Florida has robust policyholders protections, but other states may have similar protections that legal counsel can turn an insurance policy into the asset","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/","og_locale":"en_US","og_type":"article","og_title":"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available - Advise &amp; Consult, Inc.","og_description":"Florida has robust policyholders protections, but other states may have similar protections that legal counsel can turn an insurance policy into the asset","og_url":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/","og_site_name":"Advise &amp; Consult, Inc.","article_publisher":"https:\/\/www.facebook.com\/Advise-Consult-Inc-126949043996790\/","article_published_time":"2018-05-17T17:29:43+00:00","author":"admin","twitter_card":"summary_large_image","twitter_creator":"@adviseconsult","twitter_site":"@adviseconsult","twitter_misc":{"Written by":"admin","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/#article","isPartOf":{"@id":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/"},"author":{"name":"admin","@id":"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/person\/0a11abe008083d5fb19c2b0feefe7bd7"},"headline":"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available","datePublished":"2018-05-17T17:29:43+00:00","mainEntityOfPage":{"@id":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/"},"wordCount":855,"commentCount":0,"publisher":{"@id":"https:\/\/www.myconstructionexpert.com\/blog\/#organization"},"keywords":["Advise &amp; Consult","Florida","insurance coverage","Policy Exclusion"],"articleSection":["Insurance Coverage"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/","url":"https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/","name":"Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available - Advise &amp; Consult, Inc.","isPartOf":{"@id":"https:\/\/www.myconstructionexpert.com\/blog\/#website"},"datePublished":"2018-05-17T17:29:43+00:00","description":"Florida has robust policyholders protections, but other states may have similar protections that legal counsel can turn an insurance policy into the asset","inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.myconstructionexpert.com\/blog\/policy-exclusions-must-narrowly-applied\/"]}]},{"@type":"WebSite","@id":"https:\/\/www.myconstructionexpert.com\/blog\/#website","url":"https:\/\/www.myconstructionexpert.com\/blog\/","name":"Advise &amp; Consult, Inc.","description":"Construction Expert Witnesses","publisher":{"@id":"https:\/\/www.myconstructionexpert.com\/blog\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.myconstructionexpert.com\/blog\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/www.myconstructionexpert.com\/blog\/#organization","name":"Advise & Consult","url":"https:\/\/www.myconstructionexpert.com\/blog\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/logo\/image\/","url":"https:\/\/www.myconstructionexpert.com\/blog\/wp-content\/uploads\/2015\/11\/AC-Red-Logo.png","contentUrl":"https:\/\/www.myconstructionexpert.com\/blog\/wp-content\/uploads\/2015\/11\/AC-Red-Logo.png","width":162,"height":75,"caption":"Advise & Consult"},"image":{"@id":"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/Advise-Consult-Inc-126949043996790\/","https:\/\/x.com\/adviseconsult","https:\/\/www.linkedin.com\/company-beta\/204526\/","https:\/\/www.youtube.com\/user\/MrConstructionExpert"]},{"@type":"Person","@id":"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/person\/0a11abe008083d5fb19c2b0feefe7bd7","name":"admin","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/b01e71b7acadd7657af782b7ad1a30cc?s=96&d=mm&r=pg","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b01e71b7acadd7657af782b7ad1a30cc?s=96&d=mm&r=pg","caption":"admin"},"sameAs":["http:\/\/www.expertwitnessinconstruction.com"]}]}},"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p2ztG6-3KCN","jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/posts\/894213","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/comments?post=894213"}],"version-history":[{"count":1,"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/posts\/894213\/revisions"}],"predecessor-version":[{"id":894214,"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/posts\/894213\/revisions\/894214"}],"wp:attachment":[{"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/media?parent=894213"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/categories?post=894213"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.myconstructionexpert.com\/blog\/wp-json\/wp\/v2\/tags?post=894213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}