{"id":905363,"date":"2026-02-17T16:10:37","date_gmt":"2026-02-17T23:10:37","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=905363"},"modified":"2026-02-17T16:10:41","modified_gmt":"2026-02-17T23:10:41","slug":"ensuing-loss-exception-requires-more-than-increased-susceptibility","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/ensuing-loss-exception-requires-more-than-increased-susceptibility\/","title":{"rendered":"Court Says Ensuing Loss Requires More Than Increased Susceptibility"},"content":{"rendered":"\n

Joshua Tumen | Property Insurance Law Observer<\/a><\/p>\n\n\n\n

In Stella Property Development and Event Production, LLC v. Auto-Owners Insurance Company<\/em>, 2026 WL 221489 (W.D. Pa. 2026), the United States District Court for the Western District of Pennsylvania denied summary judgment as to the applicability of the subject property policy\u2019s (i) wear and tear and (ii) inadequate maintenance exclusions, holding that those issues were to be resolved by the factfinder rather than decided as a matter of law. However, the Court further held that if (i) wear and tear and (ii) inadequate maintenance were ultimately found to be dominant and efficient causes of the roof damage, the ensuing loss clauses would not reinstate coverage because those excluded conditions merely increased the roof\u2019s susceptibility to wind damage, rather than resulting in the windstorm itself.[1]<\/a><\/p>\n\n\n\n

Facts<\/strong><\/p>\n\n\n\n

The defendant insurer issued a commercial property policy to the insured plaintiff. The policy provided that the insurer would pay for \u201cdirect physical loss of or damage\u201d to covered property unless otherwise excluded. In pertinent part, the policy contained (i) wear and tear and (ii) maintenance exclusions. Both contained ensuing loss exceptions<\/a>. Thus, if an ensuing loss provision applied, it restored coverage for the loss caused by the ensuing covered cause.<\/p>\n\n\n\n

During the policy period, a windstorm occurred, which the insured claimed caused damage to its roof. Consequently, the insured submitted a claim to the insurer. After an investigation, the insurer denied coverage based on the two exclusions referenced above: \u201cOur findings indicate that the deteriorated condition of your shingles due to decay and wear and tear are what caused the singles to dislodge. In their deteriorated state, the shingles are no longer properly bonded, sealed and secured to the roof surface and cannot resist any wind uplift.\u201d The insured subsequently filed suit for breach of contract, among other things.<\/p>\n\n\n\n

Analysis<\/strong><\/p>\n\n\n\n

The insured contended that coverage existed independent of the efficient proximate cause doctrine because the (i) wear and tear and (ii) maintenance exclusions contained express ensuing loss language preserving coverage where covered and uncovered causes acted concurrently. Below is the Court\u2019s analysis each exclusion.<\/p>\n\n\n\n

a. Wear and tear<\/em><\/p>\n\n\n\n

The policy\u2019s wear and tear exclusion stated that if wear and tear \u201cresults in a specific cause of loss,\u201d the insurer would \u201cpay for the loss or damage caused by that specified cause of loss.\u201d A \u201cwindstorm\u201d qualified as a specified cause of loss.<\/p>\n\n\n\n

The insured argued that this language was \u201cplainly designed\u201d to address mixed causation scenarios \u2013 i.e.<\/em>, if an excluded condition and a covered peril combined to produce a single loss, the loss would be covered. The insurer countered that the clause applied only when the excluded condition caused the covered peril itself, which then caused distinct damage. Under that interpretation, the insured\u2019s claim would be covered only if wear and tear somehow \u201cresulted in\u201d a windstorm \u2013 an outcome which was nonsensical. The Court agreed with the insurer. It explained that \u201cthe ensuing loss clause applies when an excluded condition results in the peril itself, and the Policy then pays for the \u2018loss or damage caused by that\u2019 ensuing peril.\u201d<\/p>\n\n\n\n

The Court also rejected the insured\u2019s argument that the insurer\u2019s reading rendered the ensuing loss clause \u201cincapable of application.\u201d While acknowledging that some specified causes of loss might never be triggered by wear and tear, the Court emphasized that the provision could still apply in other contexts.<\/p>\n\n\n\n

Ultimately, the Court held that the ensuing loss provision did not reinstate coverage based on the theory that wear and tear merely made the roof more susceptible to wind damage.<\/p>\n\n\n\n

b. Inadequate Maintenance<\/em><\/p>\n\n\n\n

The Court also determined that the ensuing loss clause in the inadequate maintenance exclusion did not restore coverage. In relevant part, the exclusion provided that if inadequate maintenance \u201cresults in a Covered Cause of Loss, [the insurer] will pay for the loss or damage caused by that Covered Cause of Loss.\u201d The Court clarified that for the ensuing loss clause to apply, the excluded condition must \u201cresult in\u201d an otherwise covered peril that then caused separate loss or damage. The Court stated that, in Stella<\/em>, inadequate maintenance may have impacted how the roof performed under windy conditions, but it did not \u201cresult in\u201d a windstorm.<\/p>\n\n\n\n

Conclusion<\/strong><\/p>\n\n\n\n

Stella<\/em> made clear that ensuing loss provisions are not safety nets for conditions made worse by excluded causes of loss. Coverage is only restored when an excluded condition gives rise to a new, independent covered peril \u2013 not when it simply increases the property\u2019s susceptibility to damage from one. <\/p>\n\n\n\n

\n\n\n\n

[1]<\/a> Although the Stella<\/em> decision addressed additional issues, this blog focuses solely on the Court\u2019s analysis of the ensuing loss provisions.<\/p>\n\n\n\n

\n\n\n\n

When one of your cases is in need of a construction expert, estimates, insurance appraisal or umpire services in defect or insurance disputes – please call Advise & Consult, Inc. at 888.684.8305, or email experts@adviseandconsult.net<\/a>.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Joshua Tumen | Property Insurance Law Observer In Stella Property Development and Event Production, LLC v. Auto-Owners Insurance Company, 2026 WL 221489 (W.D. Pa. 2026), the United States District Court for the Western District of Pennsylvania denied summary judgment as to the applicability of the subject property policy\u2019s (i) wear and tear and (ii) inadequate maintenance… Continue reading Court Says Ensuing Loss Requires More Than Increased Susceptibility<\/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":[10721],"tags":[9895,11746,22],"class_list":["post-905363","post","type-post","status-publish","format-standard","hentry","category-insurance","tag-advise-consult","tag-ensuing-loss-exception","tag-insurance","entry"],"jetpack_publicize_connections":[],"yoast_head":"\nCourt Says Ensuing Loss Requires More Than Increased Susceptibility - 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