The insurer is denying this claim because of this exclusion. I believe this is incorrect for a number of different reasons. First, later editions of the Causes of Loss – Special Form CP 10 30 06 95 and all editions following have this language: "We will not pay for loss or damage caused by or resulting from any of the following … d. (5) Nesting or infestation, or discharge or release of waste products or secretions, by insects, birds, rodents, or other animals."

It seems to me ISO's intent was that which is indicated in the 1995 edition and not the 1991 edition. Granted, the 1991 language seems clear that no damage caused by animals is covered, but I do not believe that was the intent of ISO since, in the 1995 version, they clarified the language in the exclusion above. Second, in my research, everything I have found references this set of exclusions as the "wear and tear" exclusions. However, the outline used by ISO is not clear as to whether all of the exclusions indicated under d. are related to "wear and tear."

Third, humans are animals. With that in mind, a literal interpretation of the exclusion, as used by this carrier in denying this claim, would mean that if a human had broken through this door and destroyed the interior of the building, there would be no coverage.

I think the carrier is misunderstanding this exclusion. Your thoughts? As always, I greatly appreciate your willingness to help.

— Virginia Subscriber

Answer: We pulled the original circular dated 1995 that explained the changes in the "ensuing loss" provisions by stating that the changes were made to clarify the original intent of the exclusions.

Originally, the exclusion read, "Insects, birds, rodents, or other animals."

Obviously, the intent of the amended exclusion was to exclude the nesting or infestation, or the discharge or release of waste products or secretions of these insects, birds, rodents or other animals.

Therefore, in a loss for "a deer ran through the glass at the front of their building causing damage to the floors and tracking blood throughout the building," our analysis is that the floor damage from the deer would be covered, but the damage from the secretion of blood would be excluded.

Related:

Special Reports /

Interpreting the 'insects, birds, rodents, or other animals' exclusion

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