An appellate court in Missouri, reversing a trial court's decision, has ruled that contested facts precluded a determination as to whether the “technical meaning” of the term “ensuing loss” was “inconsistent with the ordinary meaning and reasonable expectations of the parties.”
The Case
On Friday, February 22, 2013, at approximately 5:00 p.m., Albert Bolinger visited the office of Ken Wolken of Wolken Insurance LLC to request a quote for insuring his property, which included his residence and several farm buildings. Mr. Bolinger was moving his insurance coverage from another carrier and he said that he specifically requested that his three turkey barns (collectively, the “Turkey Barns”) be insured against the peril of weight of ice, snow, or sleet. The Turkey Barns were approximately 25 years old.
At the end of the meeting, Mr. Wolken instructed Mr. Bolinger to return on the next business day to get an insurance quote.
On Monday, February 25, 2013, Mr. Bolinger returned to Mr. Wolken's office and was told that the premium for the coverage for his home, his farm, and the Turkey Barns would be a total of $1,770.22, which he paid before leaving the office.
Clarks Fork Mutual Insurance Company alleged that Mr. Bolinger, at the same time, also was given an insurance quote through Clarks Fork (the “Quote Proposal”). The Quote Proposal, under each of the headings “Outbuilding # 1,” “Outbuilding # 2,” and “Outbuilding # 3,” (the Turkey Barns), stated:
Underwriting: FO–323 Weight of Ice, Snow, or Sleet coverage on farm outbuildings is not in effect until inspected and approved.
The premium amount Mr. Bolinger paid included premium amounts for the FO–323 endorsement for all three Turkey Barns.
After Mr. Bolinger left the office, Mr. Wolken submitted an application for insurance to Clarks Fork. At the time Mr. Bolinger paid the insurance premium, snow had begun to fall from an impending winter snow storm.
Although the application was submitted and the premium paid, Clarks Fork did not issue a policy to the Bolingers until March 4, 2013. The policy's effective dates were backdated to 12:01 A.M. on February 25, 2013 (the date the premium was paid) until February 25, 2014. The policy did not contain the FO–323 endorsement for any of the Turkey Barns. The policy did specify that a premium was charged for each individual Turkey Barn; Turkey Barn # 1, size 50 * 320, $100,000 limit, premium $640.00, Turkey Barn # 2, size 50 * 320, $100,000 limit, premium $640.00, Turkey Barn # 3, size 50 *360, $100,000 limit, premium $704.00.
On February 26, 2013, the day after the policy became effective, Turkey Barn One and Turkey Barn Two collapsed under the weight of snow and ice, and were a total loss.
Mr. Bolinger timely reported this loss to Mr. Wolken. The Turkey Barns had not been inspected prior to their collapse. Mr. Bolinger did not receive the written policy until after the barns had collapsed and he had reported the loss to Mr. Wolken.
Clarks Fork denied coverage for the collapse of Turkey Barn One and Turkey Barn Two because loss due to weight of snow and ice was not a covered peril under the policy in effect at the time. Clarks Fork returned the portion of the premium that it alleged was attributable to the FO–323 endorsement for all three Turkey Barns to the Bolingers – approximately $181.
Although Turkey Barn Three had not collapsed, Clarks Fork returned the premium it alleged was for the FO–323 endorsement for Turkey Barn Three and never conducted an inspection.
The total premium charged for coverage for all three Turkey Barns was $1,984. The policy did not specify which portion of that premium was coverage for weight of snow and ice verses coverage for other perils.
The Bolingers sued Clarks Fork for breach of contract, alleging that the two lost barns had been covered by the policy and Clarks Fork should have paid full coverage for both destroyed barns.
The trial court granted summary judgment in favor of the Bolingers and awarded them judgment in the amount of $200,000, which was the policy limit for the two barns.
Clarks Ford appealed, alleging that the trial court had erred in finding that its policy contained coverage for the Turkey Barns in the event they were damaged as a result of the weight of ice, snow, or sleet.
The Clarks Ford Policy
The declaration's page of the policy stated that there was:
COVERAGE E FARM BARNS AND OUTBUILDINGS
and listed a machine shed and the three Turkey Barns and separate premiums for each. The declarations page also stated that there was a:
WINDSTORM OR HAIL DEDUCTIBLE ENDORSEMENT
The farm coverage listed in the policy stated:
PERILS SECTION—COVERAGES E, F, AND G“We” insure against direct physical loss to property covered under Coverages E, F, and G caused by the following perils, unless the loss is excluded under the General Exclusions:
The Perils Section listed certain perils covered by the Policy:
1. Fire or Lightening
2. Explosion
The Perils Section listed additional:
extended coverage
, available if listed on the declarations page, for the perils of:
3. Windstorm or Hail4. Riot or Civil Commotion
5. Aircraft
6. Vehicles
7. Smoke
8. Theft
9. Collison
10. Electrocution of Livestock.
The policy's declarations page stated that the Bolingers had an additional endorsement for extended coverage for the peril of:
windstorm or hail
The policy stated that loss:
caused directly or indirectly by … ice (other than hail), snow, or sleet, all whether driven by wind or not
was not covered.
The next section of the policy stated:
GENERAL EXCLUSIONS—COVERAGES E, F, and G“We” do not pay for loss if one or more of the following exclusions apply to the loss, regardless of other causes or events that contribute to or aggravate the loss, whether such causes or events act to produce the loss before, at the same time as, or after the excluded causes or events.
The General Exclusions then listed a number of events, including:
Weather Conditions
, under which it stated that the company would:
not pay for loss which results from weather conditions that initiate, set in motion, or in any way contribute to losses excluded under the preceding General Exclusions.
In the next paragraph, the policy provides that:
We do pay for an ensuing loss unless the ensuing loss itself is excluded
(Emphasis added.)
The Appellate Court's Decision
The appellate court reversed.
In its decision, the appellate court explained that there was no dispute that:
- Mr. Bolinger had specifically requested coverage on the Turkey Barns for the peril of weight of snow and ice;
- The policy was in effect at the time the Turkey Barns collapsed;
- Mr. Bolinger had paid the entire premium requested by Clarks Fork for the policy;
- Mr. Bolinger had not received the written policy from Clarks Fork until after the collapse had occurred and a claim for coverage under the policy for the collapse had been made;
- The Turkey Barns were covered by the policy under “Coverage E.”
Given that, the appellate court said, the only issue to be decided was whether the Turkey Barns were covered against damage caused by the peril of weight of snow, sleet, or ice at the time of their collapse.
It then ruled that contested issues of fact precluded the trial court from deciding that issue at the summary judgment stage.
In particular, the appellate court reasoned that contested facts precluded a determination as to whether the “technical meaning” of the term “ensuing loss” was “inconsistent with the ordinary meaning and reasonable expectations of the parties.” The appellate court found that the phrase, “'We' do pay for an ensuing loss unless the ensuing loss itself is excluded” could reasonably be read “as a broad ensuing loss clause” so that, if a weather condition caused a loss that, in turn, caused an additional, subsequent loss that otherwise would be covered under the policy, the secondary loss remained covered.
The appellate court observed that the Bolingers' interpretation was “colored by their belief that they purchased an insurance policy covering loss due to weight of snow and ice,” and declared that whether that expectation was reasonable was “dependent upon contested facts.” The appellate court stated:
While it is uncontested that the Bolingers requested and paid for such coverage, the Bolingers dispute [Mr.] Wolken's testimony that he informed Albert Bolinger that an inspection was needed prior to coverage. The Bolingers also dispute that they were given the Quote Proposal that stated the FO–323 endorsement was subject to inspection. The effect of the phrase: “'We' do pay for an ensuing loss unless the ensuing loss itself is excluded” cannot be determined until these material facts are decided by a fact finder.


