The client has a summer home that was vacant from 11/2/23-5/29/24 when the damage was discovered. Wind blew the rear roof section up allowing water to get into the second floor. There is mold throughout the home now and water damage. Insurance is denying mold damage based on the HO-9R(02) (07-08) pages 17-18 and HO-NY (04-13) page 1 which modifies the fungus language. They are currently covering repairs to the roof and repairs to the second story, but no repairs to the first. My question is whether their denial of mold would be accurate due to the exclusion second language? They originally intended to deny the claim based on the 14-day repeated seepage language which I pointed it was not applicable in this instance of a weather-related loss.
New York Subscriber
The water damage exclusion on page 17 includes a list of various causes of water damage from floods, water backup, overflow of dams, but it does not mention rain. While the list of excluded items is preceded by language excluding water from any act of nature, the principle of ejusdem generis should apply. That principle states that when a list of terms shows specific terms and then refers to them generally, then general terms only refer to items of a similar nature. The policy specifically states that "water damage consists of" and then provides the list, which does not include rain water or water from other acts of nature. What is excluded as water damage is what is listed, not the acts of nature listed in the opening clause. The water damage should be covered.
Continue Reading for Free
Register and gain access to:
- Quality content from industry experts with over 60 years insurance experience, combined
- Customizable alerts of changes in relevant policies and trends
- Search and navigate Q&As to find answers to your specific questions
- Filter by article, discussion, analysis and more to find the exact information you’re looking for
- Continually updated to bring you the latest reports, trending topics, and coverage analysis
Already have an account? Sign In Now