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Two times that flood damage was not covered.

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Analysis brought to you by the experts at FC&S Online, the unquestioned authority on insurance coverage interpretation and analysis for the P&C industry. To find out more -- or to have YOUR coverage question answered -- visit the National Underwriter website, or contact the editors via Twitter: @FCSbulletins.

Question: Regarding the the ISO Flood Coverage Endorsement Form, CP 00 10 10 12, does the form intend to cover water under the ground surface pressing on, or flowing or seeping through foundations, walls, floors or paved surfaces, basements, doors, windows or other openings? In other words, is it picking up that which would be excluded on the CP 10 30 10 12 exclusion g. water (4)?

-- Minnesota Subscriber

Related: Water, water everywhere: Flood claim questions answered

Answer: The coverage provided under CP 10 65 does not cover everything that is excluded under g. Water (4) of CP 10 30 10 12. The flood coverage endorsement does not provide coverage for water under the ground that seeps through doors, windows or other openings. Also, under the definition for Water damage in CP 10 30, it specifically states that... "there is no coverage for loss or damage caused by or related to weather-induced flooding which follows or is exacerbated by pipe breakage or cracking attributable to wear and tear." There is no coverage provision within CP 10 65 that would provide coverage for this type of situation.

Since there is no definition of 'flood' in either of these forms, the courts would rely on the standard definition. In relation to your question, Merriam Webster defines flood as:

1. The rising and overflowing of a body of water especially onto normally dry land; a condition of overflowing;

2. The flowing in of the tide...

With respect to general flooding, coverage is for water that has overflowed its confines. Therefore, the water that enters in below the lowest basement floor or the subsurface of the ground should be covered.

Question: We have a water damage claim on a hazard policy caused by a sewer back up due to excessive flooding in the area. Is the damage from the sewer water covered?

The policy is an HO policy with the following language:

Exception to C.(6)

Unless the loss is otherwise excluded, we cover loss to property covered under Coverage A or B resulting from an accidental discharge or overflow of water or steam from within a: (1) drain, or water, steam or sewer pipe, of the "residence premises"....

Section 1 - Exclusions

3. Water means: Flood, surface water, waves, including tidal wave and tsunami, tides, tidal water, overflow of any body of water, or spray from any of these, all whether or not driven by wind, including storm surge; and water that:

* Backs up through sewers or drains; or

* Overflows or is otherwise discharged from a sump, sump pump or related equipment.

-- Texas Subscriber

Answer: The exception to C.(6) is for the overflow or accidental discharge of water from a sewer pipe off the residence premises. Therefore, you have an issue of fact; did the off premises sewer pipe cause the loss, or was the loss caused due to the pipes on the premises? Note that the water exclusions for surface water and water below the surface of the ground do not apply to loss under C.(5) or (6). Recall that 5 relates to mold or fungus hidden behind walls, ceilings or floors.

However, water that backs up through sewers or drains is clearly excluded, as is flooding. The insured would need to have added the Water Back-up and Sump Discharge or Overflow endorsement HO 04 95 in order to have coverage.

Related: Court rules on meaning of homeowner's water 'leakage' insurance

Question: Insured has a standard personal auto policy. Insured is driving with his girlfriend (also a named insured on the policy). The weather conditions were poor and very heavy rains flooded the road the couple was driving on. The vehicle was swept away down the road in the flood water. Both the driver and the passenger escaped the vehicle. The passenger escaped but the driver drowned in the flood water. Is there bodily injury coverage available to the insured driver or passenger? The cause of death was due to drowning, not due to a motor vehicle accident, so it does not appear that coverage is triggered.

-- Maryland Subscriber

Answer: Generally a personal auto policy will state that in order to trigger coverage the insured has to be legally liable for bodily injury that is caused by an auto accident. Here there is no obvious liability claim, unless the insured-passenger can claim that the insured-driver was negligent when he drove down the flooded road. Although some courts have considered water as an object within the meaning of collision, in this case we cannot definitively say that this would be considered an auto accident.

Related: Is that claim covered?

In Part B of the insuring agreement, Medical Payments Coverage, the standard policy says that the insurer "will pay reasonable expenses incurred for necessary medical and funeral services because of 'bodily injury' caused by accident and sustained by an "insured." An accident in Part B is different from an accident in Part A and requires only that the insured is injured while occupying a motor vehicle designed for use on a public road. Because the insureds were escaping the vehicle at the time of the bodily injury and death, they were technically occupying the vehicle at the time of the injuries. Since the bodily injury and death in this case both occurred while the insureds were occupying a motor vehicle designed for use on a public road, this is considered an accident under Part B, Medical Payments Coverage. Since the survivor in this case was an insured, any reasonable medical expenses will be covered. Also, since the standard policy includes coverage for funeral expenses, and because the driver was also an insured, the deceased driver's funeral services will also be covered.

See also: How false water-damage claims are reaching crisis levels in Florida Here's why some water damage claims aren't covered
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Publication:Property and Casualty 360
Date:Sep 20, 2017
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