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Question: Our insured has a homeowners' policy (HO-3) with a “Backup of Sewers and Drains” add-on endorsement. The endorsement says, “We will pay up to $5,000 in total for direct physical loss to property covered under Coverages A, B & C when such loss is caused by water:
- Which backs up through sewers or drains; or
- Which enters into and overflows from within a sump pump, sump pump well or other type of system designed to remove subsurface water which is drained from the foundation area.”
The insured has a basement window with a window well that contains a thick layer of pea gravel for drainage. Our argument is that this is not “a system designed to remove subsurface water” and coverage would not apply if water accumulates and runs through the window, or even through the foundation area. What is your opinion?
— Arizona Subscriber
Answer: The purpose of a window well is to let light and air into the basement, as well as serve as a way out in event of emergency. If a window well was part of the drainage system, it would have to drain somewhere else. It is not part of the plumbing or sump system; it is a window well, pure and simple.
Related: 15 preventable homeowners' insurance claims and how to avoid them
|Low-E window glare damages neighbor's siding
Question: The neighbor of our insured had new windows installed within the last few years that have low-e glass. The insured recently noticed that a section of the vinyl siding on the rear of his home was buckled. We had an engineer go out for an inspection to determine the cause of the damage to the siding. He determined that the reflection of the sun off the low-e glass had temperatures as high as 180 degrees reflecting on this section of the siding where there is no shade. This ultimately caused the damage. Could we deny this claim based on the wear and tear or inherent vice exclusion? We write the HO3 (4/91) edition.
— Connecticut Subscriber
Answer: No, this is not “wear and tear” or “inherent vice.” This loss can be directly attributed to an outside agency; i.e., the heat from the windows. The siding didn't wear out over time, which would be excluded. Inherent vice means that there would be a characteristic within the siding that caused it to deteriorate or fail, but the outside force of the windows' heat production was what led to the buckling. No other exclusion applies, so the loss is covered.
Related: Challenges arise with matching property damage repairs
|Can a window be claimed as part of a damaged wall?
Question: We have a loss involving a broken window resulting from a heavy windstorm. Rainwater entered through the broken window and caused damage to personal property contained within the dwelling. Our policy says the following:
Perils Insured Against:
provided coverage if a wind causes an opening in a roof or wall.
Do you consider a window to be a wall? We believe a window and a wall are essentially the same thing and that coverage would apply for the loss to the personal property in these instances. Do you concur?
— California Subscriber
Answer: The intent of the policy language is to pay only for personal property when the outside of the dwelling has been breached; normally that's through the roof or wall, but a window is part of a wall, so we agree with you that the loss should be covered. Merriam Webster Online includes in its definition of wall: something resembling a wall (as in appearance, function, or effect), especially: something that acts as a barrier or defense. Therefore the loss should be paid.
Related: Capturing proof of damage after a storm
|Boarded-up window damage leads to lost property
Question: Our insured's building is covered by an ISO commercial property policy, CP 00 10 04 02, with the special causes of loss form, CP 10 30 04 02, attached. The insured uses the first floor and leaves the second floor unoccupied. The second story windows were boarded up years ago with plywood to prevent water entering through any broken panes.
This past summer, extremely heavy storms accompanied by high winds and wind-driven rain caused the plywood boarding to become loose, which resulted in water penetrating the window openings and damaging the insured's business personal property.
The insurer denied coverage for the loss, citing the following limitation on water damage: the building must first suffer damage to its roof or walls by a covered cause of loss through which the rain would enter. In supporting his denial, the adjuster compares the boarding being blown in to that of a window (we assume he means windowpane) being blown open, and states that coverage would not apply in this similar situation unless the window (pane) was blown out or damaged.
According to a standard desk-top dictionary, a “window” is the opening in a wall, covered by a material, typically glass (the glass is called a “windowpane”). Our position is that the windows, including the boarding, are part of the wall, and that the material covering the openings is irrelevant. The wind is a covered cause of loss, and it damaged the wall by blowing out the window covering. This should trigger coverage for the damage to the insured's interior business personal property. We would like your feedback.
— Colorado Subscriber
Answer: The limitation the adjuster cites says nothing about “windows.” Even if we were to accept the insurer's contention that the boarded-up window is not a “window,” it is still part of the building's wall. When the wind loosened the boards covering the opening, the wall suffered damage from a covered peril. Then, rain entered and caused a loss. “Damage” is not defined in the form, so the insured is entitled to the benefit of the doubt. The loss is covered.
Related: 3 challenges with property claims
|When animals attack… electronics
Question: Under the peril of “falling object” in the homeowners policy, would there be any coverage for a damaged television caused by a deer that entered a house by jumping through and breaking a glass window of the house?
— Kentucky Subscriber
Answer: You have an interesting scenario. The policy doesn't define “falling object,” and in such situations it is customary to go to a standard desk reference. Merriam Webster Online defines “object” as “something material that may be perceived by the senses.” Using this definition, the deer can be considered an object.
“Fall” is defined as “to descend freely by the force of gravity, or to leave an erect position suddenly and involuntarily.” This is where it becomes difficult; was the deer falling or jumping? “Jump” is defined as “to spring into the air: leap, especially to spring free from the ground or other base by the muscular action of feet and legs.”
It sounds like the deer truly jumped through the window, versus tripping over a chair on the patio and falling, although what really happened is a matter of fact. Therefore, if the deer jumped through the window, there is no coverage under the policy. Jumping animals are not a covered peril.
Related: 7 parts of your home to check for winter weather damage
|Damage to property exclusions and scratched glass
Question: Our policyholder is a painter. He was hired by a builder to paint the interior and exterior of a house being constructed. The painter primed all the windows, which were in place in the house, and then scratched the interior glass while sanding the window sashes and non-removable muntins. All the windows have to be replaced. We contend Exclusion J.5 of the CGL is applicable. The agent contends that the glass is a separate part and therefore the exclusion is not applicable. Is there coverage?
— Kentucky Subscriber
Answer: We agree with you on this. It is an interesting argument that the agent is making about the glass, but since the glass is already in the window, it is the window, and sashes and muntins are also the window. These items may be separate parts on their own, but they are now incorporated into one piece of real property and that is the window. Exclusion j5 is applicable since this part of real property has been damaged while the insured was working on it and the damage arose out of that work.
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