We insure the local Chamber of Commerce on a commercial property policy, CP 00 10 04 02, with special causes of loss, CP 10 30 04 02. We have added to this policy the insurer's independent endorsement, "Property Coverage Enhancement for Non Profit Organizations."

One of the enhancements given by this endorsement is $10,000 coverage for "Water Backup of Sewers and Drains." This coverage reads as follows: "We will pay for the loss or damage caused by or resulting from water that backs up from a sewer or drain. We will pay not more than $10,000 in any one occurrence."

During a recent heavy rainstorm, the drains on the roof became clogged with dirt, leaves, and other debris. As a result, the water stood on the roof and seeped into the building at seams in the roof covering. An inspection by a reputable roofer found that the roof had deteriorated due to its age and this contributed to the leakage. However, he was able to clean out the drains and then the water drained from the roof as designed.

The insurer has denied this claim for two reasons. First, they say that the "sewer and drain backup coverage" was intended for drains within a plumbing system. They have also cited the wear and tear exclusion.

We think the insurer is wrong and would appreciate your opinion.

Oklahoma Subscriber

The insurer's denial does not hold water for two reasons. First, the statement that the form really means drains in the ground or in a floor. The endorsement does not say that— if the authors of the policy wanted to limit the coverage to just drains in the floor, the policy could have been so drafted.

Because the policy does not define "drain," we must look to a dictionary definition. A standard desk-top dictionary says that a drain  is "a means by which usually liquid matter is drained." That same dictionary defines the verb "to drain" as: "to draw off (liquid) gradually or completely." The roof drains on this building clearly fit the definition of "drain."

Secondly, the insurer has denied the claim based on the "wear and tear" exclusion. They say if the roof hadn't been worn out, it would not have leaked.

That exclusion applies to loss that is confined to wear and tear. For example, let's say that the insured was inspecting his roof and found that it was wearing out. He could not then turn to his insurer and expect them to repair his "worn-out" roof.

Your insured has suffered covered damage to the interior of his building, due to the backup of the roof drains. That damage is covered by this policy for up to $10,000.

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