Recently I submitted a claim for an insured that operates a hospital. He carries insurance for his business's building and personal property under the CP 10 30 04 02 special coverage form. The insured claims that a scientific video monitor used in the intensive care unit was stolen.
The insurance company is denying the claim based on the exclusion found in limitation of coverage 1.e., which says, “We will not pay for loss or damage to: e. property that is missing, but there is no physical evidence to show what happened to it, such as a shortage disclosed on taking inventory.”
How, in a premises that is open 24 hours a day for public service, is there going to be physical evidence of forcible entry?
Puerto Rico Subscriber
Our answer to your question about coverage for a monitor stolen from a hospital intensive care unit is that it should be covered. The clause the insurance company relied upon to deny coverage does not apply in this case.
Limitation of coverage 1.e. does not require visible signs of forcible entry, which is a requirement for coverage under the peril of burglary in the crime policy. This limitation refers instead to the loss of property that could not be recognized except by reference to written records.
For example, if the hospital had a storage room filled with hundreds of monitors and one were stolen, that theft probably could not be recognized by physical evidence alone. The physical absence of one monitor out of hundreds could not be seen without counting the monitors and comparing the total to a known number. In the case of your insured, the absence of the monitor could be immediately noticed by anyone familiar with the room. The monitor was there yesterday and it is not there today. It is physically missing, and the hospital does not have to rely on an inventory to know that it is gone. The physical evidence is the empty space where the monitor used to be.
The purpose of the limitation of coverage in question is to prevent claiming theft when the loss might, in fact, be due to poor record keeping—a clerical error. The limitation is not intended to exclude theft, which might be thought of as the disappearance of property from a specific place during a specific time period.
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