Water Damage Losses Sprinkled with Questions
By Susan Massmann
From the February 2007 issue of Claims Magazine
Writer Toni Morrison once said, "All water has a perfect memory and is forever trying to get back to where it was." Sometimes water takes the scenic route on its journey home, pouring into basements, overflowing from toilets, and bursting through pipes.
The FC&S staff receives many questions regarding water and the damage it inflicts on its travels.
Some questions involve water falling from the sky. Some concern water flowing over land or seeping and leaking underground.
And some want to know about water just hanging out in a bathroom, like one FC&S subscriber who told us about an insured's naughty son who flushed a tennis ball in the toilet. The ball got stuck, water backed up, and the floor, walls, and room suffered extensive water damage.
The insurer denied coverage under a Homeowners HO 00 03 05 01 form, citing the exclusion of "water that backs up through a sewer or drain." The subscriber disagreed with this assessment of the situation and asked if this was the proper application of the exclusion.
Well, no. The plumbing system was blocked by the tennis ball and could not adequately handle the flow of water, so the resultant loss was plumbing overflow—not sewer or drain backup. According to Webster's Collegiate Dictionary (10th Ed.), a "sewer" is an artificial, and usually, a "subterranean conduit to carry off sewage." But, what overflowed in this instance was water from within the plumbing system. The insurer attempted to negate a covered peril by citing the backup of sewer or drain exclusion.
Another subscriber described a commercial property insured's interior water damage that resulted from water leaking through a roof following a heavy thunderstorm. The building had a flat roof with a drain. The carrier denied the claim, saying coverage was precluded by the sewer or drain backup exclusion.
The subscriber said, "Whether the drain is not clogged, partially clogged, or completely clogged, I do not believe the exclusion applies. The water entered the building because it never reached the drain, traveled the wrong way on the roof, and came through a seam or other opening."
While we agreed that, based on the wording of the ISO Special Causes of Loss form, the sewer or drain backup exclusion did not apply if the water did not even reach the drain, another limitation could apply. The form contains a limitation for damage to an interior of a building caused by rain unless the roof first sustained damage from a covered cause of loss through which the rain entered.
Although that insurer's drain did not actually come into play in his loss, the following situation illustrates how a clogged drain and water flowing on the surface caused some damage that a subscriber hoped was attributable to a drain backup.
The insured had a backup of sewer or drain water damage endorsement on his commercial property policy.. The endorsement said "We will pay for loss or damage to covered property solely caused by water that backs up from a sewer or drain. We will not pay for water or other materials that back up from any sewer or drain when it is caused by any flood. Flood means the overflow of surface water, streams or other bodies of water, or their spray, all whether driven by wind or not."
Heavy rains caused a pooling of water in a courtyard and parking lot, which flowed under a door into a basement office. An adjuster inspecting the damage noted that the drain in the parking lot was clogged with debris.
Though the subscriber admitted he knew the pooled water was surface water, he argued that it would not have pooled if not for the clogged drain. He asked if this loss would be considered backup of a drain and if the drain was covered.
Yes, the drain was covered. With debris. But the loss was not. The damage was caused by surface water. As noted in the previous situation, for water to back up from a drain, it must have actually been in the drain. Something prevented the water from being in the drain—the clog.
The actual cause of the loss was rain water that pooled because it could not go down a clogged drain, which, as the subscriber correctly stated, is surface water.
Water visiting from someone else's property can also cause problems. An insured experienced water damage due to a water main break. The water main was located in the street in front of the insured's business. Water ran for about six hours before it was turned off. The water entered the insured's basement.
Since the water main was not on the insured's property, the subscriber wanted to know if the loss was covered.
This question brought up an interesting update ISO made to the definition of "water damage" on the 2000 edition of the Special Causes of Loss form, CP 10 30.
In the 1995 edition of the form, the definition states:
Water damage means accidental discharge or leakage of water or steam as the direct result of the breaking apart or cracking of any part of a system or appliance (other than a sump system including its related equipment and parts) containing water or steam.
However, the 2000 CP 10 30 says:
Water damage means accidental discharge or leakage of water or steam as the direct result of the breaking apart or cracking of a plumbing, heating, air conditioning or other system or appliance (other than a sump system including its related equipment and parts), that is located on the described premises and contains water or steam.
See the difference? The 2000 form added "that is located on the described premises" before the clause "and contains water or steam." The 1995 form provided broader coverage by not requiring the offending systems or appliances to be located on the premises.
So, the loss due to the water main break would be covered on a pre-2000 form containing the broader language.
This is just a small sampling of the types of questions we receive. As long as water is around, we will continue to be inundated with questions about water damage.
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