Joint Loss Agreements
April 4, 2016
Gas Combustion Explosion vs. Pressure Vessel Explosion
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Introduction
The Insurance Services Office (ISO) Equipment Breakdown Protection Coverage Form, EB 00 20 01 13, is designed to dovetail with ISO's Building and Personal Property Coverage Form, CP 00 10 10 12, and its causes of loss forms: basic, CP 10 10 10 12; broad, CP 10 20 10 12; and special, CP 10 30 10 12. The property causes of loss forms exclude coverage provided by the equipment breakdown form and cover perils excluded by the equipment breakdown form. For example, the property forms exclude explosion of steam boilers, which are covered by equipment breakdown form. On the other hand, the property forms cover the explosion of gases in the furnace of a boiler, an excluded peril on the equipment breakdown form.
The description of the named peril explosion in the basic and broad property causes of loss forms and the exclusion of steam boiler explosion in the same forms set forth a distinction that can be drawn between the commercial property and equipment breakdown forms.
The named peril property forms define “explosion” as, “Explosion, including the explosion of gases or fuel within the furnace of any fired vessel or within the flues or passages through which the gases of combustion pass.” So far, any explosion, and specifically gas combustion explosions, are covered perils in the commercial property forms.
The property causes of loss forms, though, exclude “Explosion of steam boilers, steam pipes, steam engines or steam turbines.” If loss or damage by fire or combustion explosion results, the resulting loss or damage is covered. The special causes of loss form adds, “But we will pay for loss of or damage caused by or resulting from an explosion of gases or fuel within the furnace of any fired vessel or within the flues or passages through which the gases of combustion pass.”
The distinction is that the property form covers explosion due to combustion of gases (among other types of explosion) while the equipment breakdown form is designed to cover only explosion resulting from excessive pressure in steam boilers and other vessels.
This distinction between combustion explosion and excessive pressure explosion is further supported in the equipment breakdown form, which excludes all types of explosion except the loss or damage caused by an explosion of covered equipment. Covered equipment is described as steam boiler, electric steam generator, steam piping, steam turbine, steam engine, gas turbine, or moving or rotating machinery caused by centrifugal force or mechanical breakdown. The equipment breakdown form reinforces the distinction also by excluding loss from explosion “within the furnace of a chemical recovery type boiler or within the passage from the furnace to the atmosphere.” The equipment breakdown and commercial property forms make it clear that equipment breakdown forms cover only excessive pressure explosions, while commercial property forms cover all explosions except excessive pressure explosions.
Despite this careful coordination of the equipment breakdown and the property forms, cases will arise where it is unclear which policy provides coverage. If equipment breakdown coverage and commercial property coverage are written by different insurance companies, a dispute between them could arise over which carrier should cover how much of a given loss.
Suppose a hostile fire in the furnace of a steam boiler causes the pressure in the boiler to build until it explodes, damaging not only the boiler but much of the machinery and equipment around it. Damage caused by the fire in the gas combustion chamber is covered by the property form. Loss due to the explosion of the steam boiler is covered by the equipment breakdown form. Which peril caused the damage to the surrounding equipment: the fire in the boiler's furnace or the resulting explosion of the steam boiler?
Such questions are not unusual, as seen in Nitrin, Inc. v. American Motorists Ins. Co., 236 N.E.2d 737 (Ill. App. 1968). In 1963, a fertilizer manufacturer, Nitrin, Inc., was insured by American Motorists Insurance Company for boiler and machinery coverage and by Protection Mutual for property coverage. An explosion caused damage to their production equipment, causing output to cease for ten days. Protection Mutual denied coverage for the ensuing business interruption loss, asserting that the damage to insured property was caused by an explosion of an unfired pressure vessel, which was excluded in their property policy. The boiler and machinery insurer, American Motorists, denied coverage claiming that the explosion was caused directly or indirectly by a fire in part of the piping of the equipment. The case went to trial and was appealed to a higher court, where it was decided that American Motorists should pay the loss. American Motorists reimbursed Nitrin, Inc. for its business interruption loss—five and one half years after the explosion.
Upon occasion the equipment breakdown insurer and the property carrier will agree on the total amount of the loss, and even that each is responsible for a percentage of the loss, but they will disagree on how the loss should be divided between them. In St. Joseph Light & Power Co. v. Zurich Ins. Co., 698 F.2d 1351 (8th Cir. 1983), St. Joseph had placed its boiler and machinery coverage with the Zurich and had split its property insurance among sixteen insurance companies. In 1975, a ten-story boiler caught fire and suffered over $4 million in damage.
The Zurich boiler and machinery policy covered only damages resulting from low water conditions in the boilers. At first Zurich denied the loss saying that it resulted solely from fire. The fire carriers paid a sum to be applied against the portion of the loss, if any, attributable to fire. They contended, however, that a low water overheating condition, not fire, caused the damage.
A jury found that the damage was caused both by low water in the boiler and by fire, and that Zurich owed about 46 percent of the direct loss and the fire carriers owed about 54 percent. An appeal to higher courts over prejudgment interest, coinsurance, and other issues delayed the payment of the loss until 1983, seven and one half years after the occurrence of the loss.
In order to avoid lengthy and costly disputes, an attempt should be made to have the same insurer cover equipment breakdown and commercial property. If separate carriers must be used, the policies should contain what is commonly known as a joint or disputed loss agreement. When ISO updated the boiler and machinery program to the equipment breakdown program, the language from endorsement BM 99 43 09 96 was transferred to become as section of the form, so the endorsement is no longer necessary and has been withdrawn. For the Building and Personal Property Coverage Form, the Joint Or Disputed Loss Agreement endorsement, CP 12 70 09 96, can be used. The equipment breakdown joint or disputed loss agreement section and the property endorsement are mirror images of each other. Where the property endorsement talks about boiler and machinery insurance, the equipment breakdown endorsement talks about the property coverage form. (The commercial property endorsement pre-dates the switch of the boiler and machinery program to the equipment breakdown program, so it still refers to boiler and machinery coverage.)
These provisions are intended to facilitate payment of the insurance proceeds to the insured when an insured loss damages property covered both by the commercial property coverage form and the equipment breakdown policy and when the insurers disagree as to whether there is coverage or as to the amount of loss to be paid by each company. The provisions allow the insured to be paid before the two insurers settle their dispute by stipulating that each insurer will pay, at the insured's request, one half of the disputed amount and all of its respective undisputed portion of the loss.
In order for the provisions to work, three requirements must be met.
First, each policy must include substantially the language, each bearing similar requirements, procedures, and conditions.
Second, the damage to the covered property must have been caused by a loss for which both insurers accept some responsibility for payment under their respective policies; or, either insurer does not admit to any liability for payment while contending the other insurer does owe for the loss.
Third, both insurers and the insured must agree on the total amount of the loss. The only question should be the percentage of the agreed-upon loss each insurer should pay. The dispute must be over the amount of loss each insurer should pay that is attributable to a covered cause of loss covered.
Note that the St. Joseph Light and Power case does not quite fit these requirements because each insurer initially denied responsibility for coverage of the loss, although the sixteen property insurers did allow for the possibility that they might be responsible. The endorsement would have come into play had the boiler and machinery and the commercial property insurers agreed that the total loss was $4 million and that they each covered some portion of it, but the property group and the boiler and machinery carrier disputed the basis for dividing the loss between them.
Both loss adjustment provisions require that after each insurer pays its half of the disputed amount (and its full portion of the undisputed amount), the two insurance companies must submit their disagreement to arbitration within ninety days of payment. The insured must cooperate with the arbitration procedures.
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