Application of Deductible for Two Close, but Unrelated Losses

 

November 27, 2017

 

Insured's policy is the Homeowners 3- Special Form HO 03 10/00. Insured has a wind loss claim to roof of June 23, and the living room ceiling later collapses on June 26, which insured attributes to the wind loss but which our engineer says is a result of the expansion and contraction of the roof system, which weakened the integrity of the nails holding drywall in place. We believe this to be two separate losses and have applied two separate deductibles. Insured continues to believe it is all one loss and that only one deductible should apply. In reviewing the policy language, the only policy language we see is as follows:

 

DEDUCTIBLE

 

Unless otherwise noted in this policy, the following deductible provision applies:

Subject to the policy limits that apply, we will pay only that part of the total of all loss payable under Section I that exceeds the deductible amount shown in the Declarations.

 

Language does not state a separate deductible applies to each loss. We can see nowhere in the policy that addresses the issue of separate deductibles for each loss sustained.

 

Please review and advise if separate deductible should apply and policy language to justify such a position. Thanks.

 

Kentucky Subscriber

 

You are overthinking the language. Loss is a singular noun; losses is the plural per Merriam Webster Online. Therefore, when the policy states:

 

Subject to the policy limits that apply, we will pay only that part of the total of all loss payable under Section I that exceeds the deductible amount shown in the Declarations.

 

It is saying that the deductible applies to each loss separately. It could be stated more clearly, but this is standard industry language that has been used for years. If the policy said that: …we will pay only that part of the total of all losses payable… then the deductible would apply on an annual basis only once per policy, as is available under some commercial coverages.

 

You have two losses three days apart with separate causes. Therefore, you have two claims and two deductibles should be applied.

 

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