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
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.
This premium content is locked for FC&S Coverage Interpretation Subscribers
Enjoy unlimited access to the trusted solution for successful interpretation and analyses of complex insurance policies.
- Quality content from industry experts with over 60 years insurance experience, combined
- Customizable alerts of changes in relevant policies and trends
- Search and navigate Q&As to find answers to your specific questions
- Filter by article, discussion, analysis and more to find the exact information you’re looking for
- Continually updated to bring you the latest reports, trending topics, and coverage analysis
Already have an account? Sign In Now
For enterprise-wide or corporate access, please contact our Sales Department at 1-800-543-0874 or email [email protected]