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August 7, 2015  

 
 Q&A of the Week

Water Backup Is Not Surface Water

An Ohio subscriber recently asked the following question:

We have a carrier that is excluding a water damage claim where there is a water back-up endorsement that applies.
It states we will pay up to the amount shown in the Declaration, for direct physical loss to property covered under Section I caused by water, or water-borne material, which:
1. Backs up through sewers or drains, but not as a direct result from flood or surface water.
2. Overflows or is discharged from a:
a. Sump, sump pump; or
b. Related equipment: even if such overflow or discharge results from mechanical breakdown or off premises power failure but not as a direct result of flood or surface water.
This coverage does not apply to direct physical loss of the sump pump, or related equipment, which is caused by mechanical breakdown.
The HO3 policy states:
A. Coverage A – Dwelling And Coverage B – Other Structures
1. We insure against risk of direct physical loss to property described in Coverages A and B.
2. We do not insure, however, for loss:
a. Excluded under Section I – Exclusions;
SECTION I – EXCLUSIONS
A. We do not insure for loss caused directly or indirectly by any of the following.
Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area.
3. Water Damage
Water Damage means:
a. Flood, surface water, waves, tidal water, overflow of a body of water, or spray from any of these, whether or not driven by wind;
b. Water or water-borne material which backs up through sewers or drains or which over-flows or is discharged from a sump, sump pump or related equipment; or
c. Water or water-borne material below the surface of the ground, including water which exerts pressure on or seeps or leaks through a building, sidewalk, driveway, foundation, swimming pool or other structure; caused by or resulting from human or animal forces or any act of nature.
The company is saying that they will pay for backups through sewers or drains but not as a direct result from flood or surface water. The water came in through drains in the home. This was not a case of drains on the street backing up and flooding the home through the foundation. It seems to be a misinterpretation of policy language favoring the insurance company unfairly.
We have denied this claim due to the backup occurring as a result of the sewer filling up due to an inundation of the city's sewer system from naturally occurring rain water. There was no mechanical breakdown or power outage causing the sump pump to fail. The policy excludes water damage as noted above, regardless of any other cause or event contributing concurrently or in any sequence to the loss.
What are your thoughts on the matter?

ANSWER: Rain water is not surface water or necessarily flood water. Surface water is an accumulation of water that meanders along the ground outside of any boundaries of lakes, streams, ponds, etc. Rain water that falls into and accumulates in the sewer is not surface water, it is rain water. Flood water, like surface water, accumulates and inundates large areas of land; rain water collecting in a sewer is not necessarily flood water. The carrier is misreading the exclusion. Depending on the nature of the backup, which you have not described for me, there should be coverage.

 
 Litigation Watch
Contractual Liability Exclusion

In this case, the insurer (Continental Casualty Company) seeks a declaration regarding its duty to defend and indemnify the insured (Greater Omaha Packing Company) in a lawsuit filed against the insured. This case is Continental Cas. Co. v. Greater Omaha Packing Co., Inc., No. 8:14-CV-194, 2015 WL 3852772 (D. Neb. June 22, 2015).

Greater Omaha Packing Company, GOPAC, is a Nebraska corporation and supplier of raw beef. GOPAC was insured by Continental under a commercial umbrella policy. In 2009, GOPAC was implicated in an E. coli outbreak and named in multiple tort lawsuits. Fairbank Farms was a processor and seller of ground beef and had received the beef from GOPAC. After Fairbank Farms was sued over the contaminated beef, it filed a lawsuit against GOPAC for breach of contract, breach of express warranty, and breach of the implied warranties of merchantability and fitness for a particular purpose. Fairbank sought damages based on lost profits, lost enterprise value, and recall-related attorney fees, costs, and expenses. GOPAC sought coverage from Continental.

Continental filed this lawsuit, contending that it should not be required to insured GOPAC's business dealings because the contractual liability exclusion in the policy applied. The United States District Court for the District of Nebraska noted that, for the contractual liability exclusion to apply, GOPACƷs potential liability to Fairbank must have arisen by reason of the assumption of liability in a contract or agreement. The court said that the key to understanding this exclusion is the concept of liability assumed. After examining judicial rulings from courts around the country, the district court found that the majority of courts have concluded that the contractual liability exclusion applies only where the insured has contractually assumed the liability of a third party as in an indemnification or hold harmless agreement. Conversely, the exclusion does not operate to exclude coverage for any and all liabilities to which the insured is exposed under the terms of the contracts it makes.

The court said that the majority interpretation is reasonable in light of the fact that all business transactions are entered into according to some sort of agreement or understanding. If the exclusion were interpreted otherwise, so as to exclude all liability associated with a contract by the insured, then general liability policies would be severely limited in their coverage.

The court also noted that, at first glance, it would seem that Fairbank's claims arise out of an assumption of liability by GOPAC. However, in the lawsuit, Fairbank is not seeking indemnity from GOPAC for Fairbank's own conduct, that is, Fairbank is not asking GOPAC to assume Fairbank's liability to a third party. Rather, Fairbank asserts that GOPAC is contractually liable for the recall costs, lost profits, and recall-related expenses that Fairbank incurred as a result of the tainted beef. Thus, Fairbank's claims are for damages arising from GOPAC's own alleged negligence or the alleged failure of GOPAC's products to comply with certain specifications. Fairbank seeks to hold GOPAC liable for GOPAC's own conduct and is not asking GOPAC to assume liability for Fairbank's conduct. Thus, said the court, the exclusion does not apply.

The court ruled that, to the extent that Continental seeks a declaration of non-coverage based on the contractual liability exclusion, that request fails to state a claim for relief.

Editor's Note: The U.S. District Court in Nebraska examines the contractual liability exclusion and lists cases from Wisconsin, Alabama, Minnesota, Arizona, Louisiana, Michigan, Alaska, Massachusetts, Utah, and Texas to aid in its interpretation. In this instance, the insured was not sued based on the assumption of liability to a third party; the insured was sued for its own alleged negligence. The contractual liability exclusion was not applicable based on the stated claims.
 
   
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