A recent case in Florida shows why it is important to get information from those who perform repair and mitigation efforts after a loss.1 This is now a very common damage scenario where the home or company receives water damage after a storm and the insurance company receives a technical report stating that the storm did not cause the water intrusion.
The court noted the reason for the rejection of the claim:
The letter of refusal of claim stated that Citizen’s policy does not cover damage caused by wear and tear, but provides coverage for “direct physical loss of property described in coverage A and B only if that loss is a physical loss of property”; and excludes coverage for loss caused av ‘[r]ain, snow, snow, snow, sand or dust to the interior of a building “, and that there is no cover” unless a covered hazard first damages the building and causes an opening in a roof or a wall and rain, snow, snow, slush, sand or dust enters through this opening.
The court noted that policyholders hired a licensed contractor to support the theory that the storm created an opening that allowed rain to enter the building:
Homeowners hired Steven Delgado, a licensed contractor, to inspect the property and give expert testimony in the case. Mr Delgado submitted his certificate in contravention of the summary judgment, his inspection report, photos and his extensive CV. In its affidavit, Delgado stated, in the relevant part,
The insured’s property is a single-family house. The roof consisted of a wooden frame structure, covered with asphalt shingles. During a hurricane, strong winds can lift shingles and flashes and cause damage to the ground in the form of small openings that allow [sic] water to enter the property. These strong winds can also break the seals that secure the shingles together, which in the same way can cause wind-created openings in the ground, which leads to rainwater penetrating.
During my inspection and examination of the claim documents referred to in paragraph 5 of this declaration, I observed significant damage to the roof system and significant water penetration through the roof. I observed loose shingles that was likely damaged during Hurricane Irma, allowing strong winds and airborne debris to create small openings that allow water intrusion. My observations are consistent with roof damage caused by a strong wind storm like Hurricane Irma.
The court emphasized an earlier decision that also involved citizen property insurance where the policyholder’s contractor’s confirmation was sufficient to create a verifiable fact for a jury to determine what caused the water damage:
The insured opposed a summary judgment relying on a certificate, inspection report and deposit from its main contractor, which ultimately concluded that the roof leak was due to microcracks in the roof caused by strong gusts and windy rain during the thunderstorm in November 2015. The district court found that evidence which the insured relied on was insufficient to withstand a summary assessment of whether a covered hazard caused an opening in the roof of the building and made a final judgment in favor of the insurer.
Likewise, the present case found that the contractor’s assurance was sufficient to allow the case to go to a jury.
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1 Morales v. Citizens Prop. Ins. Corp.No. 3D21-276 (Fla. 3rd DCA March 16, 2022).