Home Insurance Law Washington Supreme Court docket Reaffirms the Broad Nature of Ensuing Loss Exceptions to Exclusions

Washington Supreme Court docket Reaffirms the Broad Nature of Ensuing Loss Exceptions to Exclusions

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Washington Supreme Court docket Reaffirms the Broad Nature of Ensuing Loss Exceptions to Exclusions

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Washington is among the most pro-policyholder states within the nation. As we not too long ago famous in Dan Veroff Discusses Washington Insurance coverage Legislation, Washington imposes extreme penalties for mishandled claims. As a brand new instance of the state’s dedication to defending policyholders, the Washington Supreme Court docket issued an opinion on Thursday reaffirming a pro-policyholder precept established 12 years in the past in a pair of opinions. Not solely had the court docket already addressed the problem within the latest previous, however within the new case, the intermediate appellate court docket already obtained the reply proper and adopted the present precedent. The one court docket erring within the chain of occasions resulting in the brand new determination was the trial court docket, which had already been reversed. Thus, the brand new opinion isn’t totally obligatory however a lot appreciated. Whereas the topic had already been coated, the subject is advanced, and new opinions make sure the legislation continues to be utilized correctly. Washington clearly cares deeply about its policyholders and guaranteeing the legislation is adopted.

The Washington Supreme Court docket reaffirmed its stance on ensuing loss exceptions to exclusions established in 2012. The court docket confirmed that insurance coverage insurance policies with ensuing loss exceptions cowl all ensuing losses, even when the coverage says the exclusion applies even when it “initiates a sequence of occasions that leads to loss or harm, whatever the nature of any intermediate or last occasion in that sequence.” Thus, it affirmed that the exception covers even ensuing losses which can be a part of the identical chain of causation because the excluded occasion.

Examples are one of the best rationalization of this protection provision for these unfamiliar. For example, an insurance coverage coverage may exclude protection to restore a damaged plumbing part however cowl the following water harm to the house. As one other instance, a coverage may exclude the price to restore a development defect like faulty window sealing however cowl the following water harm from a rainstorm. Insurance coverage corporations have argued, as they did within the case earlier than the Washington Supreme Court docket, that these ensuing loss provisions solely apply to losses which can be exterior the traditional and anticipated sequence of occasions from the excluded trigger. Thus, insurers argue that water harm is predicted from a plumbing break, so it isn’t a part of the following loss exception to the exclusion for damaged pipes.

The Washington Supreme Court docket rejected this interpretation in two 2012 circumstances with completely different outcomes. Within the first and first case, it held {that a} collapse ensuing from defective workmanship was coated underneath an all danger coverage with the identical language that it evaluated once more in 2024. 1 The insured in that case had an “all danger” coverage that excluded protection for losses brought on by defective workmanship, even when it “initiates a sequence of occasions that leads to loss or harm, whatever the nature of any intermediate or last occasion in that sequence.” It additionally included an ensuing loss exception, stating, “If loss or harm [caused] by a Coated Explanation for Loss outcomes [from the excluded event], we can pay for that ensuing loss or harm.” The Supreme Court docket of Washington reversed the Court docket of Appeals and stated nothing a few requirement that the coated peril be impartial. As a substitute, it particularly rejected the argument that the ensuing loss provision solely “applies when an excluded peril causes a separate and impartial coated peril.” 2

Within the different 2012 case, the Washington Supreme Court docket discovered that the collapse of a deck was not an impartial peril, and thus not an excepted ensuing loss, from the defective development and decay that triggered its collapse within the first place. 3 The court docket reiterated the rule from the case talked about above that underneath a ensuing loss exception, ensuing loss brought on by an excluded peril is roofed until it’s topic to its personal exclusion. Nonetheless, it held that the superior decay of the fin partitions was not a separate, ensuing loss coated by the coverage. It discovered that whether or not the deck was in a state of collapse was irrelevant because the deck’s situation was the results of two excluded perils—faulty development and decay—and didn’t represent a separate loss other than these perils. As a result of “the pure course of of degradation will end in collapse,” it discovered {that a} collapse is merely the top results of deterioration and never a brand new and completely different peril from rot. 4

Given the opinions above, the Washington Supreme Court docket didn’t must tackle a brand new case on the topic, however we respect that it did so nonetheless. In The Gardens Condominium v. Famers Insurance coverage Alternate, the Condominium discovered harm to its roof from condensation. The Condominium traced the harm to defective design and development of the constructing’s roof that prevented satisfactory air flow, inflicting water vapor to condense on the underside of the roof. After believing that they had repaired the harm, it was later found the fixes nonetheless didn’t permit for enough air flow, leading to additional condensation and ensuing property harm from the extra defective workmanship.

The Condominium was insured underneath a Farmers “all danger” coverage that excluded protection for losses brought on by defective workmanship, with the identical actual language stating that the exclusion applies even when it “initiates a sequence of occasions that leads to loss or harm, whatever the nature of any intermediate or last occasion in that sequence.” It additionally included an ensuing loss exception, stating, “If loss or harm [caused] by a Coated Explanation for Loss outcomes [from the excluded event], we can pay for that ensuing loss or harm.”

The Condominium contended that Farmers didn’t need to pay the prices to restore the defective workmanship however did need to cowl the price of the harm brought on by condensation. In different phrases, the loss ensuing from the excluded occasion, condensation ensuing from defective workmanship, is roofed as an exception to the exclusion. Regardless of the clear legislation, Farmers disagreed, arguing that “the ensuing loss exception applies provided that a coated occasion breaks the causal chain between the excluded danger and subsequent losses or if there’s harm to different property.”

Regardless of two Washington Supreme Court docket opinions on the topic, the trial court docket agreed with Farmers by seeking to authority from the Sixth Circuit Court docket of Appeals. Nonetheless, Washington isn’t a part of the Sixth Circuit, which applies legal guidelines of various states. The Court docket of Appeals reversed. In step with the 2 opinions referenced above, it reasoned that by together with the ensuing loss clause, Farmers agreed to pay for harm brought on by a coated peril even when it outcomes from defective workmanship. Thus, if condensation and humidity are coated perils underneath the coverage, the coverage should cowl harm brought on by these perils. The court docket additionally identified that this court docket had by no means interpreted ensuing loss clauses to protect protection just for harm brought on by impartial, unexpected coated perils. The court docket remanded to the trial court docket to find out if condensation was a coated peril and, subsequently, whether or not the ensuing loss exception utilized.

The Washington Supreme Court docket took the case and affirmed. 5 In so doing, it adopted the present precedent, particularly noting that the identical language was at concern in one of many prior two circumstances on the topic. The court docket additionally famous that insurers might keep away from this consequence by merely not together with an ensuing loss exception.

Farmers argues this holding will imply ‘there might by no means be any excluded sequence of occasions.’ We disagree. Insurers are free to draft insurance policies that include ‘sequence of occasions’ causation language and do not need ensuing loss exceptions to the exclusions. As Gardens appropriately factors out, Farmers might have drafted the coverage in a different way to make sure that your entire causal chain ensuing from an excluded peril could be excluded by not together with a ensuing loss exception or by limiting the exception.

Lastly, the Washington Supreme Court docket briefly thought of the insured’s secondary argument that the coverage was ambiguous and will, subsequently, be construed in favor of protection. The court docket famous that it rejected the identical argument in 2012. “Though this coverage could also be complicated, it isn’t ambiguous.”

The opinion was signed by all 9 justices of the Washington Supreme Court docket.


1 Imaginative and prescient One, LLC v. Phila. Indem. Ins. Co., 158 Wn. App. 91 (Wash. App. 2010).
2 Imaginative and prescient One, LLC, 158 Wn. App. at 107.
3 Sprague v. Safeco Ins. Co. of Am., 174 Wn.2nd 524, 276 P.3d 1270 (2012).
4 Sprague, 174 Wn.2nd at 530.
5 The Gardens Condominium v. Famers Ins. Alternate, No. 101892-4, — Wn.2nd — (Wash. Mar. 14, 2024).



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