November 16, 2018 | Share
What is a “Concurrent Cause” and When Can (and Can’t) Insurers Deny Coverage?
One of the most complicated (and most frustrating) issues involved with substantial homeowner’s insurance claims is the issue of “concurrent cause.” Under standard homeowner’s insurance policy language, if two factors concurrently cause property damage and one factor is covered while the other is not, then the insurer has the right to deny coverage based upon concurrent causation.
This “anti-concurrent cause clause” has understandably led to numerous legal disputes over the years; and, in Florida, the Supreme Court has ruled that this type of clause is unenforceable in circumstances where no single cause can be determined. In the words of the Court:
“[W]hen independent perils converge and no single cause can be considered the sole or proximate cause, it is appropriate to apply the concurring cause doctrine . . . .”
Contrary to the standard anti-concurrent cause clause, the “concurring cause doctrine” states that insurers must provide coverage unless it can be clearly established that the loss resulted from a peril that is excluded under the terms of the homeowner’s policy. Furthermore, for the concurring cause doctrine to apply, it is not necessary for the covered peril to be the primary cause of the homeowner’s loss.
Concurrent Cause vs. Successive Causes
The concurring cause doctrine applies in circumstances in which it is not possible to determine whether a loss resulted from a covered or excluded peril (i.e. in the case of a hurricane where a home sustains water damage due to wind damage and flooding, and the homeowner has coverage for one type of damage but not the other). It does not apply in cases where the covered and excluded perils occur in sequence. In these types of cases, the Florida courts have established two bright-line rules:
- If a covered peril sets in motion an uncovered peril, then the entire loss is covered.
- If an uncovered peril sets in motion a covered peril, then none of the loss is covered.
Even with these rules in place, disputes regarding insurance coverage following major storms are common. The insurance companies will look for any justification to deny payment; and, if it can be argued that a covered peril was not concurrent with an uncovered peril but instead followed the uncovered peril, then coverage will almost universally be denied. Additionally, in the aftermath of major storms, insurance companies often hire inexperienced adjusters simply due to the volume of the demand for adjustment of claims; and, in many cases, these inexperienced adjusters are not adequately equipped to appropriately determine causation.
What can homeowners do to make sure they receive the coverage to which they are entitled? In many circumstances, working with a public adjuster is a good option. However, if an insurance company refuses to pay based upon an anti-concurrent cause clause or an improper assessment of the timing of covered and uncovered perils, it may be necessary to hire legal representation.
Contact the Fort Lauderdale Property Damage Lawyers at Saavedra | Goodwin
If you are struggling to secure coverage from your homeowner’s insurance company and would like more information about your legal rights, we encourage you to contact us for a confidential initial consultation. To speak with a property damage lawyer at our Fort Lauderdale law offices, please call 954-767-6333 or inquire online today.
Categories: Insurance Claims