Removal of Roof to Repair not Covered Cause of Loss

Snow and Rain Entering Church Because Roof was Removed to be Replaced not Damage Caused by a Peril Insured Against

No insurance policy covers every risk of loss faced by the property of the person insured. To recover under a first party property policy for damage caused by entry of snow and rain through the roof of a building it is necessary to prove that the water entered because there was damage to the roof by a peril insured against, like wind.

In Christ Church of the Gospel Ministries d/b/a Evangel Churches v. Guideone Mutual Insurance Company, Case No. 2:19-11208, United States District Court Eastern District of Michigan Southern Division (November 19, 2019) the Christ Church of the Gospel d/b/a/ Evangel Christian Churches (“Evangel Churches”) filed a claim against their insurance provider, Guideone Mutual Insurance Company (“GMIC”), for breach of the commercial insurance policy insured by GMIC because it refused to pay for damage resulting from snow and rain entering building after the roof was removed during repair and replacement efforts.

BACKGROUND FACTS

GMIC provided insurance to Evangel Churches’ property located in Roseville, Michigan. The policy provided coverage “for direct physical loss of, or damage to, “Covered Property” caused by or resulting from a “Covered Cause of Loss.”

In early March 2017, a contractor hired by Evangel Churches began work on replacing the roof of the building, which had undergone extensive repair in years prior. During the replacement work, the contractor removed shingles from the roof, and utilized tarps to cover areas where the shingles had been removed and not yet replaced. During a storm, and perhaps at other times, the tarps blew off their position on the roof and/or were damaged. As a result, water leaked into the interior of the building. Evangel Churches says the interior of the building and the personal property inside suffered extensive water damage.

Evangel Churches alleged that the contractor began replacing the building’s prior roof. During the time of the alleged loss it rained and snowed about 18 times. As a result, water entered the building’s roof and four walls. As a result, water entered the building’s interior and damaged it, including the interior walls, drywall, carpet, tile, pews, contents and personal property, the chandeliers, and other light fixtures.

ANALYSIS

The policy expressly excludes coverage for interior water damage, unless the building first sustains damage by a “covered cause of loss.” The policy defines a “covered cause of loss” as a “risk of direct physical loss” unless the loss is excluded by the policy. In the definitions section, “specified causes of loss” include in relevant part a windstorm, hail, or water damage. Thus, the building would have to first sustain direct physical loss from a windstorm, hail, or water damage in order to be covered.

GMIC says the roof did not sustain damage by a “covered cause of loss.” Rather, exposed areas or openings in the roof created during replacement were insufficiently covered by tarps. Holes purposely created during a repair process does not fit the definition  of a “covered cause of loss.”

The Court declined to determine if the way in which the roof was covered by the tarps constituted a “roof” as defined under the policy. The Court determined that the creation of intentional holes do not constitute “damage” to the building as to be considered a “covered cause of loss” under the policy.

The record failed to support a finding that wind or rain storms caused damage to the roof, which allowed water to leak in. Rather, the repairs being done on the roof caused water to enter. The rain and snow storms were the source of the water that caused the interior damage to the building but were not a cause of “damage” to the roof.

GMIC’s motion for summary judgment was granted.

ZALMA OPINION

This case is another example of the failure of an insured to read the policy on which it was making a claim. The policy, in clear and unambiguous language, required that for there to be coverage for damage to the interior of the church by water and/or snow, there must first be damage to the roof by wind or some other peril insured against. Since the roofer’s action was not a peril insured against there was no coverage. The church is not, however, without a remedy. It can always sue the roofer for negligence in removing the roof and failing to protect the openings from rain or snow intrusion.


© 2019 – Barry Zalma

This article, and all of the blog posts on this site, digest and summarize cases published by courts of the various states and the United States.  The court decisions have been modified from the actual language of the court decisions, were condensed for ease of reading, and convey the opinions of the author regarding each case.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant  specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 50 years in the insurance business. He is available at http://www.zalma.com and zalma@zalma.com.

Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.

Over the last 51 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals.

 

 

About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.
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