MAGNOLIA MANUFACTURING OF NORTH CAROLINA, INC., Plaintiff, v.
ERIE INSURANCE EXCHANGE, ERIE INSURANCE PROPERTY AND CASUALTY
COMPANY, and ERIE INSURANCE GROUP, Defendants
NO. COA05_887
The trial court properly denied summary judgment in favor of plaintiff company, but
improperly granted it to defendant insurer on the issue of whether plaintiff suffered accidental
loss of business income due to a roof collapse covered under plaintiff's insurance policy with
defendant, because: (1) defendant waived its right to enforce plaintiff's strict compliance with the
proof of loss provision in the insurance contract by denying liability on grounds not relating to
the proofs during the period prescribed by the policy for the presentation of proofs of loss; (2)
with regard to accidental loss, plaintiff offered evidence that it had no notice that work on the
roof of the building in which plaintiff's business was located would result in roof collapses to the
extent that it would require a complete vacating of the second floor for an extended period of
time which was sufficient evidence of an accident to survive defendant's summary judgment
motion; (3) plaintiff presented evidence that it lost the use of the second floor, and defendant, the
moving party, presented no argument why that loss does not constitute loss or damage of
plaintiff's property; (4) plaintiff offered evidence in the form of a deposition that the roof
collapses were due to hidden decay as well as water damage, both covered under the pertinent
policy; and (5) defendant offered no authority requiring expert testimony to establish that one of
the listed causes existed in this case, nor has it made any argument explaining why coverage
could not be determined in the absence of expert testimony.
Appeal by plaintiff from order entered 20 April 2005 by Judge
Michael R. Morgan in Orange County Superior Court. Heard in the
Court of Appeals 9 February 2006.
The Brough Law Firm, by Robert E. Hornik, Jr., for plaintiff-
appellant.
Bailey & Dixon, L.L.P., by David S. Coats, for defendants-
appellees.
GEER, Judge.
Plaintiff Magnolia Manufacturing of North Carolina, Inc.
("Magnolia") appeals from a grant of summary judgment in favor of
defendants Erie Insurance Exchange, Erie Insurance Property andCasualty Company, and Erie Insurance Group (collectively "Erie").
Because we hold that genuine issues of material fact exist as to
whether Magnolia suffered accidental loss of business income due to
a roof collapse covered under Magnolia's insurance policy with
Erie, we hold that summary judgment was improper.
Facts and Procedural History
Magnolia is a closely held North Carolina corporation founded
in 1993 by Robin Dashman, the company's president. Magnolia's
business involved the creation and sale of silk plants, florals,
and trees to a national market. In 1996, in order to accommodate
its growing business, Magnolia moved into a two-story building in
Hillsborough, North Carolina, known as the Saratoga Mill building.
The building was built in 1908 and was owned by the Hillsborough
Owners Company ("HOC"). A year after moving into the second floor
of the building, Magnolia expanded to take over the ground floor as
well.
At that time, the second floor of the Saratoga Mill building
had a dropped ceiling made of ceiling tile that was suspended from
the bottom side of the wooden roof decking. Above the wooden
decking was a roof membrane exposed to the outer air. In late
2000, Magnolia notified HOC that planks from the wooden roof
decking were falling onto the dropped ceiling and sometimes
breaking through the dropped ceiling into the second floor working
space. In response, HOC contracted with ADM Building Contractors,
L.L.C., ("ADM") to repair the roof. ADM began work in January 2001
and quickly discovered that the roof was in much worse conditionthan anyone had originally anticipated. ADM recommended that the
entire roof of the Saratoga Mill building be replaced.
After soliciting bids, HOC ultimately contracted with ADM to
replace the roof. According to Magnolia's evidence, the original
plan was for ADM to work across the roof in small sections, with
Magnolia taking the precaution of moving second-floor inventory and
equipment out from underneath the work as ADM progressed along the
roof. Accordingly, in anticipation of the start of the work,
Magnolia cleared out a portion of the second floor, including the
break room, glass room, pour room, and acrylics department.
A day or two later, in late February 2001, ADM began the roof
replacement. On the morning of the first day of work, a large
portion of rotted wood roof planks fell through the dropped ceiling
and into the break room, pulling down the interior wiring and
lighting fixtures with the ceiling. No one was injured, and no
inventory or equipment was damaged, but Dashman sent her employees
home for the day.
The following business day, Magnolia moved all of its
equipment and inventory out of the second floor. It also began to
daily shift its equipment and inventory around on the first floor
to stay out from underneath the path of construction. Over the
course of the spring of 2001, as ADM moved across the roof in the
course of replacing it, rotted wood continued to fall into the
building. Dashman estimated that there were about 40 separate
instances of wood planks falling onto or through the dropped
ceiling onto the second floor. Sometimes, only a few planks wouldfall through at once, and other times, the ceiling of an entire
room would crash down.
ADM finished the new roof decking and outer membrane by April
2001. The associated electrical work, rehanging of the dropped
ceiling, and refinishing of the interior of the second floor was
not complete until August 2001. Although HOC paid for the roof
replacement, Magnolia paid for most of the refitting of the second
floor.
From January to August 2001, Magnolia's productivity went into
decline. According to an affidavit from Dashman:
As a result of the roof collapse, Magnolia's
production capability was crippled. We lost
time moving the second floor operations to the
first floor. Then, as the roof replacement
project progressed, we had to shuffle material
and equipment on the first floor to protect it
from dirt and debris which managed to fall or
otherwise migrate from the second floor to the
first floor. Magnolia's staff spent so much
time moving equipment and materials, that we
could not fill orders fast enough to satisfy
our customers. As we lost customers, I had to
lay off experienced personnel. By mid-to-late
June 2001, Magnolia had only a skeleton crew
working to fill the few remaining orders we
had.
Throughout the relevant time period, Magnolia was covered by
an "Ultrapack Business Policy" from Erie. In early March 2001, as
ADM was in the process of replacing the old roof, Dashman contacted
Erie's agent over the telephone to file a loss of income claim
under the policy. Soon afterwards, a representative from Erie
photographed the premises. On 14 March 2001, Dashman received a
letter from David Smeltz, a senior property claims specialist at
Erie, stating that Erie was denying Magnolia's claim because "theloss of income is being caused by the work being conducted by the
contractor which is excluded under the policy."
In September 2001, Magnolia hired the entire sales force of a
competitor. In October 2001, it opened a new showroom that was
triple the size of the old one. In February 2002, Magnolia
terminated its lease with HOC and moved its business out of the
Saratoga Mill building and into a new location in Efland, North
Carolina. Despite these efforts to revive and expand its business,
by the end of 2002 Magnolia was no longer in operation. In early
2003, it filed for bankruptcy.
During this time period, Magnolia continued to request
indemnification from Erie for its income losses. In September
2001, Erie denied coverage in a telephone conversation with
Magnolia's attorney, on the grounds that no collapse covered by
Magnolia's policy had taken place. After this September phone
call, the next recorded contact between the parties is a letter
from Erie dated 5 February 2002 that stated:
The original notice of claim [for loss of
income] was investigated and determined to be
outside the coverage provided.
. . . No damages have been presented for
our consideration of . . . any claim for loss
of business income.
. . . In order to trigger business
income protection, [policyholders] must first
sustain damage resulting from a covered peril.
The letter also referenced Magnolia's apparent lack of any business
personal property losses and stated, "I am enclosing a Proof of
Loss form for Mrs. Dashman to complete should she wish to presentfurther claims for consideration." Magnolia did not respond to
this letter or to a 1 April 2002 letter, enclosing another Proof of
Loss form and stating that if Erie did not hear from Magnolia in
the near future, it would assume Magnolia had no further claims and
close the outstanding claim.
Magnolia filed a complaint against Erie on 12 January 2004.
Ultimately, the parties filed cross-motions for summary judgment.
On 20 April 2005, the trial court denied Magnolia's motion and
granted Erie's motion. Magnolia filed a timely appeal to this
Court.
(See footnote 1)
Discussion
"This Court's standard of review on appeal of summary judgment
is well-established. Summary judgment is properly granted if
considering the pleadings, depositions, answers to interrogatories,
and admissions on file, together with affidavits, there is no
genuine issue of material fact and a party is entitled to judgment
as a matter of law."
Moore v. Coachmen Indus., Inc., 129 N.C. App.
389, 393-94, 499 S.E.2d 772, 775 (1998). "The moving party bears
the burden of showing the lack of triable issue of fact. . . .
Once the moving party meets its burden, the [nonmoving party] must
produce a forecast of evidence demonstrating that the nonmoving
party will be able to make out at least a prima facie case attrial. The evidence is to be viewed in the light most favorable to
the nonmoving party."
Id. at 94, 499 S.E.2d at 775 (alteration in
original) (internal quotation marks and citation omitted).
In this case, Erie contends that the trial court properly
granted summary judgment because (1) Magnolia failed to comply with
the insurance policy's requirement that it file a proof of loss
form, and (2) it failed to establish that it suffered an accidental
loss as a result of a collapse due to a covered reason. Magnolia,
on the other hand, contends that Erie waived the proof of loss
requirement and that genuine issues of material fact exist as to
whether the following policy provision entitled Magnolia to
recovery under its Ultrapack Business Policy:
We do not cover . . . loss caused directly or
indirectly . . . by collapse. We will cover
loss from collapse caused by fire; lightning;
windstorm; hail; explosion; smoke; aircraft;
vehicles; riot; civil commotion; vandalism or
malicious mischief; breakage of building
glass; falling objects; weight of snow, ice,
or sleet; water damage; hidden decay; hidden
insect or vermin damage; sprinkler leakage;
sinkhole collapse; volcanic action; weight of
people or personal property; weight of rain
that collects on a roof; or use of defective
material or methods in construction,
remodeling, or renovation if the collapse
occurs during the course of the construction,
remodeling, or renovation.
I.
Proof of Loss Requirement
It is well-established in North Carolina that an insurance
contract provision requiring the insured party to file a proof of
loss with the insurance carrier should be construed as existing for
the benefit of the insurer.
Brandon v. Nationwide Mut. Fire Ins.
Co., 301 N.C. 366, 370-71, 271 S.E.2d 380, 383 (1980). An insurermay "be found to have waived a provision or condition in an
insurance policy which is for its own benefit."
Id. at 370, 271
S.E.2d at 383.
See also Hicks v. Home Sec. Life Ins. Co., 226 N.C.
614, 616-17, 39 S.E.2d 914, 915-16 (1946) (holding that life
insurance company waived its right to enforce provision that
insured could not hold more than one policy at once from the same
company).
Our courts have found that the proof of loss requirement may
be waived "'by any conduct on the part of the insurer or its
authorized agent inconsistent with an intention to enforce a strict
compliance with the insurance contract in such regard.'"
Brandon,
301 N.C. at 370-71, 271 S.E.2d at 383 (quoting 44 Am. Jur. 2d
Insurance § 1509 (1969)). Specifically, "[a] well-recognized
situation giving rise to a justifiable claim of waiver . . . occurs
when the insurer denies liability, on grounds not relating to the
proofs, during the period prescribed by the policy for the
presentation of proofs of loss."
Id. at 371, 271 S.E.2d at 383-84
(holding that issue of fact existed as to whether insurance company
had waived right to enforce proof of loss requirement when company
repeatedly rejected insured's incomplete proof of loss forms,
without telling the insured its grounds for rejecting his claim).
See also Gerringer v. N.C. Home Ins. Co., 133 N.C. 407, 414-15, 45
S.E. 773, 776 (1903) ("A distinct denial of liability and refusal
to pay on the ground that there is no contract, or that there is no
liability, is a waiver of the condition requiring proofs of loss."
(internal quotation marks omitted)). This rule exists because adenial of a claim "is equivalent to a declaration that [the
insurer] will not pay, though the proofs be furnished; and to
require the presentation of proofs in such a case, when it can be
of no importance to either party, and the conduct of the party in
whose favor the stipulation is made has rendered it practically
superfluous, is but an idle formality, the observance of which the
law will not require."
Id. at 415, 45 S.E. at 776 (internal
quotation marks omitted).
Although, generally, "'[w]aiver is a mixed question of law and
fact[, w]hen the facts are determined, it becomes a question of
law.'"
Cullen v. Valley Forge Life Ins. Co., 161 N.C. App. 570,
575, 589 S.E.2d 423, 428 (2003) (alterations in original) (quoting
Hicks, 226 N.C. at 619, 39 S.E.2d at 918),
disc. review denied sub
nom. Santomassimo v. Valley Forge Life Ins. Co., 358 N.C. 377, 598
S.E.2d 138 (2004). In the present case, according to the terms of
the insurance contract, Magnolia had 90 days from the date of its
loss to file a signed and sworn proof of loss statement. It is
undisputed that Erie denied Magnolia's claim for loss of income in
writing on 14 March 2001, about two weeks after Dashman telephoned
regarding the claim and well within the 90-day period. In case
there was any mistake as to the 14 March 2001 denial, Erie also
repeated its denial of the claim by phone in September 2001 and,
again, by letter in February 2002. As reasons for its denial, Erie
relied upon the absence of a covered peril, the same ground relied
upon by Erie before the trial court and this Court. Thus, the uncontroverted facts indicate that Erie "denie[d]
liability, on grounds not relating to the proofs, during the period
prescribed by the policy for the presentation of proofs of loss."
Brandon, 301 N.C. at 371, 271 S.E.2d at 383-84. Filing proofs of
loss would have been an act of futility in light of the specificity
of the denials of coverage. Accordingly, Erie waived its right to
enforce Magnolia's strict compliance with the proof of loss
provision in the insurance contract. Magnolia is thus not barred
from litigating its claims under the contract.
II.
Accidental Loss
Magnolia's policy states that Erie will cover "loss from
collapse." The policy defines "loss" as "direct and accidental
loss of or damage to insured property." Erie contends first that
any "collapse" that may have taken place was not an accident, but
rather was foreseeable as the natural result of ADM's roof repair.
Magnolia, however, contends that the magnitude of the roof
collapses, rendering the second floor workspace unusable, were
unforeseeable to it and, therefore, constituted an accidental loss.
In the context of accident insurance, our Supreme Court has
defined an "accident" as "an unplanned and unforeseen happening or
event, usually with unfortunate consequences."
Gaston County
Dyeing Mach. Co. v. Northfield Ins. Co., 351 N.C. 293, 302, 524
S.E.2d 558, 564 (2000).
See also Clay v. State Ins. Co. of
Indianapolis, 174 N.C. 642, 645, 94 S.E. 289, 290 (1917) (defining
an accident as "an unusual and unexpected occurrence _ one that
takes place without the foresight or expectation of the personaffected[;] . . . [a]n event which, under the circumstances, is
unusual and unexpected by the person to whom it happens" (internal
quotation marks omitted)). The Court has also stated, in the
context of an accidental death insurance policy:
An injury is "effected by accidental
means" if in the line of proximate causation
the act, event, or condition from the
standpoint of the insured person is
unintended, unexpected, unusual, or unknown. .
. . Injuries caused to the insured by the
acts of another person, without the consent of
the insured, are held due to accidental means
unless the injurious acts are provoked and
should have been expected by the insured.
Fallins v. Durham Life Ins. Co., 247 N.C. 72, 75, 100 S.E.2d 214,
217 (1957). In
Pleasant v. Motors Ins. Co., 280 N.C. 100, 102, 185
S.E.2d 164, 166 (1971), the Court further stressed that "whatever
is unexpected or unforeseen is determined from the standpoint of
the named insured in the policy."
The question in this case is thus whether the collapses were
"unexpected or unforeseen" by Magnolia. While Magnolia offered
evidence that it knew some material might fall to the floor from
the ceiling during ADM's roof repair, it also offered evidence that
the company did not expect that entire portions of the roof would
collapse into the second floor workspace, bringing down the
electrical wires and lighting with the falling roof, rendering the
entire second floor unusable, and disrupting work on the first
floor.
Dashman testified that Magnolia had expected only that it
would have to reposition its equipment and work around the second
floor so that it was not directly under ADM's work. Dashmanexplained, however, that, on the first day that the roof
replacement project began, she and the other Magnolia employees
were forced to halt work and move all inventory and equipment from
the second floor to the first floor of the Saratoga Mill building
_ actions indicating that they failed to anticipate possible roof
collapses ahead of time. While Erie points to an affidavit of
Allen D. Myers of ADM that the roofing project was "completed
timely and without incident," that affidavit gives rise to an issue
of fact and cannot establish that Erie is entitled to summary
judgment.
See Ward v. Durham Life Ins. Co., 325 N.C. 202, 209, 381
S.E.2d 698, 702 (1989) ("'In ruling on summary judgment, a court
does not resolve questions of fact but determines whether there is
a genuine issue of material fact.'" (quoting
Dickens v. Puryear,
302 N.C. 437, 453, 276 S.E.2d 325, 335 (1981)).
Erie also argues that
Bagelman's Best, Inc. v. Nationwide Mut.
Ins. Co., 167 N.C. App. 370, 605 S.E.2d 266, 2004 N.C. App. LEXIS
2126, 2004 WL 2793214 (2004) (unpublished), supports its position
that no accident occurred. There, we decided that an insured was
not entitled to coverage for lost business income from a five-day
power loss that was announced ahead of time by the power company,
because that loss was not unexpected by the insured and therefore
was not "accidental."
We note initially that unpublished opinions are not
controlling authority.
Erie Ins. Exch. v. Miller, 160 N.C. App.
217, 222, 584 S.E.2d 857, 860 (2003).
See also N.C.R. App. P.
30(e)(3) ("An unpublished decision of the North Carolina Court ofAppeals does not constitute controlling legal authority.").
Further, while the plaintiff in
Bagelman's Best knew in advance
that it would suffer a complete loss of power for five days,
Magnolia offered evidence that it had no notice that the roof work
would result in roof collapses to the extent that it would require
a complete vacating of the second floor for an extended period of
time.
See Am. Mfrs. Mut. Ins. Co. v. Morgan, 147 N.C. App. 438,
441, 556 S.E.2d 25, 28 (2001) (holding in the insurance context
that an "accident" includes an intentional act if the injury is not
intentional or substantially certain to be the result of the
intentional act),
cert. denied, 355 N.C. 747, 565 S.E.2d 191
(2002).
We hold that Magnolia has forecast sufficient evidence of an
accident to survive Erie's summary judgment motion. Erie, however,
argues further that any accident did not result in a covered loss
because there was no loss or damage to Magnolia's personal property
or inventory. The policy defines "property damage" to include
"loss of use of tangible property which is not physically injured
or destroyed." Magnolia has presented evidence that it lost the
use of the second floor, and Erie, the moving party, has presented
no argument why that loss does not constitute loss or damage to
Magnolia's property. This argument, therefore, is not a sufficient
basis for upholding the trial court's grant of summary judgment.
III.
Cause of the Collapse
Erie also denied coverage on the grounds that, even if an
accidental collapse occurred, Magnolia has failed to demonstratethat the collapse resulted from a cause covered by the policy.
Magnolia, however, offered evidence in the form of Dashman's
deposition that the roof collapses were due to hidden decay as well
as water damage, both covered under the Ultrapack policy. In
addition, an affidavit from Dashman stated: "When ADM started to
remove the roof membrane on the top side of the roof, the rotted
wood decking below the membrane seemed to disintegrate and break
apart. . . . As far as I know,
nobody was aware of exactly how bad
the decay of the roof-decking was until ADM was tearing off the
roof membrane beginning in late February 2001." (Emphasis
original.) Finally, Erie submitted to the court a photograph
bearing the caption, "Old roof decking showing signs of rot."
While Erie asserts that Magnolia "has not identified any
contractor or other expert to opine that [one of the covered
causes] was the cause of this alleged collapse," it has cited no
authority requiring expert testimony to establish that one of the
listed causes existed in this case. Nor has it made any argument
explaining why coverage could not be determined in the absence of
expert testimony. Indeed, there appears to be no dispute that the
deterioration of the roof decking was due to decay and water
damage. While a case might arise in which expert testimony would
be required, Erie, the moving party, has failed to demonstrate that
it is necessary in this case. We, therefore, conclude that
Magnolia has presented sufficient evidence to survive summary
judgment as to whether the roof collapse was the result of a cause
covered under the policy.
Conclusion
To summarize, in light of the many conflicting factual issues
presented by both parties' affidavits, depositions, and other
evidence, we are of the opinion that this case cannot be resolved
at the summary judgment stage. We hold that the trial court
properly denied summary judgment to Magnolia, but improperly
granted it to Erie. This case is, accordingly, remanded for
further proceedings consistent with this opinion.
Affirmed in part, reversed in part, and remanded.
Judge HUDSON concurs.
Judge TYSON dissents in a separate opinion.
TYSON, Judge dissenting.
The majority's opinion reverses the trial court's grant of
summary judgment for defendants and holds plaintiff's allegations
presented a genuine issue of material fact. The majority's opinion
ignores the plain and unambiguous meaning of the provision of the
insurance contract between the parties. I vote to affirm the trial
court's order and respectfully dissent.
I. Standard of Review
The movant of a motion for summary judgment bears the burden
to establish no genuine issues of material fact exist and that it
is entitled to judgment as a matter of law. Hines v. Yates, 171
N.C. App. 150, 157, 614 S.E.2d 385, 389 (2005). The movant can
meet this burden by either: 1) proving that an essential elementof the opposing party's claim is nonexistent or 2) showing through
discovery that the opposing party cannot produce evidence
sufficient to support an essential element of his claim nor
[evidence] sufficient to surmount an affirmative defense to his
claim. Id.
When a motion for summary judgment is made and
supported as provided in this rule, an adverse
party may not rest upon the mere allegations
or denials of his pleading, but his response,
by affidavits or as otherwise provided in this
rule, must set forth specific facts showing
that there is a genuine issue for trial. If
he does not so respond, summary judgment, if
appropriate, shall be entered against him.
Id.; see N.C.R. Civ. P. 56(c) (2005). On appeal, an order
allowing summary judgment is reviewed de novo. Howerton v. Arai
Helmet, Ltd., 358 N.C. 440, 470, 597 S.E.2d 674, 693 (2004).
II. Contract Interpretation
The interpretation of language used in an insurance policy is
a question of law, governed by well-established rules of
construction. N.C. Farm Bureau Mut. Ins. Co. v. Mizell, 138 N.C.
App. 530, 532, 530 S.E.2d 93, 95, disc. rev. denied, 352 N.C. 590,
544 S.E.2d 783 (2000). 'An insurance policy is a contract and its
provisions govern the rights and duties of the parties thereto.'
Herring v. Liner, 163 N.C. App. 534, 538, 594 S.E.2d 117, 120
(2004) (quoting Gaston County Dyeing Machine Co. v. Northfield Ins.
Co., 351 N.C. 293, 299, 524 S.E.2d 558, 563 (2000)). The language
in the policy is to be construed as written 'without rewriting the
contract or disregarding the express language used.' Id. (quotingFidelity Bankers Life Ins. Co. v. Dortch, 318 N.C. 378, 380, 348
S.E.2d 794, 796 (1986)).
The Court determines whether coverage exists under an
insurance policy for a claim by examining the four corners of the
complaint in the underlying action to determine whether the
allegations contained in the claim are covered under the plain and
ordinary language used in the policy. See Waste Management of
Carolinas, Inc. v. Peerless Ins. Co., 315 N.C. 688, 340 S.E.2d 374
(1986). 'Where a policy defines a term, that definition is to be
used. If no definition is given, non-technical words are to be
given their meaning in ordinary speech, unless the context clearly
indicates another meaning was intended.' Herring, 163 N.C. App.
at 538, 594 S.E.2d at 120 (quoting Gaston County Dyeing Machine
Co., 351 N.C. at 299, 524 S.E.2d at 563). When we [are required
to] construe provisions of an insurance policy, 'the goal of
construction is to arrive at the intent of the parties when the
policy was issued.' Id. (quoting Woods v. Insurance Co., 295 N.C.
500, 505, 246 S.E.2d 773, 777 (1978)).
'Provisions which exclude liability of insurance companies
are not favored and therefore all ambiguous provisions will be
construed against the insurer . . . .' Id. (quoting State Capital
Ins. Co. v. Nationwide Mutual Ins. Co., 318 N.C. 534, 538, 350
S.E.2d 66, 68 (1986)). 'Exclusions from, conditions upon and
limitations of undertakings by the [insurance] company, otherwise
contained in the policy, are . . . construed strictly . . . to
provide coverage.' Herring, 163 N.C. App. at 538, 594 S.E.2d at120 (quoting Trust Co. v. Insurance Co., 276 N.C. 348, 355, 172
S.E.2d 518, 522-23 (1970)).
The insurance contract between the parties at bar states:
We do not cover . . . loss caused directly or
indirectly regardless of any cause or event
contributing concurrently or in any sequence
to the loss:
. . . .
8. by collapse. We will cover loss from
collapse caused by fire; lightening;
windstorm; hail; explosion; smoke; aircraft;
vehicles; riot; civil commotion; vandalism or
malicious mischief; breakage of building
glass; falling objects; weight of snow, ice or
sleet; water damage; hidden decay; hidden
insect or vermin damage; sprinkler leakage;
sinkhole collapse; volcanic action; weight of
people or personal property; weight of rain
that collects on a roof; or use of defective
material or methods in construction,
remodeling or renovation if the collapse
occurs during the course of the construction,
remodeling or renovation.
Any damage plaintiff suffered from a collapse is expressly
excluded from coverage unless plaintiff proves her claim fits into
the enumerated exceptions.
Plaintiff alleges in her affidavit that a portion of the roof
of the second story of the building collapsed into the second story
of the building. Under the contract's plain and unambiguous
language, loss caused directly or indirectly from collapse is
expressly excluded from coverage. Under plaintiff's own sworn
admissions, its claim is not a covered loss under the contract.
Plaintiff failed to present any evidence that its loss
resulted from one of the exceptions to the collapse exclusion. Inan affidavit, Allen D. Myers, Managing Member of ADM Building
Contractors, L.L.C., stated:
[p]rior to the Roof Repair Project, the roof
had not collapsed in any manner but was in
poor condition and in need of repair . . . .
During the course of the Roof Repair Project,
ADM took down portions of the old roof and put
in a new roof. ADM was able to assist
[plaintiff] during the Roof Repair Project to
help ensure that Magnolia sustained no damage
to any of their inventory or personal
property.
(Emphasis supplied). It is undisputed that plaintiff's loss did
not occur until ADM began construction to replace the roof. Under
the contract's plain and unambiguous language, plaintiff's loss is
excluded.
On 14 March 2001, defendants denied plaintiff's claim because:
(1) the contract excluded plaintiff's claim and (2) plaintiff's
loss was caused by the contractor's work on the roof. Exclusions
numbered 4 and 12 in the insurance contract state, in pertinent
parts:
We do not cover . . . loss caused directly or
indirectly regardless of any cause or event
contributing concurrently or in any sequence
to the loss:
. . . .
12. by faulty, inadequate, or defective
. . . .
b. design, development of specifications,
workmanship, construction;
. . . .
d. maintenance;
of property whether on or off the insured
premises by anyone.
We do not cover . . . loss caused:
. . . .
4. to the interior of the building or the
contents by rain, snow, sand, or dust, whether
driven by wind or not, unless the exterior of
the building first sustains damage to its roof
or walls by a covered loss. We will pay for
loss caused by or resulting from the thawing
of snow, sleet, or ice on the building.
As Myers's uncontradicted affidavit shows, the roof on the
building plaintiff leased had not collapsed and plaintiff
suffered no covered losses prior to the commencement of work on the
Roof Repair Project. Myers testified the roof was in poor
condition and in need of repair. Undisputed evidence shows
plaintiff's losses were caused by a poorly maintained roof and
during the work to repair or replace it. Construing the contract's
plain and unambiguous language, losses caused by collapse, faulty
or inadequate maintenance, or construction are expressly excluded
from coverage.
Defendants incurred no liability under the policy for
plaintiff's loss. These losses occurred and resulted for
activities expressly excluded from coverage. Plaintiff's loss is
also expressly excluded under contract exclusion numbered 4.
Reviewing plain and unambiguous provisions contained in the four
corners of the contract, plaintiff's loss is excluded from
coverage. The trial court properly granted summary judgment in
favor of defendants.
III. Conclusion