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Exclusionary Clauses in Property Insurance Policies

Fri Jan 5th, 2018 on     Property Insurance,    

In Florida, as is the case in other jurisdictions, almost all property insurance coverage includes exclusionary clauses that are meant to constrict the ability of policyholders to claim a covered loss.  Depending on the language of the insurance contract at-issue, your claim may be clearly excluded from coverage, or the exclusionary clause may be ambiguous enough that a skilled attorney can convince a court of law to find on your behalf.

Fortunately for Florida policyholders, ambiguities in the language of the exclusionary clause are more favorably interpreted for the policyholders, as opposed to the insurer.  Let’s take a look at how it all works.

Ambiguities and Exclusionary Clauses in Florida

According to the Florida Supreme Court in Swire Pacific Holdings, Inc. v. Zurich Insurance Company, an established principle of insurance law is that — where the insurance contract may be construed either as providing or limiting coverage — the particularities of coverage must be strictly construed against the insurer.  More specifically, exclusionary clauses are construed even more strictly against the insurer than coverage clauses.  As such, ambiguities in the language of your exclusionary clause are much more likely to be construed in your favor.  An insurer cannot therefore benefit from ambiguous exclusionary clauses in the insurance contract that are intended to induce you into entering the contract, only to later interpret them in ways that circumscribe coverage and prevent you from claiming a loss.

The Concurrent Cause Doctrine

In Florida, the concurrent cause doctrine is applied when there are independent perils that each contribute to a particular loss.  Essentially, even if several of the “concurrent causes” are excluded — whether due to a coverage clause or an exclusionary clause — so long as one of the concurrent causes is covered under the policy, then you may put forth a legitimate insurance claim.

There has been some controversy over application of the concurrent cause doctrine, as many critics argue that nearly all losses can be attributed to some peril that falls within an insurance plan’s coverage.  Regardless, the continued application of the concurrent cause doctrine is certainly helpful for policyholders who have had their claims wrongfully denied by an insurer on the basis of an exclusionary clause interpretation — with the aid of an attorney, you can conduct an investigation into the facts and potentially argue that there were multiple perils that led to the losses at-issue, and that at least one such peril was covered by the insurance plan.

If you have had your property insurance claim wrongfully denied on the basis of an exclusionary clause (or for some other stated reason), you may be able to revise and resubmit your insurance claim, or, depending on the circumstances, pursue litigation against your insurer to recover damages.  In Florida, and elsewhere, exclusionary clauses are commonly used by insurers to constrict the ability of policyholders to make a legitimate insurance claim.  Denial of coverage is frequently premised on the applicability of an exclusionary clause written into the insurance contract.

Ver Ploeg & Lumpkin, P.A. is an insurance litigation firm with over two decades of experience representing policyholders in a variety of litigation, from bad faith scenarios to wrongful denial on the basis of messy exclusionary clause language.  Here at Ver Ploeg & Lumpkin, P.A., we are deeply committed to our clients, and go to great lengths to ensure that their needs are prioritized from beginning-to-end of the engagement process.

Call (305) 577-3996 to get connected to an experienced Miami property insurance lawyer.  Your initial consultation is free.  During this consultation, your attorney will evaluate your various insurance claims and assist you with developing a plan for securing a payout (or damages, if necessary).

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