Does an Insurance Policy Cover Only “Loss” or “Damage” to Property? | SLG

Property insurance policies are written in complex language. The fact that there are so many different interpretations and disputes about the language by some very bright people is probably enough evidence to prove that point. David Rossmiller wrote a post, Corban v. USAA: A few (more) words about anti-concurrent causation, which had me thinking about words used in an insurance policy and what a policy covers. He stated:

“The most important thing is the court realized the key thing to look for is to identify the “loss,” because that is what the policy covers, not “damage.” The Supreme Court also well understood that once loss has occurred and is covered, it can never become uncovered no matter what happens later.” (emphasis added)

When considering a policy that covers “accidental physical risks of loss,” I wonder what a “loss” would be if there were no “damage” that occurred with it. I cannot think of such a situation. Therefore, I do not think Rossmiller is right. When advocating for his insurance company clients, I am certain Rossmiller would argue that there must be “damage” for a “loss” to occur.

Indeed, this situation arises in many cases where adjusters determine whether “damage” is pre-existing (resulting from wear and tear) and not covered or caused by a non-excluded peril and covered. “Causes” of loss necessarily means “physical damage” in most property insurance policies, and this is what adjusters and courts should focus upon when considering coverage issues involving concurrent causation language. Property can be damaged by a sequence of causes.

For those who want a practical perspective about anticoncurrent clause situations, I suggest Concurrent Causation Analysis Applied by FC&S—Learning From an Insurance Industry Source. Additionally, as I noted in the comment I wrote for the Mississippi Law Journal and cited in Anticoncurrent Causation Clause Explained in Relation to Hurricane Losses, Rossmiller wrote excellent discussions of the topic for more academic types.

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