No Alarm No Coverage
Barry Zalma, Esq., CFE
Insurance claims expert, consultant at Barry Zalma, Inc. and author/Publisher at ClaimSchool, Inc.
Posted on March 13, 2024 by Barry Zalma
Protective Safeguards Endorsement is a Condition Precedent
Post 4754
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Kinsale Insurance Company (“Kinsale”) sought declaratory relief against
In Kinsale Insurance Company v. Sea Brook Marine, L.L.C.; et al.? v. Central Monitoring, Incorporated et ap, No. 23-30436, United States Court of Appeals, Fifth Circuit (March 7, 2024) the Fifth Circuit explained the importance of a condition requiring protective safeguards.
BACKGROUND ?– THE POLICY
The insurance policy contained a “Protective Safeguards Endorsement,” requiring that Seabrook maintain an “Automatic Fire Alarm, protecting the entire building, that is: a. Connected to a central station; or b. Reporting to a public or private fire alarm station.” The summary judgment evidence
Seabrook contended that it “had a good faith belief that the property was covered by a centrally monitored fire alarm system, which included hardwired smoke detectors.”
Seabrook further argued that Kinsale either waived its right to exercise the protective safeguards endorsement or should be estopped from using it to deny coverage because the absence of a centrally monitored fire alarm system did not increase the “moral or physical hazard” under the policy. Specifically, Seabrook argued that “a centrally monitored [fire] alarm would not have alerted the New Orleans Fire Department any sooner in battling this conflagration” because the fire’s origin was outside of the Seabrook office building and the wind driven fire would have started on the office building’s exterior in the same area as the alarm monitoring equipment.
The district court determined that Seabrook’s maintenance of a centrally monitored, automatic fire alarm was a condition precedent to insurance coverage under the policy. It was undisputed that Seabrook did not satisfy that condition. It granted summary judgment in favor of Kinsale that the insurance policy it issued to Seabrook provided no coverage for the fire occurring at Seabrook’s facility.
DISCUSSION
Under Louisiana law an insurance policy is a contract and is construed using the general principles for contract interpretation. The parties’ intent, as reflected by the words of the policy, determines the extent of coverage. If the words of the policy are clear and unambiguous, it must be enforced as written.
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The Fifth Circuit noted that Seabrook appears to be asserting that Kinsale has no right to deny coverage for the fire unless it proves that Seabrook misrepresented information to Kinsale with the intent to deceive.
The Fifth Circuit disagreed.
Kinsale did not contend that Seabrook misrepresented information in its insurance application or in negotiating with Kinsale, and it does not seek to void or rescind its policy based on any such misrepresentation. Instead, Kinsale argues that it is entitled to deny Seabrook’s fire insurance claim because a condition precedent was not met and/or an exclusion applies.
It is undisputed that Seabrook did not have a centrally monitored fire alarm at the time of the fire. As the district court found, the absence of such an alarm undoubtedly increased the physical hazard under the policy.
The Fifth Circuit concluded that there can be no doubt that the lack of such an alarm increased the physical hazard of a fire spreading and causing further damage, as the lack of an alarm would result in either no notice or delayed notice to fire responders.
ZALMA OPINION
Protective Safeguards endorsements are not suggestions they are conditions precedent. As a result, failure to provide the protective safeguard required by the policy deprives the insured of coverage for a loss under the policy even if the alarm system would have been irrelevant to the effect of the condition. Every person acquiring insurance with such a protective safeguard endorsement must comply fully with the endorsement or agree it has paid for an insurance policy that provides no coverage for a loss.
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Partner at Taylor, Wellons, Politz & Duhe’s Northshore Office
12 个月Paula Wellons Jon Womack Congrats on the big win!
Safety and Health Specialist at State of Nevada
1 年If it's a term and condition specified in plain, clear English in the policy contract and the policyholder does not abide by it, the policyholder is SOL. Plain and simple. The policyholder's attorneys were the winners on this case and their frivolous argument making nice bank $$$ on their fees.