Insurer is ‘Torturing’ Policy Using Pollution Exclusion to Deny Death Claims

By | December 22, 2008

  • December 22, 2008 at 12:32 pm
    Jeff Betts says:
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    As a former employee of Great American, I am embarrased by this. As an insurance agent, I am shocked by this. As a person, this is exactly what gives insurance a bad name in the public opinion polls!

    The author of this article is 100% correct if the briefs are accurate to start.

  • December 22, 2008 at 12:52 pm
    Ray Johnson says:
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    I don’t disagree.
    However,the real unfair aspect is that the building owner and their Insurer are being held liable for these deaths that a criminal court has already agreed were caused by the intentional act of an employee of the building owners tenant. I realize I am beating a dead horse with that approach but the “deep pockets” mentality is totally unfair and results in higher insurance costs for all of us.

  • December 22, 2008 at 1:03 am
    Blind Justice says:
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    The developers at the time of the building’s construction had bamboozled Harris County Texas into not requiring sprinklers in this six story building. This is a failure of regulation that is unarguable because new buidlings must be sprinklered and change of occupancy in older buildings requires retrofitting sprinklers–now, a little bit late for these three people.

    So a few developers made off with a few $$$ more by blocking regulation (through the incredibly corrupt staunchly Republican commissioner’s court–one commissioner has come out in public to say that the FBI is investigating him and they have enough to get him–this is for real). The current landlord is left holding the liability bag because they did not provide adequate safety protection and three people are dead and three families are now wrecked.

    Another triumph for the local unregulated Republican free market and its corruption of the political process.

    Put me on this jury, please!

  • December 22, 2008 at 2:08 am
    Rick Y says:
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    Wow! Why isn’t GA looking for defense (or even summary judgement for dismissal) based on lack of evidence to support liability. It would seem that evoking the pollution exclusion has potential for bad faith in Texas as it has been widely considered that smoke caused by a hostile fire (which this clearly and unequivocally is) is NOT pollution. Either the GA defense team knows something that is not revealed or they are potentially really screwing up it would seem.

  • December 22, 2008 at 3:34 am
    Nugget says:
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    Since you’ve diverted this into politics… Let’s clarify:
    1. Corruption is not unique to Republicans, both major parties have their fair share of crooks.
    2. Corruption was the cause of not having a sprinkler, not a “unregulated Republican free market”- you yourself said they ignored the regulation.
    3. If you travel outside the U.S. you’ll find that some of the most corrupt political systems in the world were and are also the most regulated.
    4. The problem isn’t Republicans or Democrats or deregulation- it’s corruption, which we can only hope to limit with a system of checks and balances which neither allows too much room for bad behavior nor allows the concentration of power in the hands of the corrupt.

  • December 22, 2008 at 3:36 am
    wudchuck says:
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    i think the issue is pollution vs fire. it’s not a matter of if the sprinkler system was in place or not. it was an intentional fire that was set. pollution – NO! if this were true, then why in the past have we seen insurance companies pay out. it looks like great american is slowing the process down. if this is the case, i can see a bigger payout for delaying the inevitable.

  • December 22, 2008 at 5:34 am
    Roy says:
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    Blind hatred is more like it…

    Why someone’s political vitrial would cause them to turn a personal tragedy and a challenging coverage debate to instead be about hating one political party is beyond belief.

    Get over yourself, “blind justice”.

  • December 23, 2008 at 9:21 am
    okt0ber says:
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    I have the expectation that if my building catches on fire, the owners have done all within their power to try and have a system in place to suppress the fire. They should have retrofitted the building with sprinklers when they bought it, or they should have passed on the purchase. I would be sueing them, too. But, then again, I’m from Houston, so maybe I’m a little too expecting of my landlord.

  • December 23, 2008 at 11:48 am
    Rick Y says:
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    Politics and negligence aside……isn’t the question whether or not a carrier can stand a chance of defeding themselves on a coverage issue stating that bodily injury (death in this case) caused by smoke inhalation from a hostile fire is categorically excluded? What if they had been killed by the flames? Am Gen’s stance is not condioned upon negligence or a lack therof, it is prediacted on their apparent belief that bodily injury caused by smoke is excluded. They are not arguing liability or looking for other parties. They are hanging their hat on an eclsuion that is clearly an important one but was certainly crafted with no intnet to exclude this type of loss if, in fact, there is negligence. They better pray for an extremely conservative court that is willing to throw the doctrine of adhesion out the window and then they will need to contine to pray that the Texas Supreme Court will feel the same way. That would seem very unlikely so its a good guess that they are just posturing for a negotiated settlement and have zero intnet of taking this to trial. Surprise, Surprise!

  • December 23, 2008 at 12:17 pm
    The Underwriter says:
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    We don’t have complete details, but I have seen claims adjusters misuse the pollution exclusion before. Can any broker sell an Umbrella from a carrier who takes this approach to claims? Stop selling the policies and the company either gives a better explanation or retracts their denial.

  • December 23, 2008 at 4:21 am
    Peon Agent says:
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    Well said, Nugget & Roy.

  • December 29, 2008 at 9:17 am
    Tony A says:
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    Looking at the ISO CGl form, CG 0 01 10 01, at least…thought that the exceptions to the pollution exclusion, (iii) BI or PD arising out of het, smoke or fumes from a hostile fire”…would leave no doubt as to the coverage. While I haven’t reviwed a total or absolute pollution exclusion. SO not sure if that language amends the exception. Although on the surface, Great American’s appraoch seems contridictory to exception to the exclusion.

  • December 29, 2008 at 9:59 am
    Rick Y says:
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    Regardless of what a compnay places in a so called “absolute” exclusion, the court will generally look very unfavorably at a positon that is totally contrary to past precedent and industry practice(such as the language clearly established by ISO Form CGl form, CG 0 01 10 01 and its exception to what was called an absolute exclusion). Wouldn’t be unlike a Texas court to evoke some “contrary to public policy” ruling on this type of carrier position. Hard to imagine Great American will really run with this. Most likely just positioning toward negotiated settlement.

  • December 29, 2008 at 10:15 am
    wudchuck says:
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    when u say hostile fire? do you mean an arson? or act of war?

  • December 29, 2008 at 10:41 am
    Icee says:
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    One example I read early on in my career for the difference between a “hostile” fire and a “friendly” fire was: a fire in a fireplace is a friendly fire, when the fire escapes the fireplace and burns your livingroom carpet, it becomes a hostile fire.

  • December 29, 2008 at 11:08 am
    Rick Y says:
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    In control vs out of control
    Doing what is intended (fireplace, kiln, controlled burn, barbeque grill) vs what is not intended and/or controlled (garage wall burning as a result of the grill flaring up). Smoke from a friendly fire would be smoke coming from the chimney of a building that was from its fireplace.



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