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“Ensuing Loss” Exception to Coverage Exclusion for Water Damage Did Not Apply to Water Damage Stemming from an “Explosion” of a Water Main Outside Plaintiffs’ Home—The “Ensuing Loss” Exception in the Policy Referred Only to Water Damage which Stemmed from a Covered Peril (Like a Fire)

The Court of Appeals, in a full-fledged opinion by Judge Read, with a concurring opinion, determined the water-damage exclusion in the homeowner’s policy precluded recovery for water entering plaintiffs’ basement when a water main burst outside the home.  Plaintiffs argued that an exception in the policy for water damage resulting from an “explosion” allowed recovery.  The Court of Appeals held that the “explosion” exception was part of an “ensuing loss” exception referring to water damage which necessarily followed a covered event, like an explosion or fire, and did not cover water damage stemming from an “explosion” of a water main outside the home:

First, “[i]n determining a dispute over insurance coverage, we first look to the language of the policy” … . Concomitantly, we “construe the policy in a way that affords a fair meaning to all of the language employed by the parties in the contract and leaves no provision without force and effect” … .

Second, although the insurer has the burden of proving the applicability of an exclusion …, it is the insured’s burden to establish the existence of coverage … . Thus, “[where] the existence of coverage depends entirely on the applicability of [an] [*5]exception to the exclusion, the insured has the duty of demonstrating that it has been satisfied” … .

And finally, “[w]here a property insurance policy contains an exclusion with an exception for ensuing loss, courts have sought to assure that the exception does not supersede the exclusion by disallowing coverage for ensuing loss directly related to the original excluded risk” …

In this case, plaintiffs’ loss occurred when water from a burst water main flowed onto their property, flooding the basement of their home. Accordingly, their loss clearly falls within item 4 of the water loss exclusion, which bars coverage for “loss to the property . . . consisting of or caused by . . . 4. Water . . . on or below the surface of the ground, regardless of its source . . .[, including] water . . . which exerts pressure on, or flows, seeps or leaks through any part of the residence premises” … .

Turning … to the sudden and accidental exception, this clause is properly characterized as an ensuing loss provision, which “provide[s] coverage when, as a result of an excluded peril, a covered peril arises and causes damage” … . Platek v Town of Hamburg, 2015 NY Slip Op 01483, CtApp 2-19-15

 

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