The Florida courts have not issued any consumer noteworthy insurance law for the last few weeks, so I thought I’d give you some insights into the “Anti Concurring Cause Clause”, which has become a recent focus in insurance litigation. Principally, it is a creation by insurers to ensure they will not be responsible for paying any part of a loss, as long as an excluded cause contributes in any way to the damage.
THE ANTI-CONCURRING CAUSE CLAUSE
Many insurers are dramatically limiting their exposure for claims by including specific anti-concurring causation clauses (“ACCC”). In order to understand the ACCC, it is necessary to review the concurring cause doctrine, review the validity of such exclusions, and look at application and effect of anti-concurring cause policy language.
The Concurring Cause Doctrine
The concurring cause doctrine applies where there are “independent” causes of damage which combine which cause a single loss. For example, where two independent causes such as an earthquake and an unrelated lightning bolt, independently combine to cause a house fire. Hrynkiw v. Allstate Floridian Ins. Co., 844 So. 2d 739, 743 (Fla. 5th DCA 2003). Causes are independent “when they are unrelated such as an earthquake and a lightning strike, or a windstorm and wood rot.” Paulucci v. Liberty Mut. Fire Ins. Co., 190 F.Supp.2d 1312, 1319 (M.D. Fla. 2002). Under the concurring cause doctrine there is coverage “when a loss results from multiple independent causes, as long as one of the causes is an insured risk.” Transamerica Ins. Co. v. Snell, 627 So. 2d 1275, 1276 (Fla. 1st DCA 1993); and Hrynkiw, above.
The concurring cause doctrine is contrasted to the “efficient proximate cause doctrine.” The efficient proximate cause doctrine applies where “dependent” causes combine to cause a single loss. For example, where a fire causes an explosion or (seen below) where vandalism causes flooding. Causes are dependent “when one peril instigates or sets in motion the other, such as an earthquake which breaks a gas main that starts a fire.” Paulucci, above.
In discussing insurance coverage pursuant to the concurring cause doctrine, the court in Wallach v. Rosenberg, 527 So. 2d 1386 (Fla. 3rd DCA 1988), stated: “[W]here an insured risk constitutes a concurrent cause of the loss even where ‘the insured risk [is] not … the prime or efficient cause of the accident.’ ” Id. (quoting 11 Couch, Couch on Insurance 2d §44:268 (rev. ed. 1982). Wallach went on to state: “[I]t seems logical and reasonable to find the loss covered by an all-risk policy even if one of the causes is excluded from coverage.” Wallach, at 1388.
Wallach‘s reasoning was followed in Paulucci. The Paulucci court, in comparing and contrasting the concurring cause and efficient proximate cause doctrines, gave the example:
“[W]here an excluded earthquake and covered fire were independent such as where loss is caused by an unrelated simultaneous earthquake and lightning strike, the efficient proximate cause doctrine would be inapplicable. In this scenario, the concurring causation doctrine would apply and mandate coverage regardless of which peril was covered and which peril excluded.”
Id. at 1319. See also, W. Am. Ins. Co. v. Chateau La Mer II Homeowners Ass’n, 622 So.2d 1105, 1108 (Fla. 1st DCA 1993)(holding that pursuant to the subject insurance policy and Florida law coverage existed for damage to balconies which resulted from both a covered cause (hidden decay) and an excluded cause (faulty design)).
In Paulucci, the court noted the concurring cause doctrine is the prevailing standard to evaluate loss in Florida when multiple perils are independent. Paulucci at 1318.
Anti-Concurring Cause Clause – The Language
In order to avoid the coverage consequences of the concurring cause doctrine, insurers abrogate the doctrine by inserting an ACCC. Typical ACCC language provides, under “Exclusions”:
“We will not pay for loss or damage caused directly or indirectly by any of the following. Such loss or damage is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss.”
See, e.g., ISO form CP 10 30 04 02. Following the exclusionary language, an extensive list of exclusions and qualifiers (including exclusions for earth movement, water, rot, fungus and bacteria, governmental action, etc.) sets forth those items that are not covered regardless of the cause of the loss. Id. It is also apparent from the language of the ACCC that the ACCC is intended to exclude not only concurrent causes, but also efficient proximate causes.
Anti-Concurring Cause Clause – Validity
In light of such exclusions, it is important to determine whether such ACCCs are valid in the state of Florida. The question turns on whether the concurring cause doctrine is a mandatory principal of insurance, a rule of interpretation of insurance contracts, or merely a default rule to utilize when interpreting coverage. See, e.g., David P. Rossmiller, “Interpretation and Enforcement of Anti-Concurrent Policy Language in Hurricane Katrina Cases and Beyond” at p. 57-58, New Appleman on Insurance: Current Critical Issues in Insurance Law”, citing Kenneth S. Abraham, Peril and Fortuity in Property and Liability Insurance, 36 Tort & Ins. L. J., 777, 778 (Spring, 2001).
Mandatory insurance rules cannot be set aside and cannot be altered by contractual agreement–if so, it would destroy the very principle of insurance. Few mandatory rules exist, such as: the insured must have an insurable interest in the property or thing insured; the insured may not recover more than the total amount of the loss; and the insured may not insure against losses that are intended (from the standpoint of the insured.) Id., citing Abraham at 780. Such mandatory rules are routinely upheld, because it would be violation of public policy to violate the mandatory rules. Clearly, the concurring cause doctrine is not a mandatory principle of insurance.
The concurring cause doctrine is also not a rule of interpretation. A rule of interpretation may not be altered by the parties, since it is a creature of ancient contract law and the judiciary. For example, the parties may not contract that any ambiguity in the insurance policy would be decided against the insured. Id. Such a provision would not stand up in the courts of law. Indeed, the concurring cause doctrine is not a guide to policy construction or interpretation, but actually presupposes policy construction and interpretation–the concurring cause doctrine is a “framework for analyzing the causal events that require interpretation of the policy to begin with.” Rossmiller at 58.
The concurring cause rule (and efficient proximate cause rule) is a default rule of coverage. And, unlike mandatory rules or rules of interpretation, parties can contract around a default rule. Id., citing Abraham at 780. See, for example, Couch on Insurance:
“The majority of jurisdictions permit the parties to an insurance contract to contract out of the efficient proximate cause doctrine. However, there are a few jurisdictions which have statutory provisions which specifically prohibit an insurer from contracting out of the efficient proximate cause doctrine. [California and North Dakota].”
7 Couch, Couch on Insurance 3d § 101:45 (rev. ed. 2007). Presumably, Couch’s pronouncement would hold true for the concurring cause doctrine as well.
Moreover, it is apparent from reviewing Florida court decisions, that F
lorida courts anticipate and accept contractual exceptions to the concurrent cause doctrine. In Wallach, above, the court applied the concurrent cause doctrine and specifically noted the policy did not contain a provision excluding concurrent causation. (“There is no contention here that the policy contains a provision which specifically excludes coverage where a covered and an excluded cause combine to produce a loss.” Id. at 1388). Additionally, in Chateau La Mer, above, the court held the concurrent cause doctrine was applicable in part because there was no policy provision which specifically excluded coverage where both a covered and an excluded cause combined to produce a loss. Id. at 1108 (emphasis added). Finally, in Paulucci, above, the court reviewed Wallach and Chateau La Mer II, and came to the conclusion “[U]nder Florida law, parties can contract around the concurrent cause doctrine through an express anti-concurrent cause provision.” Paulucci at 1320. The court also referenced the fact that courts applying Florida law (and the law of other states) have repeatedly upheld the validity of policy provisions which exclude coverage where a loss results from a combination of covered and non-covered causes. Id.
It is apparent that the parties may contract out of the concurring cause doctrine and efficient proximate cause doctrine, and the ACCC is valid in the state of Florida.
Anti-Concurring Cause Clause and the Valued Policy Law
Initially, in Florida it appeared that the ACCC may not have been as effective as insurers intended, especially when faced with a “total loss” situation. In Mierzwa v. Florida Windstorm Underwriting Ass’n, 877 So. 2d 774 (Fla. 4th DCA 2004), Florida’s Fourth District Court of Appeal the court reviewed an insurer’s exposure after a homeowner’s total loss during Hurricane Irene. The insured had wind insurance with one carrier and flood insurance with another, and the wind insurer’s policy contained an anti-concurrent cause clause excluding coverage for any damage other than by wind. The wind insurer argued it was liable only for its pro rata share, not for the face amount of the policy.
The wind storm policy language clearly provided the amount of liability could be less than the face amount of the policy if the actual amount of repair/replacement was less than policy limits. However, the court determined the insurance policy was subject to the 2003 version of the VPL which stated:
“In the event of the total loss of any building … located in this state and insured by any insurer as to a covered peril … the insurer’s liability, if any, under the policy for such total loss shall be in the amount of money for which such property was so insured as specified in the policy….”
Mierzwa at 765 (citing § 627.702(1), Fla. Stat. (2003)). The court noted the VPL is “part of every real property casualty insurance policy written on property in Florida.” Id. The court interpreted the VPL as a total loss requiring payment of the policy’s face amount regardless of liability and causation: “[T]he VPL provides that any liability of a casualty insurer where a covered peril is involved in a total loss must be for the face amount rather than pro rata with other coverages.” Id. at 776. The court then specifically analyzed the interplay between the ACCC and the VPL. The Mierzwa court provided two reasons why the ACCC was void in light of the VPL:
- The court found the policy’s ACCC did not explicitly say that it overrode the meaning of VPL. Thus, because the policy was silent on whether the insurer’s liability was merely pro rata with other coverage, or whether the VPL took precedence over the ACCC, there was a conflict between the VPL text and the ACCC text. The court determined the conflict created an ambiguity in the policy. The court followed the rule that where two interpretations could be given to an insurance contract, the interpretation which gives the greater indemnity prevails.
- The court also determined the insurer did not establish that wind damage alone did not result in the total loss of the building, just that the wind was responsible for a certain percentage of the building’s damages. Because of the possibility the wind damage alone could have resulted in the total loss of the building, the court determined the owner was entitled to the face amount of the policy on account of the windstorm damage.
Id. at 777-79.
The Mierzwa opinion was released on June 23, 2004. A Legislative fix soon followed. Effective June 1, 2005, the VPL was amended, removing the very language Mierzwa was focused on. Additionally, the liability for a total loss became proscribed by whether it was “caused by a covered peril”, and the following subsections were added:
“(b) The intent of this subsection is not to deprive an insurer of any proper defense under the policy, to create new or additional coverage under the policy, or to require an insurer to pay for a loss caused by a peril other than the covered peril. In furtherance of such legislative intent, when a loss was caused in part by a covered peril and in part by a noncovered peril, paragraph (a) does not apply. In such circumstances, the insurer’s liability under this section shall be limited to the amount of the loss caused by the covered peril. However, if the covered perils alone would have caused the total loss, paragraph (a) shall apply. The insurer is never liable for more than the amount necessary to repair, rebuild, or replace the structure following the total loss, after considering all other benefits actually paid for the total loss.
(c) It is the intent of the Legislature that the amendment to this section shall not be applied retroactively and shall apply only to claims filed after effective date of such amendment.”
Laws 2005, c. 2005-111, § 16.
Soon after the Legislative fix, the Florida Supreme Court stepped in and expressly disapproved of Mierzwa‘s interpretation of the VPL. In Fla. Farm Bureau Cas. Ins. Co. v. Cox, 967 So. 2d 815 (Fla. 2007), the supreme court held the prior version of the VPL was intended only to set the valuation of the insured property. The court also determined that the VPL did not intend for an insurer to pay for the total loss if a covered peril caused part of the total loss. The Cox court completely ignored the issue of the ACCC.
In light of the foregoing, the ACCC is a viable provision in Florida insurance policies.
Brief History of the ACCC
In response to judicial expansion of property damage coverage in the 1960s and 1970s, Insurers and the Insurance Service Office developed newer and tougher ACCC restrictions in the early 1980s. (Many property insurance policies prior to this time contained some form of ACCC language, but it did not cover the same breadth or scope as the language drafted in the 1980s. Rossmiller at 46, n.5) The new ACCC language was intended to bypass efficient proximate cause standard and a tort-like analysis of causation; restore the primacy of the policy’s contractual language; and prevent coverage of losses which the insurers never intended to cover. Rossmiller at 46.
This clear intent of the clause was set out by Michael E. Bragg, assistant counsel for State Farm Insurance Companies who wrote “Concurrent Causation and the Art of Policy Drafting: New Perils for Property Insurers”, 20 Forum 385 (Spring 1985) cited extensively throughout Rossmiller, above.
The ACCC is a draconian provision. Recall the ACCC language:
“We will not pay for loss or damage caused directly or indirectly by any of the following. Such loss or damage is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss.”
Broken into its simplest parts, if an excluded cause contributes to any portion of the loss, the loss is excluded in its entirety. No portion of the loss is compensable.
The ACCC language accomplished the insurer’s goal. Bragg, above, noted that the ACCC was intended to apply in “every situation where the loss would not have occurred ‘but for’ the excluded peril.” Mr. Bragg also claimed:
“The new language established a purging effect by making the occurrence of any of these excluded events an absolute prohibition to a finding of coverage. Thus, once a loss occurs which would not have happened in the absence of an excluded event, there is no coverage.”
Rossmiller at 71 (citing Bragg).
The sweeping effect of the ACCC was seen in Front Row Theatre, Inc. v. American Manufacturer’s Mut. Ins. Companies, 18 F.3d 1343 (6th Cir. 1993). In Front Row Theatre, the theatre property was flooded and the carpet damaged. The cause of the flood was attributed both to a covered event (water backing up from a sewer) and an excluded event (surface water). The court noted coverage was not warranted because of the explicit language of the flood exclusion:
“Despite our conclusion that a portion of the damage to the theater fell within the ‘water that backs up from a sewer’ exception, however, we cannot agree with Plaintiff that this conclusion mandates a ruling in their favor. As discussed above, a portion of the damage to the theater was also caused by surface water flooding. Thus, the language of the policy that specifically barred coverage where flooding was a contributory cause governs, and precludes payment.
* * * Damage to the theater’s carpeting was caused both by surface water, and by water that backed up from a sewer. However, under the specific language of the policy in the instant case where, as here, a contributing cause of the damage was a flood, [the insurer] explicitly contracted out of liability.”
Id. at 1348-49 (emphasis added). It is not clear from the facts whether Front Row Theatre involved the concurring cause doctrine or the efficient proximate cause doctrine. It is a common problem for courts to confuse the efficient proximate cause doctrine with the concurrent cause doctrine in reviewing ACCC provisions. (This fact is extensively dealt with in Rossmiller.) However, as noted above, the ACCC intents to eliminate the insurer’s duty to pay in either situation.
In TNT Speed & Sport Center, Inc. v. American States Ins. Co., 114 F.3d 731 (8th Cir. 1997), a vandal removed sandbags from a levee and, as a result, the levee collapsed and water damaged the insured’s buildings. The insurance policy covered losses caused by vandalism, but excluded flood losses. The policy’s ACCC also excluded coverage for damage arising concurrently from a covered and an excluded peril. After a review of state and extra jurisdictional cases, the Eighth Circuit held that the ACCC was valid and precluded recovery under the policy.
In Ramirez v. American Family Mut. Ins. Co., 652 N.E.2d 511 (Ind. Ct. App. 1995), the insured’s claimed their water damage was caused by ice accumulating on power lines, resulting in a power outage, which was a peril covered by the policy. The court, however, determined the water damage was caused by failure of a sump pump (regardless of the cause of its failure). Accordingly, the court held the ACCC excluded the loss for damage caused by a sump pump:
“The Ramirezes’ contention necessarily fails in light of the clear and unambiguous language of the exclusion. The exclusion unequivocally states that loss resulting from sump pump failure is not covered ‘regardless of any other cause or event contributing concurrently or in any sequence to the loss.’ Thus, the fact that the sump pump failure was preceded by a power outage resulting from the accumulation of ice on the power lines does not remove the Ramirezes’ claim from this exclusion….”
Id. at 516.
above, the parties moved for summary judgment on an ACCC provision in the policy. The insurer argued the insured’s building collapsed in part because of wet and dry rot and wear and tear, excluded causes under the ACCC, and therefore no coverage was available. The insured argued the ACCC was a violation of public policy and against Florida law, and argued the building collapsed due to excessive rain pooling on the roof during Tropical Storm (formerly Hurricane) Gordon. After deciding the ACCC clause was valid in Florida, and recognizing the exclusion would completely bar the insured’s claim (citing Front Row Theatre, above), the court determined the evidence was conflicting as to the prior condition of the structure before the collapse and as to the severity of the storm:
“[I]n evaluating whether the anti-concurrent cause provision provides a defense in the instant case, there must be a factual determination as to whether the loss was caused by an excluded cause. Ultimately, summary judgment is not warranted for either party on this affirmative defense because questions of fact remain as to the storm’s impact on the garage and as to the extent to which the structural condition of the garage was less than ideal.”
Id. at 1318.
In Citizens Property Ins. Corp. v. Manning, 966 So. 2d 486 (Fla. 1st DCA 2007), the trial court determined, on the authority of Mierzwa, above, that the 2004 version of the VPL required the insurer to pay the face amount of the policy because wind had contributed to a total loss of the house. The appellate court noted: “The record left no doubt that wind contributed to the total loss of the Mannings’ home, but was unclear as to what damage the wind alone caused.” Id. On the authority of Fla. Farm Bureau Cas. Ins. Co. v. Cox, above, which was not available at the time of the trial court’s ruling, the First District Court of Appeal reversed the trial court award. Significantly, the court referenced the ACCC and remanded the case to determine what portion of the loss, if any, was solely attributable to the covered cause of wind. Based upon the expert testimony set forth in the case, it is not apparent the plaintiff would be able to easily accomplish this task. Manning is a practical example of the effects of the ACCC on the insured’s and insurer’s burdens of proof, as explained below.
Burden of Proof
Typical insurance law holds that the burden is initially on the insured to prove that the insurance policy provides coverage for a claim. Once the insured shows coverage, the burden shifts to the insurer to prove an exclusion applies to the coverage. If there is an exception to the exclusion, the burden shifts back to the insured to demonstrate the applicability of the exception. See, e.g., East Florida Hauling, Inc. v. Lexington Ins. Co., 913 So. 2d 673 (Fla. 3rd DCA 2005).
Under the Concurring Cause Doctrine, the insurer was required to show the exclusion was the sole, proximate cause of the loss. In Wallach, above, the Third DCA approved the trial court’s jury charge which stated: “[The insurer] has the burden of proof to show by the greater weight of the evidence that the exclusion in the insurance policy was the sole, proximate cause of damage or loss to the property.” Id. at 1387. Significantly, under the Concurring Cause Doctrine, it was not incumbent upon the insured to apportion the loss (and would not benefit the insured to do so). In Guideone Elite Ins. Co. v. Old Cutler Presbyterian Church, Inc., 420 F.3d 1317 (11th Cir. 2005), the court held:
“The concurrent cause doctrine does not demand that we apportion the loss. See generally Wallach; see also Orient Mid-East Lines, Inc. v. Shipment of Rice on Board S.S. Orient Transporter, 496 F.2d 1032 (5th Cir. 1974) (holding shipowner liable for entire loss when it could not show how much of the damage resulted from a cause entitled to exemption); Fire Ass’n of Philadelphia v. Evansville Brewing Ass’n, 73 Fla. 904, 75 So. 196, 199 (1917) (finding that plaintiff could recover for the entire loss, even if the loss was facilitated in part by an explosion excluded by the policy); Armco Chile Prodein, S.A. v. M/V NORLANDIA, 880 F.Supp. 781, 791 (M.D.Fla. 1995) (if claimant is able to prove at least a concurrent cause of damage, the burden then shifts back to the carrier to apportion between amount of damages caused by the exception and those damages caused by the covered cause; failure of carrier to differentiate causes of damage renders the carrier liable for the entire damage).”
Guideone Elite at 1330-31 (emphasis added).
However, the burden of proof analysis is encumbered with dealing with an ACCC. Recall that once the insured shows coverage, the burden shifts to the insurer to prove an exclusion applies to the coverage and, if there is an exception to the exclusion, the burden shifts back to the insured to demonstrate the applicability of the exception. East Florida Hauling, above.
One of the clearest pronouncements of the parties’ respective burdens is set forth in a Texas federal case,
Lexington Ins. Co. v. Unity/Waterford-Fair Oaks, Ltd., 2002 WL356756 (N.D. Tex. 2002), wherein the court held:
“[The insurer] has the burden of proving that the exclusionary language contained in the Anti-Concurrent Cause Clause exempts [the insurer] from liability for interior damage to the second floor units caused by roof leaks. To do so under section (D) of the Anti-Concurrent Cause Clause, [the insurer] must establish the absence of a genuine issue of material fact concerning whether inadequate maintenance was a contributing cause to the roof leaks. In other words, [the insurer] must conclusively establish that inadequate maintenance was a contributing cause. If [the insurer] succeeds in making this showing, it is exempt from liability for all damages caused directly or indirectly by the excluded cause, i.e., inadequate maintenance, regardless of any other cause or event contributing concurrently or in any sequence to the loss. That this is the legal effect of the adoption of an Anti-Concurrent Cause Clause within a policy is well established in those jurisdictions that have considered the question.”
Id. at *4.
In Manning, above, the insured’s expert plainly stated he could not allocate the loss. Under the concurrent cause doctrine, the insurer would have been liable for the entire amount of damages for the indivisible loss. However, when the court analyzed the expert opinion under the ACCC, the court found the opinion insufficient to satisfy the insured’s burden to establish what property was solely damaged by the covered cause, wind. In other words, the insurer failed to meet its first burden to prove coverage under the policy:
“The record does contain an uncontroverted engineer’s affidavit to the effect that wind, wind-driven rain, and storm surge combined to destroy the [insureds’] home (and other evidence values the house at considerably more than the sum of the face amount of [the insurer’s] policy and the flood insurance proceeds), but the record is devoid of evidence establishing the amount of damage caused solely by wind. The engineer’s affidavit explicated his opinion that, while wind undoubtedly contributed to the destruction of the house, wind acted in combination with other forces, and that the precise effects of wind alone were difficult, if not impossible, to ascertain from the rubble:
‘It is an arduous task to determine the failure mode of
a structure when it lies in front of you. It is bordering on clairvoyance to state with certainty a particular mode of failure when you don’t even have the ability to examine the structure because it has been removed.
We all understand that a hurricane is a very complex and violent set of variables and is highly unpredictable at best. Therefore I am not prepared to say with any degree of certainty that the failure of this structure was due to a single source. To the contrary, I think this failure was caused by a whole series of events that will never be established for certain. I also think that to rule out the effects of hurricane force winds contributing to failure of this structure is simplistic and naive.’
The [insureds] never even alleged that the amount of damage attributable to wind alone exceeded the policy deductible. Since the record does not establish this threshold fact, it is not clear that the [insureds] are entitled to recover anything or that the burden to prove an exclusion will ever shift to [the insurer].”
Manning at 486 and n.3.
Hurricane Katrina litigation may help to clarify the uncertainty surrounding the burden of proof with the ACCC. Initially, in Tuepker v. State Farm Fire & Cas. Co., 2006 WL 1442489 (S.D.Miss. 2006), the court stated “[B]ecause this is an exclusion from coverage in a comprehensive homeowners insurance policy, and because the exclusion constitutes an affirmative defense, State Farm would bear the burden of proving that the exclusion applies to the plaintiffs’ claims.” When Tuepker was appealed to the Fifth Circuit, State Farm argued “[O]nce an insurer has provided evidence that an item of claimed damage resulted at least in part from an excluded peril, the burden shifts to the insured to produce evidence as to what portion of the damages were caused by perils covered by the policy.” Tuepker v. State Farm Fire & Cas. Co., 507 F.3d 346, 357 (5th Cir. 2007) The Fifth Circuit conveniently sidestepped the issue due to a high-low agreement between the parties: “The questions that the parties raise regarding the burden of proof are not relevant to the case and controversy at issue in this court….” Id.
In another Katrina case, Broussard v. State Farm Fire & Cas. Co., 2007 WL 113942 (S.D. Miss. 2007), the trial judge made specific findings regarding the burden of proof:
“6. Once the plaintiffs established this prima facie case [that the plaintiffs’ dwelling sustained wind damage during Hurricane Katrina and that ultimately the dwelling was a total loss], based on the stipulations in the pre-trial order, the burden shifted to [the insurer] to prove the merits of its affirmative defense based upon the water damage exclusion in the policy. That burden of proof requires [the insurer] to establish, by a preponderance of the evidence, what portion of the total loss is attributable to flood damage and is therefore outside the policy coverage….
7. All of [the insurer’s] evidence was directed to proving that 100% of the damage to the insured property was caused by rising water, yet [the insurer’s] own expert witness, Dr. Gurley, testified that it was more probable than not that the [insureds’] dwelling sustained at least some wind damage to its roof. In an attempt to quantify the likelihood of this wind damage having occurred, Dr. Gurley estimated that there was a 75% probability that the damage to the plaintiffs’ roof consisted of the loss of between 0% and 35% of the shingles on the roof of the dwelling. Dr. Gurley also testified that based on the data now available he cannot make a determination of the extent of wind damage to the [insureds’] dwelling before the storm surge arrived.
8. The evidence is overwhelming that when the flood reached the [insureds’] property it was sufficient in force and duration to destroy the dwelling regardless of the extent of the preceding wind damage. Thus, the force of the storm surge was sufficient to destroy the dwelling if it were undamaged at the time the water reached it, and it was sufficient to remove the debris of the property if the dwelling had collapsed or suffered extensive damage from the force of the wind before the storm surge arrived. The key issue is how much damage had occurred as a result of wind before the storm surge arrived. That preceding wind damage would be covered, and any additional damage caused by the arrival of the flood would be excluded.
9. In these circumstances, it is the allocation of the burden of proof that is critical, for one party or the other must bear this total loss in the absence of evidence by which the two types of losses may be reasonably identified and separated.
10. Because the plaintiffs have met their burden of proof under the policy, via the stipulations in the pre-trial order, the burden of proof was and is on [the insurer] to establish, by a preponderance of the evidence, that portion of the total loss that was attributable to excluded flooding and rising water. [The insurer] is obliged under its policy to pay all of the loss that it does not establish, by a preponderance of the evidence, to have been caused by flooding.
11. No evidence has been introduced from which any finder of fact could reasonably determine what part of the loss of the [insureds’] property is attributable to water as opposed to wind.
12. Accordingly, I find, as a matter of law, that [the insurer] has not met its burden of proof as to the segregation of this total loss into wind damages, which are covered, and water damages which are excluded from coverage. [The insurer] has also failed to establish or to offer evidence that would support a finding that the insured property sustained no wind damage.
13. Since [the insurer] has offered no evidence which would allow the finder of fact to make a reasonable determination of the amount of the total loss that is attributable exclusively to water damage, I find that [the insurer] has failed to meet its burden of proof as to the extent of the damage caused by water, and since the [insureds] have established by stipulation that they sustained a total loss of their dwelling and its contents as a result of Hurricane Katrina, a covered windstorm peril, I find that [the insurer] is liable to the plaintiffs for the limits of coverage under the policy….”
Id. at *2, 3 (citations omitted, emphasis added).
State Farm has appealed this Order, and the Fifth Circuit heard oral argument on December 5, 2007. The results should be enlightening regarding the insured’s and insurer’s respective burdens of proof under the ACCC.
It is apparent the anti concurring cause clause is valid in Florida, and will serve to contract around both the concurrent cause doctrine and the efficient proximate cause doctrine. Summary judgment would be appropriate in cases where there is no dispute whether an excluded peril caused the loss in any measure.