Forums

Interesting thread here. Moco, if the tree rots then falls, I'd think the damage to the tree was rot (excluded) or wind maybe (not a covered peril for tree damage). When the broken tree hits the house, the damage to the house would be from "falling object". In my mind, falling object would be proximate cause thus covered. Alternately, it might also be wind.

Arch marks on roof from overgrown trees blowing in the wind, I'd call damage over time, not covered. If the limbs are a couple of foot above the roof, but the wind blows them into the roof to damage it. I'd probably recommend covering that as sudden wind damage. I don't know if I'm right but that's what I'd do, and recommend to the homeowner that he cut that tree back before it happened again. Usually that's not the only damage to the roof on a claim, but additional to other wind damage.

I never have recommended paying to reseal, but will in the future if appropriate. Usually, if there are only a few shingles lifted and no break-back damage, I'd report it to the insured suggesting it would re-seal in time. From now on I'll just write those few shingles up as reseal...or minimum repair. During Ike, all those lifted shingles I saw with pine needles under them either had enough missing shingles on the slope to justify replacing the slope, or I could take close-ups of the breaks in the tab. I just didn't focus on the pine needles, except to be careful where I stepped.

When I started this business, I was taught debris under the shingles preventing reseal was damage. Now, I'm told it might not be. Solution: change the focus. Look for the break across the top of the tab. If it was wind, it'll be there.

What about Jim's battle with the bulge? If it be true that a little debris under the shingle isn't damage, then a bulge of debris would be a totally different consideration. A bulge like that might be sudden damage. We don't cover the thermal expansion, or the bulges due to expansion because those are over time maintenance issues. The sudden bulge of windblown debris might be a differnt matter. As to causing damage to the shingle over time, well I think that wouldn't be a coverage consideration at all due to the exclusion.

The first question would be: is there debris under the bulge?  We've got to know the answer to that to solve the puzzle.

The next question is: Is a large bulge under a shingle caused by a single occurrence of wind driven debris damage? Since most of us have never seen a bulge like that, we can't say it is a normal event. If a covered peril, wind, changed a normal roof to an abnormal roof, then it probably is damage. If there is physical damage, then don't we owe "to remove the debris"? Anyway our focus here has been on the bulge; if the wind blew that much debris under the shingle, then a closer look at the top of the tab might reveal some damage less controversial in nature.

Randy C
 

Posted By RandyC on 13 Nov 2009 02:28 PM
When the broken tree hits the house, the damage to the house would be from "falling object". In my mind, falling object would be proximate cause thus covered. Alternately, it might also be wind. 

That is my point, did winds cause it to fall, or did it fall from ongoing rot/deterioration? I would recommend payment if the area was hit with hard winds, but if only a particular home was damaged by a tree or limb from tree falling (tree located on the same premises of course), which was obviously rotten then i will canvas and speak with neighbors and research weather report's. If all lead to simply a rotten tree issue then i would not view this as a sudden, unexpected or accidental. My input on falling object is. Well the NI likley knew,or should have known the tree was rotted. They should have addressed it? The inevitable is going to happen. Does the NI not have an obligation to maintain the home and property to safeguard against damages that could be foreseen. If the tree was located on the neighbors property and was rotten then there are subrogation issues if wind was not the cause. If tree is, or appears healthy in all aspects then there should be coverage. But that is a different situation than a clearly rotten poorly maintained tree hovering over the roof.

Arch marks on roof from overgrown trees blowing in the wind, I'd call damage over time, not covered. If the limbs are a couple of foot above the roof, but the wind blows them into the roof to damage it. I'd probably recommend covering that as sudden wind damage.  Again , was wind the cause, or simple neglect? I don't know if I'm right but that's what I'd do, and recommend to the homeowner that he cut that tree back before it happened again. That is excatly right. Inform them of there obligation to safeguard and prevent unneccesary damage.

What about Jim's battle with the bulge? What caused the bulge? He did not clarify if the bulge was to the shingles or beneath them, perhaps on the sheathing itself. If winds blew  so much debris beneath the shingles that it accumulated and bulged, it does not seem they would still be sealed as Jim stated. If the roof sheathing itself is bulging then why? Winds strong enough to lift sheathing would certainly cause shingle damage that would be beyond capable of resealing. Obviously the eaves are not open, which would allow wind to lift sheathing with shingles attached from beneath, as Jim stated the gutter nails had backed from the fascia.If it be true that a little debris under the shingle isn't damage, then a bulge of debris would be a totally different consideration.  But shingles still sealed?? Seems unlikley. A bulge like that might be sudden damage. We don't cover the thermal expansion, or the bulges due to expansion because those are over time maintenance issues. Being the shingles are still sealed, as Jim stated. The question is WHAT caused the bulge? Sounds to me that thermal expansion or simply roof sheathing releasing over time has contributed, but he has not attached any photos of what he has listed, and i was not there. 

So the question is: Is a large bulge under a shingle caused by a single occurance of wind driven debris damage? Since most of us have never seen a bulge like that, we can't say it is a normal event. If a covered peril, wind, changed a normal roof to an abnormal roof, then it probably is damage. If there is physical damage, then don't we owe "to remove the debris"? Anyway our focus here has been on the bulge; if the wind blew that much debris under the shingle, then a closer look at the top of the tab might reveal some damage less controversial in nature.

Randy C

What if the tree falls, no wind, just gravity?

All perils, unless otherwise excluded.

I have paid about 6 of those "windless tree falling into house" events over the last 20 years. I have had them where "after the fact" it was obvious that the trunk was a hollowed out rotten piece of junk inside the bark, no-one ever seems to make an issue out of it.  The homeowner isn't claiming rot dmg to his tree. (3rd party claims may kick in liability for negligence, but not "your tree vs your house")

I remember at least 2 of them where trees mysteriously split in 1/2 or huge branch breaks off during very hot summer days with no wind, and the arborist says it is from 100 degree heat... who knows. but if it's an all-risk policy and a tree hits a house, you pretty much owe it.

Posted By RandyC on 13 Nov 2009 06:24 PM
The insured's duty to maintain property and prevent damage is an important point. Sometimes tree limbs just break. I have pecan trees and they break in the strangest places. I do try to keep them trimmed back from the house.

Then there are healthy trees where surface and sub-surface water collects over a period of heavy rain. Maybe the earth around the root ball shifts a little. Both of these causes of loss, earth movement and surface water are excluded. What if the tree falls, no wind, just gravity?

RandyC

LOL, Randy... Again, if the tree has no apparent issues and falls then yes, i would complete an estimate and recommend payment. But not if that tree is obviously dead and gone, and no wind contributed. If the tree is dead, rotten or whatever, though heavy winds were present  and verified(several other homes or property damaged, weather report) then this is a gray area and i could not say for certain that wind was not involved and would recommend payment. I have done this before. But i also have inspected the aforementioned with only my NI claiming damage from a fallen tree that my inspection revealed to be dead, rotten or poorly kept. Canvas revealed no other homes in the area being damaged from downed trees or winds making it obvious to me that the tree was dead or neglected and eventully fell. This is deemed by the majority of examiners i report to  well as my opinion, as NEGLECT and POOR MAINTENANCE but subject to change any day now as all else is.

If a tree just suddenly falls as you also asked? You stated "what if the earth around the root base shifts". Earth movement is normally excluded. Gravity felled tree is a new one to me. I guess i would allow payment in this case, but dunno if i would put in my report "Due to gravity blah blah blah". I could see where this may be also construed as earth movement.

Risk of loss, or open peril contracts, although I have heard it called open policy. I treach this : It can be fortutious but not inevitable, a  time  and date must be established by the insured, sudden and accidental is necessary, it must be not be intrended or expected from the stand point of the insured. shoddy workmanship (design) is a basic exclusion.

Ever adjuster worth his salt has to ask himself and answer himself on the above question, before spouting about open perils.

Posted By Ray Hall on 13 Nov 2009 08:52 PM

sudden and accidental is necessary, it must be not be intrended or expected from the stand point of the insured.

That statement pretty much says it like i interpret it. If the tree is obviously rotten from a glance. Am i the only one to notice? No, i believe the NI knew this as well and also should have been expecting it. Sudden and accidental i don't think so. Lighting strike, collision with tree and very strong winds causing it to fall are things i would call sudden and accidental, not standing dead for however long and eventually falling from the weight

Adding photos to your post.

In addition to the way moco wrote you can use the "Attachments" at the bottom of the message box or if all else fails email them to me at roy@catadjuster.org and I will add them to your post.

A few images of a fallen tree, which is healthy at the time of loss and payment was made. This by all means was related to winds. I will look in my external HD for older photos of rotten and neglected trees that fell causing damage for clarification of what i have been spatting about.

Because this issue of a rotten tree and subsequent damage to dwelling has been raised and discussed, I'd like us to address it in 'context' of say, a Homeowners - Special Form HO 00 03 10 00: at the link below you will find a sample form. I always find it's best to use actual real world variables (for us in the claims business that usually means reviewing the applicable coverage form(s)).

Much has been discussed with terms such as 'falling object', 'neglect' and 'ensuing loss' and perhaps, inferred 'intentional loss' - all such terms are discussed within the subject HO form.

I'd like MOCO or anyone else to point specifically to the provisions of subject HO3 form, as if I were the insured making a 1st party claim and you were writing a required declination (full or partial) to me. That is, explain to me with citations that a) the tree is/is not covered; b) the damage to the dwelling roof is/is not covered; c) if there is ensuing water damage to the interior, why it is/is not covered; and finally, d) there is/is not any Additional Coverage issue which should also be addressed.

Then, if you'd be so kind, provide me the same coverage analysis for a 3rd party claim scenario where say, the insured's rotten tree fell onto the neighbor's fence or structure or simply fell into the neighbor's yard.

You might want to comment whether or not the insured is a certified arborist or, at least, whether or not that enters into your coverage analysis.

Just to make this as 'real world' as possible, assume your letter will be reviewed by the State Insurance Commissioner and/or the insured's/claimant's legal representative. Also, you might want to comment whether or not you took a written or recorded statement from the insured.

Thank you.

server.iii.org/yy_obj_data/binary/7...sample.pdf

Posted By BobH on 13 Nov 2009 07:23 PM

What if the tree falls, no wind, just gravity?

All perils, unless otherwise excluded.

I have paid about 6 of those "windless tree falling into house" events over the last 20 years. I have had them where "after the fact" it was obvious that the trunk was a hollowed out rotten piece of junk inside the bark, no-one ever seems to make an issue out of it.  The homeowner isn't claiming rot dmg to his tree. (3rd party claims may kick in liability for negligence, but not "your tree vs your house")

I remember at least 2 of them where trees mysteriously split in 1/2 or huge branch breaks off during very hot summer days with no wind, and the arborist says it is from 100 degree heat... who knows. but if it's an all-risk policy and a tree hits a house, you pretty much owe it.

 

As my first boss used to say "what does the policy say about coverage/no covereage?". After we told him what we thought, then he would tell us if we were correct.

What does the policy say? Then folks can join in after reviewing your answer.

PDF of photos from Jim Acree.

I agree with you that generally speaking there would be coverage for the "named peril" of falling object.

If there is no wind or storm present, I don't know how much time the insured would have to cut that limb at the time of the loss. Maybe if he listened to it crack and pop for a few days, but otherwise I think I recommend covering it.

One of the carriers I have worked for asks that the adjuster submit an "Underwriting Review" if something is observed during an inspection that is a hazard, or that the property is not being maintained. Maybe you are there for a pipe leak, but see that the front steps are rotten and the roof is toast.

I have seen claims where prior claims existed for interior dmg from a poorly maintained roof, with Underwriting Reviews submitted, and they STILL haven't fixed the roof.

Getting back to the tree thing, it would have to be pretty gross neglect to deny coverage - but a DOCUMENTED observance of the property prior to the loss with warning to cut that dead tree down, especially after a piece of it hit one part of the house already, would be a "solid" example of what Moco is talking about.