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ISO Mold Filings CAS Ratemaking 2002

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Page 1: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

ISO Mold Filings

CAS Ratemaking 2002

Page 2: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Agenda

Claims Situation Goal of Filings Present Coverage, Proposed Changes Personal Lines, Commercial Property, CGL Current Approvals

Page 3: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Property Problems Associated with Mold

Costs of remediation and clean up are considerable

Proper precautionary and disposal procedures must be followed to avoid further exposure and additional losses

The longer the delay in inspecting a loss, the more difficult it is to prove the mold was caused by a covered loss

Page 4: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Property Claims

Generally, property damage claims for mold arise from two types of incidents: Exposure to water following the sudden intrusion of

water such as from fire-fighting or the breaking apart of a water system component within the premises

Accumulation of moisture over a prolonged period such as would occur because of faulty, inadequate or defective materials, construction, maintenance or repair

Page 5: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

CGL Claims

A products-completed operations exposure for contractors and subcontractors

A premises/operations exposure for owners or lessees of premises

Claimants may allege bodily injury, property damage, and personal and advertising injury

Multiple plaintiffs mean potential for class action lawsuits

Page 6: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

CGL Claims (Cont’d) Third party actions may be filed for

contribution regarding damages Bodily injury claims similar to pollution

claims because they allege future damages A key problem is the lack of scientific

evidence demonstrating a causal relationship between mold and serious health effects

Page 7: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

CGL Claims (Cont’d)

No standard guidelines for cleanup and disposal, therefore, further contamination and additional claims may result

A small number of court decisions have addressed mold

Insufficient number of cases to date to be able to identify a trend in court decisions with respect to the application of the pollution exclusion to mold

Page 8: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

ISO Research

We have held a number of panel meetings and done extensive research

Lack of consumer education, and of federal and state guidelines for evaluating the potential health risks of mold or its remediation

Inconclusive reports from the medical and scientific communities

Paranoia from public due to media coverage

Page 9: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Goal of ISO Filings Well-reasoned, balanced solution that restores

predictability Decreases financial incentives for trial lawyers

and mold remediation “experts” Limited coverage options intended to put property

owner on the road to recovery Caps the catastrophic potential for insurers Supports insurance availability Addresses the mold problem before it spreads

Page 10: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Fungi Endorsements Developed to offer insurers and insureds

options regarding mold-related exposures Provide a means for the industry, particularly

in those areas of the country where this type of exposure occurs more often, to place a limit on the amount of coverage offered

Insurers can continue to write water damage coverage

Bacteria included

Page 11: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Homeowners 2000 Program Property Coverage

Damage caused by mold, fungus and wet rot, resulting from a covered peril: water to fight fire wind-driven rain accidental discharge storm drain back-up off the residence premises

Mold-related claims may trigger coverages under Building, Contents, Additional Living Expense, Liability, and Medical Payments

Page 12: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Personal Lines Changes Optional endorsement Sub-limits provide limited first ($10,000) and third

($50,000) party mold coverage, both on an annual aggregate basis

Options to purchase additional limits The current mold, fungus or wet rot preclusion is

deleted and a Fungus, Wet or Dry Rot Section I Exclusion is introduced

The limited mold coverage will address mold losses including testing that result from any covered peril

Page 13: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Personal Lines Changes (Cont’d) A constant or repeated seepage or leakage

preclusion has been added but limited coverage exists if the seepage or leakage and resultant damage is hidden from view and not known

For fire and lightning, if there is water damage and mold following a fire, the total of all damages is subject to the full policy limit

A definition of "Fungi" has been added

Page 14: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Definition of Fungi

"Fungi" means any type or form of fungus, including mold or mildew, and any mycotoxins, spores or scents or byproducts produced or released by fungi, but does not include any fungi that is, is on, or is contained in any goods or products intended for consumption. (Exception for liability only.)

Page 15: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Personal Lines Changes (Cont’d)

Underlying base loss costs do not reflect the increased cost to provide remediation of mold losses as we now understand them

Loss costs being calculated for various limit options

Page 16: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Personal Lines Data Collection

We are introducing a new Mold Damage Coverage Code to capture the extent of coverage for losses due to mold or bacteria.

We are introducing new Cause of Loss Codes to segregate loss assessment expenses from remediation expenses, and to identify the peril causing the damage.

We are introducing new Cause of Loss Codes to identify these losses as either Bodily Injury-related or Property Damage-related.

Page 17: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial Property Coverage Policy intent and practice is to cover fungus

only in the immediate aftermath of a covered cause of loss

Like Debris Removal, mold claims are changing in size and character to the point where the cost of mold remediation may exceed other damages

Commercial Property policies cover a mold loss that results from a covered peril

Page 18: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial Property Coverage (Cont’d)

Not all mold losses are covered. Exclusions in the Special Form: Loss resulting from fungus, rust, corrosion,

decay, hidden or latent defect that causes property to damage or destroy itself

Damage due to continuous or repeated seepage of water over a period of 14 days or more

Loss arising from faulty design, construction and materials

Page 19: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Undermining Coverage Intent An overly broad interpretation of water damage

coverage in the Broad and Special Forms has been used to undermine the mold exclusion

An overly broad interpretation of water damage coverage has been used to defeat the exclusion for construction error. An exception to the exclusion provides coverage where the faulty design, construction or maintenance results in a covered peril

Page 20: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial Property Revisions Modify the present wear and tear exclusion to

eliminate reference to fungus and retain reference to the remaining conditions

Introduce a separate exclusion addressing fungus (a newly defined term), and wet and dry rot with an exception for loss from specified perils, to the extent provided in an "Additional Coverage”

Require that, to be covered, the insured use all reasonable means to preserve the property from further loss

Page 21: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial Property Revisions (Cont’d) The new Additional Coverage:

is subject to a sub-limit of $15,000 per premises, runs to specified causes of loss (includes windstorm, sudden/accidental on-

premises water damage, leakage from fire extinguishing equipment) with the addition of accidental discharge from an off premises system break, and

includes post-remediation testing for the presence of mold

The sub-limit includes all expenses related to mold, including tearing out and replacing parts of the building to allow access; does not increase the limit of insurance; and applies on an aggregate limit basis

Page 22: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial Property Revisions (Cont’d)

Reinforces the 14-day continuous and repeated water leakage exclusion by adding “discharge” and explicitly referring to the presence or condensation of humidity, moisture or vapor

Ensuing loss covered, if mold results in a specified cause of loss

For fire and lightning, if there is water damage and mold following a fire, the total of all damages is subject to the full policy limit

Page 23: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial Property Revisions (Cont’d)

These changes also impact Time Element coverage. If mold is the only loss, a 30-day limit applies. If in combination with other damage, if mold is not remediated by the time the other property is restored, an additional period of restoration of 30 days for mold only is provided

No change in base loss costs; recent mold data not included in current loss costs

Page 24: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial General Liability

Possible legal liabilities (covered or not): negligence, strict liability, breach of warranty, constructive eviction, failure to disclose, breach of contract, fraud, workers compensation, and violation of air quality laws.

Page 25: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

CGL Exclusions

Pollution: Is mold an irritant or contaminant? Some courts

hesitant to consider common natural organisms a pollutant

Does a discharge, dispersal, release or escape take place as the exclusion specifies? Mold does emit toxins during its reproductive cycle

Your Product Your Work (exception for sub-contractor)

Page 26: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

CGL Changes

Two optional fungi endorsements in addition to the current coverage:

A Fungi Exclusion endorsement that totally excludes coverage for injury or damage caused by fungi

A Limited Fungi Coverage endorsement that puts a limit of liability on coverage for bodily injury and property damage caused by fungi, and excludes coverage for fungi under Personal and Advertising Injury

Both use the identical definition of fungi Endorsements will be a-rated

Page 27: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Fungi Exclusion

Excludes all: bodily injury or property damage arising out of

mold related clean-up costs and associated expenses

States that the Personal and Advertising Injury coverage does not apply to mold

Page 28: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Limited Fungi Exclusion

Provides a BI and PD Fungi Liability Limit that applies regardless of whether any other cause, event, material or product contributed concurrently or in any sequence to the injury or damage

States that the Personal and Advertising Injury Coverage does not apply to mold claims

Page 29: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Commercial Lines Data Collection We are introducing a new Mold Damage Coverage

Code to capture the extent of coverage for losses due to mold or bacteria.

For commercial property coverage we are introducing new Type of Loss Codes to identify mold damage, including the antecedent peril causing the consequential mold damage

For commercial liability coverage we are introducing new Type of Loss Codes to identify mold as the cause of either a bodily injury or property damage

Page 30: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Current Approvals

April effective date Commercial Property = 22 (Forms) General Liability = 22 Homeowners = 21

July effective date BOP Farm

Page 31: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

Current Approvals (Cont’d)

The Commercial Property filing will be supplemented to provide rating information for mold increased limit options and, at that time, the effective date will be revised to June 1, 2002.

Page 32: ISO Mold Filings CAS Ratemaking 2002. Agenda  Claims Situation  Goal of Filings  Present Coverage, Proposed Changes  Personal Lines, Commercial Property,

ISO Mold Filings

CAS Ratemaking 2002