Tag Archives: national flood insurance program

Catastrophe Models Allow Breakthroughs

“In business there are two ways to make money; you can bundle or you can unbundle.” –Jim Barksdale

We have spent a series of articles introducing catastrophe models and describing the remarkable benefits they have provided the P&C industry since their introduction (article 1, article 2, article 3, article 4). CAT models have enabled the industry to pull the shroud off of quantifying catastrophic risk and finally given (re)insurers the ability to price and manage their exposure to the violent and unpredictable effects of large-scale natural and man-made events. In addition, while not a panacea, the models have leveled the playing field between insurers and reinsurers. Via the use of the models, insurers have more insight than even before into their exposures and the pricing mechanics behind catastrophic risk. As a result, they can now negotiate terms with confidence, whereas prior to the advent of the models and other similar tools, reinsurers had the upper hand with information and research.

We also contend that CAT models are the predominant cause of the reinsurance soft market via the entry of alternative capital from the capital markets. And yet, with all the value that CAT models have unleashed, we still have a collective sour taste in our mouths as to how these invaluable tools have benefited consumers, the ones who ultimately make the purchasing decisions and, thus, justify the industry’s very existence.

There are, in fact, now ways to benefit customers by, for instance, bundling earthquake coverage with homeowners insurance in California and helping companies deal with hidden volatility in their supply chains.

First, some background:

Bundling Risks

Any definition of insurance usually addresses the concept of risk transfer: the mechanism that ensures full or partial financial compensation for the loss or damage caused by event(s) beyond the control of the insured. In addition, the law of large numbers applies: the principle that the average of a large number of independent identically distributed random variables tends to fall close to the expected value. This result can be used to show that the entry of additional risks to an insured pool tends to reduce the variation of the average loss per policyholder around the expected value. When each policyholder’s contribution to the pool’s resources exceeds the expected loss payment, the entry of additional policyholders reduces the probability that the pool’s resources will be insufficient to pay all claims. Thus, an increase in the number of policyholders strengthens the insurance by reducing the probability that the pool will fail.

Our collective experiences in this world are risky, and we humans have consistently desired the ability to shed the financial consequences of risk to third parties. Insurance companies exist by using their large capital base, relying on the law of large numbers, but, perhaps most importantly, leveraging the concept of spread of risk, the selling of insurance in multiple areas to multiple policyholders to minimize the danger that all policyholders will experience losses simultaneously.

Take the peril of earthquake. In California, 85% to 90% of all homeowners do NOT maintain earthquake coverage even though earthquake is the predominant peril in that state. (Traditional homeowners policies exclude earth movement as a covered peril). News articles point to the price of the coverage as the limiting factor, and that makes sense because of that peril’s natural volatility. Or does it make sense?

Is the cost of losses from earthquakes in California considerably different than, say, losses from hurricanes in Florida, in which the wind peril is typically included in most homeowners insurance forms? Earthquakes are a lot more localized than hurricanes, but the loss severity can also be more pronounced in those localized regions. Hurricanes that strike Florida can be expected with higher frequency than large damage-causing earthquakes that shake California. In the final analysis, the average projected loss costs are similar between the two perils, but one has nearly a 100% take-up rate vs. the other at roughly 10%. But why is that so? The answer lies in the law of large numbers, or in this case the lack thereof.

Rewind the clock to the 1940s. If you were a homeowner then, the property insurance world looked very different than it does today. As a homeowner back then, you would need to virtually purchase separate policies for each peril sought: a fire, theft and liability policy and then a windstorm policy to adequately cover your home. The thought of packaging those perils into one convenient, comprehensive policy was thought to be cost-prohibitive. History has proven otherwise.

The bundling of perils creates a margin of safety from a P&C insurer’s perspective. Take two property insurers who offer fire coverage. Company A offers monoline fire, whereas Company B packages fire as part of a comprehensive homeowners policy. If both companies use identical pricing models, then Company B can actually charge less for fire protection than Company A simply because the additional premium from Company B affords peril diversification. Company B has the luxury of using premiums from other perils to help offset losses, whereas Company A is stuck with only its single-source fire premium and, thus, must make allowances in its pricing that it could be wrong. At the same time, Company B must also make allowances in the event its pricing is wrong, but can apply smaller allowances because of the built-in safety margin.

This brings us back to the models. It is easy to see why earthquake and other perils, such as flood, was excluded from homeowners policies in the past. Without models, it was nearly impossible to estimate future losses with any sort of reliable precision, leaving insurers the inability to collect enough premium to compensate for the inevitable catastrophic event. Enter the National Flood Insurance Program (NFIP), which stepped in to offer flood coverage but never fundamentally approached it from a sound underwriting perspective. Instead, in an effort to make the coverage affordable to the masses, the NFIP severely underpriced its only product and is now tens of billions of dollars in the red. Other insurers bravely offered the earthquake peril via endorsement and were devastated after the Northridge earthquake in 1994. In both cases, various market circumstances, including the lack of adequate modeling capabilities, contributed to underpricing and adverse risk selection as the most risk-prone homeowners gobbled up the cheap coverage.

Old legacies die hard, but models stand ready to help responsibly underwrite and manage catastrophic risk, even when the availability of windstorm, earthquake and flood insurance has been traditionally limited and expensive.

The next wave of P&C industry innovation will come from imaginative and enterprising companies that use CAT models to economically bundle risks designed to lower the costs to consumers. We view a future where more CAT risk will be bundled into traditional products. As they continue to improve, CAT models will afford the industry the confidence needed to include earthquake and flood cover for all property lines at full limits and with flexible, lower deductibles. In the future, earthquake and flood hazards will be standard covered perils in traditional property forms, and the industry will one day look back from a product standpoint and wonder why it had not evolved sooner.

Unbundling Risks

Insurance policies as contracts can be clumsy in handling complicated exposures. For example, insurers have the hardest time handling supply chain and contingent business interruption exposures, and rightly so. Because of globalization and extreme competition, multinational companies are continuously seeking value in the inputs for their products. A widget in a product can be produced in China one year, the Philippines the next, Thailand the following year and so on. It is time-consuming and resource intensive to keep track of not only how much of a company’s widgets are manufactured, but also what risks exist surrounding the manufacturing plant that could interrupt production or delivery. We would be hard-pressed to blame underwriters for wanting to exclude or significantly sublimit exposures related to supply chain or business interruption; after all, underwriters have enough difficulty just to manage the actual property exposures inherent in these types of risks.

It is precisely this type of opportunity that makes sense for the industry to create specialized programs. Unbundle the exposure from the remainder of the policy and treat it as a separate exposure with dedicated resources to analyze, price and manage the risk.

Take a U.S. semiconductor manufacturer with supply exposure in Southeast Asia. As was the case with the 2011 Thailand floods or the 2011 Tohoku earthquake and tsunami, this hypothetical manufacturer is likely exposed to supply chain risks of which it is unaware. It is also likely that the property insurance policy meant to indemnify the manufacturer for covered losses in its supply chain will fall short of expectations. An enterprising underwriter could carve out this exposure and transfer it to a new form. In that form, the underwriter can work with the manufacturer to clarify policy wording, liberalize coverage, simplify claims adjusting and provide needed additional capacity. As a result, the manufacturer gets a risk transfer mechanism that more precisely aligns with the balance sheet affecting risks it is exposed to. The insurer gets a new line of business that can provide a significant source of new revenue using tools such as CAT models and other analytics to price and manage those specific risks. By applying some ingenuity, the situation can be a win/win all around.

What if you are a manufacturer or importer and rely on the Port of Los Angeles or Miami International Airport (or any other major international port) to transport your goods in and out of markets? This is another area where commercial policies handle business exposure poorly, or not even at all. CAT models stand ready to provide the analytics required to transfer the risks of these choke points from business balance sheets to insurers. All that is required is vision to recognize the opportunity and the sense to use the toolsets now available to invent solutions rather than relying on legacy group think.

At the end of the day, the next wave of innovation will not come directly from models or analytics. While the models and analytics will continue to improve, real innovation will come from creative individuals who recognize the risks that are causing market discomfort and then use these wonderful tools to build products and programs that effectively transfer those risks more effectively than ever. Those same individuals will understand that the insured comes first, and that rather than retrofitting dated products to suit a modern-day business problem, the advent of new products and services is an absolute necessity to maintain the industry’s relevance. The only limiting factor preventing true innovation in property insurance is imagination and a willingness to no longer cling to the past.

How CAT Models Lead to Soft Prices

In our first article in this series, we looked back at an insurance industry reeling from several consecutive natural catastrophes that generated combined insured losses exceeding $30 billion. In the second article, we looked at how, beginning in the mid-1980s, people began developing models that could prevent recurrences of those staggering losses. In this article, we look at how modeling results are being used in the industry.

 

Insurance is a unique business. In most other businesses, expenses associated with costs of operation are either known or can be fairly estimated. The insurance industry, however, needs to estimate expenses for things that are extremely rare or have never happened before. Things such as the damage to a bridge in New York City from a flood or the theft of a precious heirloom from your home or the fire at a factory, or even Jennifer Lopez injuring her hind side. No other industry has to make so many critical business decisions as blindly as the insurance industry. Even in circumstances in which an insurer can accurately estimate a loss to a single policyholder, without the ability to accurately estimate multiple losses all occurring simultaneously, which is what happens during natural catastrophes, the insurer is still operating blindly. Fortunately, the introduction of CAT models greatly enhances both the insurer’s ability to estimate the expenses (losses) associated with a single policyholder and concurrent claims from a single occurrence.

When making decisions about which risks to insure, how much to insure them for and how much premium is required to profitably accept the risk, there are essentially two metrics that can provide the clarity needed to do the job. Whether you are a portfolio manager managing the cumulative risk for a large line of business or an underwriter getting a submission from a broker to insure a factory or an actuary responsible for pricing exposure, what these stakeholders need to minimally know is:

  1. On average, what will potential future losses look like?
  2. On average, what are the reasonable worst case loss scenarios, or the probable maximum loss (PML)?

Those two metrics alone supply enough information for an insurer to make critical business decisions in these key areas:

  • Risk selection
  • Risk-based pricing
  • Capacity allocation
  • Reinsurance program design

Risk Selection

Risk selection includes an underwriter’s determination of the class (such as preferred, standard or substandard) to which a particular risk is deemed to belong, its acceptance or rejection and (if accepted) the premium.

Consider two homes: a $1 million wood frame home and a $1 million brick home both located in Los Angeles. Which home is riskier to the insurer?  Before the advent of catastrophe models, the determination was based on historical data and, essentially, opinion. Insurers could have hired engineers who would have informed them that brick homes are much more susceptible to damage than wood frame homes under earthquake stresses. But it was not until the introduction of the models that insurers could finally quantify how much financial risk they were exposed to. They shockingly discovered that on average brick homes are four times riskier than wood frame homes and are twice as likely to sustain a complete loss (full collapse). This was data not well-known by insurers.

Knowing how two or more different risks (or groups of risks) behave at an absolute and relational level provides a foundation to insurers to intelligently set underwriting guidelines, which work toward their strengths and excludes risks they do not or cannot absorb, based on their risk appetite.

Risk-Based Pricing

Insurance is rapidly becoming more of a commodity, with customers often choosing their insurer purely on the basis of price. As a result, accurate ratemaking has become more important than ever. In fact, a Towers Perrin survey found that 96% of insurers consider sophisticated rating and pricing to be either essential or very important.

Multiple factors go into determining premium rates, and, as competition increases, insurers are introducing innovative rate structures. The critical question in ratemaking is: What risk factors or variables are important for predicting the likelihood, frequency and severity of a loss? Although there are many obvious risk factors that affect rates, subtle and non-intuitive relationships can exist among variables that are difficult, if not impossible, to identify without applying more sophisticated analyses.

Regarding our example involving the two homes situated in Los Angeles, catastrophe models tell us two very important things: what the premium to cover earthquake loss should roughly be and that the premium for masonry homes should be approximately four times larger than wood frame homes.

The concept of absolute and relational pricing using catastrophe models is revolutionary. Many in the industry may balk at our term “revolutionary,” but insurers using the models to establish appropriate price levels for property exposures have a massive advantage over public entities such as the California Earthquake Authority (CEA) and the National Flood Insurance Program (NFIP) that do not adhere to risk-based pricing.

The NFIP and CEA, like most quasi-government insurance entities, differ in their pricing from private insurers along multiple dimensions, mostly because of constraints imposed by law. Innovative insurers recognize that there are literally billions of valuable premium dollars at stake for risks for which the CEA, the NFIP and similar programs significantly overcharge – again, because of constraints that forbid them from being competitive.

Thus, using average and extreme modeled loss estimates not only ensures that insurers are managing their portfolios effectively, but enables insurers, especially those that tend to have more robust risk appetites, to identify underserved markets and seize valuable market share. From a risk perspective, a return on investment can be calculated via catastrophe models.

It is incumbent upon insurers to identify the risks they don’t wish to underwrite as well as answer such questions as: Are wood frame houses less expensive to insure than homes made of joisted masonry? and, What is the relationship between claims severity and a particular home’s loss history? Traditional univariate pricing analysis methodologies are outdated; insurers have turned to multivariate statistical pricing techniques and methodologies to best understand the relationships between multiple risk variables. With that in mind, insurers need to consider other factors, too, such as marketing costs, conversion rates and customer buying behavior, just to name a few, to accurately price risks. Gone are the days when unsophisticated pricing and risk selection methodologies were employed. Innovative insurers today cross industry lines by paying more and more attention to how others manage data and assign value to risk.

Capacity Allocation

In the (re)insurance industry, (re)insurers only accept risks if those risks are within the capacity limits they have established based on their risk appetites. “Capacity” means the maximum limit of liability offered by an insurer during a defined period. Oftentimes, especially when it comes to natural catastrophe, some risks have a much greater accumulation potential, and that accumulation potential is typically a result of dependencies between individual risks.

Take houses and automobiles. A high concentration of those exposure types may very well be affected by the same catastrophic event – whether a hurricane, severe thunderstorm, earthquake, etc. That risk concentration could potentially put a reinsurer (or insurer) in the unenviable position of being overly exposed to a catastrophic single-loss occurrence.  Having a means to adequately control exposure-to-accumulation is critical in the risk management process. Capacity allocation enables companies to allocate valuable risk capacity to specific perils within specific markets and accumulation zones to minimize their exposure, and CAT models allow insurers to measure how capacity is being used and how efficiently it is being deployed.

Reinsurance Program Design

With the advent of CAT models, insurers now have the ability to simulate different combinations of treaties and programs to find the right fit, maximizing their risk and return. Before CAT models, it would require gut instinct to estimate the probability of attachment of one layer over another or to estimate the average annual losses for a per-risk treaty covering millions of exposures. The models estimate the risk and can calculate the millions of potential claims transactions, which would be nearly impossible to do without computers and simulation.

It is now well-known how soft the current reinsurance market is. Alternative capital has been a major driving force, but we consider the maturation of CAT models as having an equally important role in this trend.

First, insurers using CAT models to underwrite, price and manage risk can now intelligently present their exposure and effectively defend their position on terms and conditions. Gone are the days when reinsurers would have the upper hand in negotiations; CAT models have leveled the playing field for insurers.

Secondly, alternative capital could not have the impact that it is currently having without the language of finance. CAT models speak that language. The models provide necessary statistics for financial firms looking to allocate capital in this area. Risk transfer becomes so much more fungible once there is common recognition of the probability of loss between transferor and transferee. No CAT models, no loss estimates. No loss estimates, no alternative capital. No alternative capital, no soft market.

A Needed Balance

By now, and for good reason, the industry has placed much of its trust in CAT models to selectively manage portfolios to minimize PML potential. Insurers and reinsurers alike need the ability to quantify and identify peak exposure areas, and the models stand ready to help understand and manage portfolios as part of a carrier’s risk management process. However, a balance between the need to bear risk and the need to preserve a carrier’s financial integrity in the face of potential catastrophic loss is essential. The idea is to pursue a blend of internal and external solutions to ensure two key factors:

  1. The ability to identify, quantify and estimate the chances of an event occurring and the extent of likely losses, and
  2. The ability to set adequate rates.

Once companies have an understanding of their catastrophe potential, they can effectively formulate underwriting guidelines to act as control valves on their catastrophe loss potential but, most importantly, even in high-risk regions, identify those exposures that still can meet underwriting criteria based on any given risk appetite. Underwriting criteria relative to writing catastrophe-prone exposure must be used as a set of benchmarks, not simply as a blind gatekeeper.

In our next article, we examine two factors that could derail the progress made by CAT models in the insurance industry. Model uncertainty and poor data quality threaten to raise skepticism about the accuracy of the models, and that skepticism could inhibit further progress in model development.

Lessons Learned From Hurricane Sandy

Hurricane Sandy is said to have been the most damaging hurricane recorded in U. S. history. There appears, however, to be some dispute as to whether Hurricane Katrina holds that dubious honor. The loss estimates and concerns are changing daily. The cost of the storm, estimated by private firms including PricewaterhouseCoopers and the PFM group, points to the fact that Hurricane Sandy destroyed or damaged more units of housing, affected more businesses and caused more customers to lose power. Here is the breakdown provided on November 26, 2012: http://www.governor.ny.gov/press/11262012-damageassessment.

  Sandy in New York ALONE Katrina & Rita in Louisiana
Housing units damaged or destroyed 305,000 214,700
Power Outages (peak) 2,190,000 800,000
Businesses Impacted 265,300 18,700
  • Number of deaths is more than 110 from Hurricane Sandy http://articles.latimes.com/2012/nov/03/nation/la-na-nn-hurricane-sandy-deaths-climb-20121103
  • The official death toll from Katrina was 1,723. http://robertlindsay.wordpress.com/2009/05/30/final-katrina-death-toll-at-4081/
  • 7.5 million power outages throughout Hurricane Sandy's two day assault on land
  • Moody's Analytics estimates the loss in the vicinity of the storm to be $50 billion, of which $30 billion will be directly from damage to property and the remaining $20 billion from economic activity, not all of which is going to come from an insurance policy.
  • 60% of the losses in economic activity, or about $12 billion, will come from the New York City metropolitan area.
  • Because of the storm's intensity and the breadth and scope of the damage, President Obama declared New York and New Jersey federal disaster zones without waiting for any damage estimates.
  • As of 12/3/2012, the Federal government has already issued $180 million in federal contracts related to Sandy.
  • The President has declared several areas as disaster areas, which means that federal funds will now be available to storm victims. (This is not limited to those without flood insurance.) This federal disaster assistance usually takes the form of low-interest loans to help home and business owners rebuild, which you can learn more about on the Disaster Loan page.

The statistics are staggering as are the losses (both covered and not covered) that are emerging from the storm. We will attempt to discuss some of the unique and troublesome issues that are arising from the storm.

Article Discussion Points:

  • Definition of “Storm” and its impact on insurance
  • Flood or NOT Flood?-that is the question (or the hope)
  • Personal Auto salvage concerns
  • The Lawyers are out to get you

Definition Of “Storm” And Its Impact On Insurance

A storm reaches tropical storm status by reaching sustained winds of 39 miles per hour. The National Hurricane Center creates annual lists of names from the database of names maintained and updated by the World Meteorological Organization. If a storm causes significant damage and /or loss of life, the name is retired from the list permanently. Thus, there will be no Katrina II or Sandy II.

1. What Does The Definition Of “Storm” Have To Do With Insurance? There May NOT Be Coverage On The DIC.
Thousands of businesses were affected by Sandy. Many times those larger clients have flood and wind coverage, but written on a large property or DIC (Difference in Conditions) policy.

In those policies there may be restrictions, sub-limits or different deductibles that apply to “Named Storms.” Those policies will define what that is, and should include flood, wind, wind gusts, storm surges, tornadoes, cyclones, hail or rain into this category once the storm has been declared by the National Weather Service to be a hurricane, typhoon, tropical cycle, tropical storm or tropical depression, thus bringing into focus the entire life cycle that a storm may go through.

We have found a number of articles written by law firms that are already taking on the issue of “named storm,” claiming that even though the National Weather Service had named the storm, it was not at hurricane strength when it reached landfall. A comprehensive definition of “named storms” would be helpful to clarify coverage. The fact that the meteorologists are discussing the attributes of this storm to be more like a winter storm rather than a tropical storm may end up on the chopping block of justice in a civil court or two and test the insurance policy coverages.

2. What Is Unique About Hurricane Sandy?

  • Sandy has defied normal storm behavior by moving east to west; it acted both like a hurricane and a cyclone simultaneously.
  • The result of this last odd wind pattern was the root cause of the flood tides and the inundation of the New York subway system.
  • The storm qualified as a hurricane at the time of landfall and its wave “destruction potential” reached a 5.8 on the National Oceanic and Atmospheric Administration's 0 to 6 scale.

3. One Storm or Two Storms:
Bad memories of the World Trade Center came immediately to mind when I read about this potential concern relating to Hurricane Sandy in the Daily Report. You might remember there was a significant concern that a second storm, following the initial impact of Sandy, was going to hit which would have further devastated the area.

Richard Mackowsky, a member of the Cozen O'Connor's global insurance group, said “new damage from a second storm could result in a separate occurrence, potentially requiring a separate set of deductibles.”

“If there is damage caused by a second storm but related to the first storm, issues arise as to whether there were one or two occurrences. A second storm could impact causation as to what is really driving the loss. If the only reason the second storm caused damage was because of damage from Sandy, the question then becomes whether that is a covered cause of loss,” Mackowsky said. “A second storm could trigger a separate limit of liability if it's a big enough situation,” he said.

But even one storm can create causation questions. Was the damage from wind or flooding? Not a simple question to answer, litigation stemming from previous storms has shown.

Excerpted from the Daily Report

Saved by the bell on this one — the second storm never hit, but the insurance pundits were armed and ready.

Flood … Not Flood? — That Is The Question

This appears, at first glance, to be Insurance 101 — most of this damage was either directly or indirectly caused by the condition of flooding. That is sure what it looked like to me and that is not a very popular observation. Why? Because most people did not have flood insurance and if they did, the flood insurance policy has limited amounts of insurance and significant restrictions such as no business income coverage.

1. Dilemma Of The Federal Flood Insurance Program — It's A Problem:
Even if it is covered on the flood insurance policy, there is real concern about the overall program. See this article from Reuters for more information.

2. Flood Or Not Flood
Whether talking about homeowner's insurance (including renters and condominium owners) or commercial property insurance, those forms most often include an exclusion for flood. So, here is where it gets a little tricky:

  1. Did the property owner sustain damage from storm surge?
  2. Was the loss due to rising flood waters?
  3. Was the loss due to too much rain that entered into the building because the wind removed the roof, blew out the windows or knocked a part of the building down?

“It is an ongoing saga,” says insurance lawyer Frank Darras, who has worked extensively on litigation scenarios following Katrina. “If you are a homeowner, you are going to argue that you have damage caused by wind and wind-driven rain. If you are the carrier, you are going to say the damage was caused by flood, tidal surge or a hurricane, which requires hurricane coverage.”

Excerpted from The Street

In a unique twist, New York has a specific website that contains a regularly updated scorecard on insurance company performance. Here's the link. For example, State Farm has had 48,109 claims; 6,363 closed with payment; 5,229 closed without payment.

3. Problems With The Flood Insurance Solution
FEMA says that less than 15% of homeowners nationally carry flood coverage. Federally backed lenders have been lax in enforcing the obligation to purchase flood insurance (that may change due to higher penalties being imposed upon the banks as of July, 2012).

The National Flood Insurance Program anticipates claims between $6 and $12 billion but has borrowing power at $2.9 billion. Reauthorization from Congress would be required, and Homeland Security is expected to request appropriation soon. Those current and new policyholders of National Flood Insurance Program coverage will be getting a scheduled rate increase that predates Sandy.

Even if the person or business purchased flood coverage, there are still problems and concerns.

  1. The limits of insurance available through the National Flood Insurance Program are small.
  2. Replacement cost coverage applies only to a dwelling and not to commercial structures.
  3. There may be wind damage to the building that the flood insurer will not pay but is covered in the homeowner's policy.
  4. The insured will get to pay two deductibles for those two separate policies.
  5. What kind of coverage is there if the first layer of property coverage is the NFIP coverage and the insured purchases excess layers of flood coverage above that policy?

    1. Will it drop down to pick up the replacement cost difference? No.
    2. Will it drop down to pick up business income, extra expense coverage? It should. Check the policy language.

4. The Future Of Flood Insurance
The future of the entire program is bleak enough. Add to that the impact of Hurricane Sandy on the future purchase of flood insurance. Homeowners in storm-damaged coastal areas who had flood insurance, and many more who did not, still now may be required to carry flood insurance and will face premium increases for flood from an estimated 20 to 25 percent per year beginning January. This is due in part to legislation enacted in July to shore up the debt ridden National Flood Insurance Program and is exacerbated by Hurricane Sandy.

“Because private insurers rarely provide flood insurance, the program has been run by the federal government, which kept rates artificially low under pressure from the real estate industry and other groups. Flood insurance in higher-risk areas typically costs $1,100 to $3,000 a year, for coverage capped at $250,000; the contents of a home could be insured up to $100,000 for an additional $500 or so a year,” said Steve Harty, president of National Flood Services, a large claims-processing company.

Excerpted from The New York Times)

Lenders, in addition, will be affected by Hurricane Sandy if they fail to enforce the requirement for their lenders to carry flood insurance. They will face even higher penalties then they have in the past.

5. Ordinance Or Law

  1. Many of those properties damaged by Hurricane Sandy had been built a number of years ago. So here are the questions:

    1. Does the Homeowner's Policy, Commercial Property Policy or Difference in Conditions include contingent ordinance or law coverage, demolition coverage and increased cost of construction coverage?
    2. What about the loss of use for the homeowner as well as the business interruption coverage?
  2. The National Flood Insurance Program policy is out as there is no coverage for the indirect loss.
  3. Many Difference in Conditions policies do not include ordinance or law automatically and many more do not include ordinance or law — increased period of restoration to cover the additional down time due to code or law enforcement.

6. Power Loss
Earlier we quoted the statistic of there being approximately 7.5 million power outages throughout Hurricane Sandy's two day assault on land. Many of these outages lasted days and weeks. There are several issues relating to insurance in terms of the power outages:

  1. Requirement Of An Off Premises Endorsement: In order for businesses to have coverage for either direct or indirect losses relating to power outage, the insurance would first have “off premises” or “utility coverage” on the policy. Typically, losses stemming from off premises situations are excluded on property insurance policies.
  2. Causation Of The Power Outage: If there was coverage on the property policies for the off premise loss, the situation that occurred off premises would have to be covered. For example, if the off premises loss were caused by a windstorm, that cause of loss is typically covered on a Commercial Property Policy or personal form. If the loss were caused by flooding, then that cause of loss is excluded and the off premises endorsement would not apply.
  3. Off Premises Deductible: Off premises coverage oftentimes has a “time” deductible or waiting period of 72 hours unless endorsed. This waiting period would have eliminated coverage for many of the properties that had their power back in three days or less.
  4. Direct vs. Indirect Loss: An Off Premises Endorsement would have to cover both direct damage and indirect to pick up a loss for Business Income.
  5. Other Perils such as Equipment Breakdown (EB): The cause of off premises loss may be due to a power surge that results from the storming. If the Equipment Breakdown policy has off premises coverage and business income coverage, then recovery can be sought under that policy.
  6. Some Off Premises Policies Have Distance Limitations: It must be ascertained if there is any distance indication on the policy to which the off premises is being attached. For example, some policies have a 500-foot distance radius which means the source of the off premises loss must be within 500 feet of the insured's premise.
  7. Spoilage: It may be that the loss the insured sustained while the power was out was spoilage, such as loss to refrigerated items and the business income that stems from that loss. This could be covered on either an Equipment Breakdown Form depending on whether there was a “breakdown” or on a Commercial Property Spoilage Form. Some Homeowners have limited coverage built in for refrigeration loss but not for the peril of flood.

7. Business Income
Now we are talking about one of the bigger claims that will result from Hurricane Sandy and much of it will not be covered. Here are some of the pressure points of this coverage:

  1. Cause of Loss — back to that one. Flood is excluded on the Commercial Property form so there will be no response for business income.
  2. The Flood insurance policy does not cover business income.
  3. If the cause of loss is determined to be “windstorm” and the insured has Business Income insurance, then the policy should respond from the causation point of view assuming they had direct damage.
  4. The insured will have to prove that their income loss is directly attributable to Hurricane Sandy.
  5. The policy has a waiting period for coverage typically 72 hours unless endorsed.
  6. The policy would have to be endorsed with Off Premise coverage for the Business Income stemming from loss of power to apply.
  7. There is no building ordinance for the business income — it would have to be endorsed.
  8. Civil Authority: Many of the businesses did not sustain direct damage but were closed by civil authority.

    1. There is limited coverage on the Business Insurance form
    2. There may be distance limitations
  9. Ingress/Egress: A bigger problem is the ingress/egress issue which basically means “because of the condition, itself, access to an area is affected or unavailable.” For example, if a road is flooded out so that there is no access to a grocery store, the grocery store will be able to demonstrate they are losing customers. However, if the store was not directly affected by the physical loss, there will be no trigger on their business income form. Civil Authority did not close down the area — it was closed due to natural events in this case.

Traditional Business Income Policies require that there be direct damage to the premises by a peril insured against for there to be any business income insurance response. However, there is talk, in the aftermath of Hurricane Sandy, of what is referred to as Non-Damage Business Interruption or Non Physical Business Interruption Insurance. It is referred to as NDBI. While articles are referring to these coverages, as if they are readily available, I believe they are truly exceptional in availability and accessibility. Sometimes these forms are part of a “supply line coverage” for very large businesses that often have an international component. There is also the TDI or CDI coverage — Trade Disruption which could come into play — however, that coverage has a very limited market. Bottom line, the average business that sustained damage as a result of Hurricane Sandy had neither one of these types of coverage. Liberty International apparently has a program.

8. Automobile Losses From Hurricane Sandy
Autos are the easiest part of this equation: whether wind, flood or a combination, all are covered under the “Other Than Collision” coverage. The salvaging of these autos is where it gets interesting. Canadian officials are now bewailing the fact that thousands of autos — some estimates are as high as 250,000 — are likely making their way to Canada. Those storm-damaged vehicle are classified in Canada as “non-repairable” and are illegal to sell. But, in the aftermath of Katrina, Canadian citizens were buying these vehicles in the thousands, and they expect the same thing to happen again. What I wonder is, who is selling those vehicles? The original owner? The salvage company the insurer uses?

The Lawyers Are Out To Get You

Errors And Omissions Litigation
Well, as if all the foregoing isn't depressing enough, we cannot end this article without a little nudge to the insurance agent and broker.

If you are relying upon “conversations” with your client along the lines of “Do you want flood insurance? No. OK, then,” you are going to be sadly mistaken that your client is not going to enjoin you in litigation over your standard of care. Your client is going to claim an increased standard of care, yes including New York residents, and that you had a duty to advise and quote coverage for them or at the very least, tell them in writing of the limitations of coverage in the policies they purchased and that they relied upon you for your expertise. Many agents simply renew, year after year, their direct bill homeowner's and small business clients without any documentation of coverage offers. Even those handling larger accounts somehow rely upon the client's memory and good will not to sue you. So, again, for the millionth time already, please, please document your file, in writing, to the insured, with a rejection signature every year or, for larger accounts, an authorization to bind affirmation from the insured.

As we were all glued to the TV, watching reporters being blown around reporting the devastation, my insurance brain immediately went to “flood exclusions.” I saw the wind ravaging the houses, the uprooted trees blocking the roads, but also saw the rising waters in the streets, along the shores, in the housing areas.

The question will come down to that simple reality — was the damage due to flooding or not? The attorneys are out in force, fighting for first page on the Google search engine so you get to them first. It reminds me of an old Gun Smoke movie — ready, aim, fire. Barrels are being loaded against the insurance companies.

There is no easy way to end this article, although I am sure all of you who reached the very end are hopeful that I will. The storm was one of the biggest ever, and the insurance story will not end soon. There is so much more we could say but best end this with a heads up to watch and see how these claims unravel; and, for those of you who did not insure any of these damaged properties, I say a toast of champagne is in order.