Professional Liability

Two years prior to Evelyn Pitts’ death, she placed her property in a revocable living trust, entered an assisted living facility and then rented her property to tenants. After Evelyn’s passing, her son reported water damage to the property to Universal Property & Casualty Insurance Company. Universal initially extended coverage for emergency water mitigation services, but upon finding out that the insured did not live at the property as required by the policy, they denied any further coverage under the policy. 

It was undisputed that the insured did not live at the property, but the insured’s attorney argued that Universal’s policy was ambiguous as the property was not identified as the “residence premises” in the declarations page. That argument failed as the property was clearly identified as the “residence premises” on the declarations page. 

The insured’s attorney also argued that Universal waived its right to deny the insurance claim because Universal had accepted premiums from the insured and made an initial payment on the claim. Those arguments failed because accepting premiums is not knowledge that the insured no longer resides at the property and issuing payment on a claim does not waive coverage provisions in the insuring agreement or policy exclusions, only the post-loss obligations under the policy. 

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