READ, J.
On September 7, 2010, a subsurface water main abutting the property of plaintiffs Frederick J. and Mary E. Platek ruptured, causing water to flood into and severely damage their home's finished basement. Plaintiffs immediately made a claim under their homeowners' insurance policy, which was issued by defendant Allstate Indemnity Company. The insuring agreement excludes property damage caused by water, with an exception for certain sudden and accidental direct physical losses; specifically, the section entitled "Losses We Do Not Cover Under Coverages A [Dwelling
On September 9, 2010, Allstate disclaimed coverage, based on item 4 of the policy's water loss exclusion. For the reasons that follow, we conclude that the policy's unambiguous language excludes the water damage to plaintiffs' home from coverage, and the exception does not nullify the water loss exclusion or render it ambiguous.
Plaintiffs commenced this action by summons and complaint dated and filed on November 23, 2010. They alleged that Allstate had improperly disclaimed coverage, causing them to suffer damages in excess of $100,000.
In support of their motion, plaintiffs submitted the affidavit of an engineer, who stated that the water main "suddenly exploded from the internal water pressure being exerted on the pipe walls. Hence, the explosion resulted from internally pressurized water that was supposed to be contained in a buried underground pipe." He opined that plaintiffs had therefore suffered
By notice of motion dated April 7, 2011, Allstate opposed plaintiffs' motion and cross-moved for summary judgment to dismiss the complaint against it on the ground that the policy did not cover plaintiffs' claim, as a matter of law. Quoting the water loss exclusion, Allstate pointed out that the policy excludes property losses "consisting of or caused by ... 4. Water... on or below the surface of the ground, regardless of its source[,] [including] water ... which exerts pressure on, or flows, seeps or leaks through any part of the residence premises." Allstate added that the exception did not apply because, under that provision's wording, any "loss caused by ... explosion" must "result[] from" the explosion. Here, by contrast, any explosion "occurred earlier, outside the residence premises, when the water main broke."
By order granted May 6 and filed May 12, 2011, Supreme Court granted plaintiffs' motion and denied Allstate's cross motion, and declared that plaintiffs' loss was covered under the policy and Allstate was required to pay the claim. Allstate appealed, and on July 6, 2012, the Appellate Division, with two Justices dissenting in part, modified Supreme Court's order by vacating the declaration and otherwise affirmed (97 A.D.3d 1118 [4th Dept 2012]). All the Justices agreed that, since plaintiffs asserted a cause of action against Allstate for breach of contract, Supreme Court erred by "declaring" that plaintiffs' claimed loss was covered under the policy and directing payment. The Court split on the issue of whether the policy's sudden and accidental exception to the water loss exclusion applied.
With respect to the exception, the majority explained that
Concluding that both interpretations were reasonable, the majority held that the policy was therefore ambiguous and should be construed in favor of plaintiffs, the insureds.
The dissenting Justices observed that plaintiffs, not Allstate, bore the burden of demonstrating the applicability of the exception, and reasoned that, in any event, the policy's language was not ambiguous. In their view,
Plaintiffs and Allstate subsequently entered into a stipulation whereby the parties agreed that plaintiffs' damages totaled $110,000. Allstate now appeals pursuant to CPLR 5601 (d) from the resulting judgment granted on January 13 and entered on January 14, 2014.
Three basic principles guide our analysis. First, "[i]n determining a dispute over insurance coverage, we first look to the language of the policy" (Consolidated Edison Co. of N.Y. v Allstate Ins. Co., 98 N.Y.2d 208, 221 [2002]). Concomitantly, we "construe the policy in a way that affords a fair meaning to all of the language employed by the parties in the contract and
Second, although the insurer has the burden of proving the applicability of an exclusion (see Seaboard Sur. Co. v Gillette Co., 64 N.Y.2d 304, 311 [1984]), it is the insured's burden to establish the existence of coverage (see Lavine v Indemnity Ins. Co., 260 N.Y. 399, 410 [1933]). Thus, "[where] the existence of coverage depends entirely on the applicability of [an] exception to the exclusion, the insured has the duty of demonstrating that it has been satisfied" (Borg-Warner Corp. v Insurance Co. of N. Am., 174 A.D.2d 24, 31 [3d Dept 1992], lv denied 80 N.Y.2d 753 [1992]; see also Northville Indus. Corp. v National Union Fire Ins. Co. of Pittsburgh, Pa., 89 N.Y.2d 621, 634 [1997]).
And finally, "[w]here a property insurance policy contains an exclusion with an exception for ensuing loss, courts have sought to assure that the exception does not supersede the exclusion by disallowing coverage for ensuing loss directly related to the original excluded risk" (Narob Dev. Corp. v Insurance Co. of N. Am., 219 A.D.2d 454, 454 [1st Dept 1995], lv denied 87 N.Y.2d 804 [1995]; see also ITT Indus. v Factory Mut. Ins. Co., 303 A.D.2d 177, 177 [1st Dept 2003] [rejecting plaintiff's "untenable interpretation that the policy provided coverage for a resulting loss of an excluded risk"]; Montefiore Med. Ctr. v American Protection Ins. Co., 226 F.Supp.2d 470, 479 [SD NY 2002] [where the policy excluded losses for faulty workmanship, the court rejected the insured's claim for the collapse of a defectively designed facade, explaining that "(a)n ensuing loss provision does not cover loss caused by the excluded peril, but rather covers loss caused to other property wholly separate from the defective property itself"]).
In this case, plaintiffs' loss occurred when water from a burst water main flowed onto their property, flooding the basement of their home. Accordingly, their loss clearly falls within item 4 of the water loss exclusion, which bars coverage for "loss to the property ... consisting of or caused by ... 4. Water ... on or below the surface of the ground, regardless of its source[,] [including] water ... which exerts pressure on, or flows, seeps or leaks through any part of the residence premises" (see Neuman v United Servs. Auto. Assn., 74 A.D.3d 925, 926 [2d Dept 2010] [similarly-worded water loss exclusion precludes coverage for water damage to basement]; Harleysville Ins. Co. of N.Y. v Potamianos Props., LLC, 108 A.D.3d 1110, 1111-1112 [4th Dept 2013] [accord]).
Stated another way, an ensuing loss "at least requires a new loss to property that is of a kind not excluded by the policy" (id. at 31); it "[does not] resurrect coverage for an excluded peril" (id. at 34).
Plaintiffs nonetheless argue that the water damage to their basement was covered because it was "
Additionally, plaintiffs ignore the water loss exclusion's prefatory language, which specifies that "[Allstate does] not cover loss to the property ... consisting of or caused by: [any of the four items of water loss]" (emphases added). This phrase is an integral part of each of the four items, and makes the sentence complete. Reading the policy as a whole, then, the exception would trigger coverage for any sudden and accidental direct physical loss caused by an explosion resulting from a loss to the property consisting of or caused by water on or below the surface of the ground of the residence premises, regardless of its source. As already noted, this does not describe what happened here according to plaintiffs' own expert.
Further, it is unimportant that Allstate did not label the exception an "ensuing loss provision," or use "ensuing from" instead of "resulting from" in the policy as "[t]hese clauses are common in all-risk policies, and while rarely identical they share more similarities than differences" (Fiess v State Farm Lloyds, 202 S.W.3d 744, 752 [Tex 2006]; id. at 752-753 [noting that a majority of jurisdictions, including New York, refuse to interpret an ensuing loss provision to make an excluded loss reappear as a covered loss]). Indeed, the phrases "ensuing loss" and "resulting loss" have been used interchangeably to mean a loss that follows chronologically or occurs after an excluded event (see Narob Dev. Corp., 219 AD2d at 454; TMW Enters., Inc. v Federal Ins. Co., 619 F.3d 574, 579 [6th Cir 2010]; see also Paul T. Sullivan & Jeffrey A. Gordon, A Review of Ensuing Loss Case Law: 2010 to Present, 43 The Brief [No. 3] 18 [Spring 2014]).
Finally, plaintiffs take the position that even if "resulting from" does mean "follows," it is not "irrational" for it also to mean "caused by." The sudden and accidental exception to the water loss exclusion, however, uses the phrase "caused by" earlier when referring to "loss caused by ... explosion" (emphasis added). The exception then uses a different phrase — i.e., "resulting from items 1 through 4" (emphasis added). The use of different terms in the same agreement (here, in the same sentence) implies that they are to be afforded different meanings (see Frank B. Hall & Co. of N.Y. v Orient Overseas Assoc.,
In sum, interpreting the insurance policy as plaintiffs propose would contravene the water loss exclusion's purpose, as expressed in unambiguous language, which is to preclude coverage for damages caused by the entry of water onto an insured's property. As stated by the Supreme Court of New Hampshire when interpreting a policy excluding water loss, "[t]o apply the ensuing loss provision to provide coverage for what is essentially a flood would subvert the intent of the parties" (Bates v Phenix Mut. Fire Ins. Co., 156 N.H. 719, 723, 943 A.2d 750, 754 [2008] [internal quotation marks omitted]). In the same way, permitting coverage under the facts of this case would force Allstate to insure a loss it did not contemplate and, indeed, affirmatively excluded.
Accordingly, the judgment appealed from and the order of the Appellate Division brought up for review should be reversed, with costs; plaintiffs' motion for summary judgment denied; and Allstate's cross motion for summary judgment granted.
PIGOTT, J. (concurring).
I agree with my colleagues that the exception to the water loss exclusion in the Allstate policy does not provide coverage for plaintiffs' loss. I disagree, however, that the loss "clearly falls within item 4 of the water loss exclusion" (majority op at 694).
The homeowner's insurance policy at issue is an "all risk" policy, which covers "sudden and accidental direct [and] physical loss to [the] property" unless specifically excluded (see Parks Real Estate Purch. Group v St. Paul Fire & Mar. Ins. Co., 472 F.3d 33, 41 [2d Cir 2006]). There is little doubt that the policy at issue would, in the normal course, cover direct and physical loss from an "explosion."
On plaintiffs' motion for summary judgment, the only testimony with respect to what occurred in this case was plaintiffs' expert opining that plaintiffs suffered direct water loss from an "explosion" of a water pipe (see generally Goldner v Otsego Mut. Fire Ins. Co., 39 A.D.2d 440, 442 [1972]). Allstate proffered no evidence to dispute this evidence.
Because plaintiffs' argument to the court was predicated on the exception to the water loss exclusion of the policy, however, the courts did not address this primary coverage issue. I therefore concur with the result in this case.
Judgment appealed from and order of the Appellate Division brought up for review reversed, with costs, plaintiffs' motion for summary judgment denied and defendant Allstate Indemnity Company's motion for summary judgment granted.