Anti-concurrent cause, Ontario style

I saw an interesting case on anti-concurrent cause language in a liability policy on the blog for the Cavanagh Williams firm in OttawaHere’s a copy of the case, Appin v. Economical Ins. Co., in the Ontario Court of Appeals.  The decision was handed down in mid-February.

The court referred to it by another name — the concurrent exclusion clause — but it is worded more or less the same as the kind of anti-concurrent cause clauses we have discussed at length here, except for one thing: this provision is in the liability form of a Commercial General Liability policy, and is attached to a mold exclusion.

The purpose of the anti-concurrent cause language in the policy appears to be to reinforce the exclusion’s status as an "absolute" mold exclusion — no matter what combination of origins, causes, effects, happenings, events, or whatever word you come up with, the insurer does not intend to pay for any liability if the harm is caused in any way by mold.

To consider this clause in the proper context, let’s broaden our perspective for the moment.  Anti-concurrent cause language, as I’ve written about at length, is merely one way of addressing what I have called the Unbearable Lightness of Causation (with apologies to Kundera).  Causal relationships are among the most intellectually perplexing constructs of human thought, and theories of concurrent and sequential causation are likewise theoretically complex.   I’ve written about it in this article for New Appleman: Critical Issues from last year, and a second article on anti-concurrent causation and Fifth Circuit Katrina cases will come out in the same publication next month.  Anti-concurrent cause language posits an arbitrary analysis of causation — arbitrary in the sense that the areas of inquiry are limited so that, when certain factors are present, the result of the analysis each time will be the same: no coverage.

These clauses were developed to deal with adverse court precedent in first-party property policies, however, and I have expressed some skepticism about how well the language transfers to liability policies.  Consider this: property insurance causation has traditionally been viewed far differently from tort causation — the blurring of the distinction between the two, in fact, resulted in the development of the modern anti-concurrent cause clause. But tort causation is what liability insurance is all about, so whenever anti-concurrent cause language is inserted into the liability portion of a policy, sharp lawyers will look to attack it as incompatible with the underlying concept behind liability insurance — tort law can and does impose liability for concurrent causes of damage, so limitations on that theory of causation, some will say, are inherently ambiguous. 

OK, enough mumbo jumbo, right?  Let’s look at the case, and the language of the exclusion.  Now, I know what any normal person is thinking when they look below: "You expect me to read on past this point when the headline is ‘Fungi and Fungal Derivatives? See you later’."  Quite true, but those interested in reading a post on anti-concurrent cause language are by definition not normal people, and I have every confidence that those who have stuck with me this far won’t let a little fungus deter them from reading to the end.  I have put the anti-concurrent cause language in bold to make it easier to find among the fungi.

This insurance does not apply to:

7. FUNGI AND FUNGAL DERIVATIVES
(a) “bodily injury”, “property damage”, “personal injury”, or Medical Payments or any other costs, loss or expense incurred by others, arising directly or indirectly, from the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, presence of, spread of, reproduction, discharge or other growth of any “fungi” or “spores” however caused, including any costs or expenses incurred to prevent, respond to, test for, monitor, abate, mitigate, remove, cleanup, contain, remediate, treat, detoxify, neutralize, assess or otherwise deal with or dispose of “fungi” or “spores”; or

(b) any supervision, instructions, recommendations, warnings, or advice given or which should have been given in connection with (a) above; or

(c) any obligation to pay damages, share damages with or repay someone else who must pay damages because of such injury or damage referred to in (a) or (b) above.

This exclusion applies regardless of the cause of the loss or damage, other causes of the injury, damage, expense or costs or whether other causes acted concurrently or in any sequence to produce the injury, damage, expenses or costs.

Here, I am not sure the anti-concurrent cause language adds anything to what was already said: we do not cover any liabilities arising in any way from harm caused by mold.   The appellate court agreed with the trial court — both found the exclusion ambiguous and unenforceable. The reason the court did so, is that the insurer denied the duty to defend the insured against allegations that the claimant was harmed by exposure to mold (uncovered) and bacteria (covered). The court explained it this way:

We disagree with the insurer’s position. The language in clause 7(a) is both unclear and ambiguous in its effect. A plain reading of the provision does not support the insurer’s position. Indeed, the clause is worded in a fashion that would leave most people guessing as to its meaning. For example, on another possible interpretation, the clause could be taken to mean that wherever injury from mould is alleged in a claim, even if it is ultimately established that the injury arose solely from a covered peril, such as bacteria, the claim would exclude both the duty to defend and the duty to indemnify. This would effectively extend the exclusion to otherwise non-excluded perils. 

Now, to me, the key is not whether bacteria might ultimately be proven a cause of harm, therefore calling for indemnity.  The key for the duty to defend question is whether, under the allegations, mold and bacteria are concurrent or sequential causes of the harm claimed.  These are terms with highly specialized meanings in insurance.  Concurrent means independent causes that combine to produce a result that would not have occurred but for the existence of one of the causes.   Sequential can be ruled out — it refers to dependent causes, one cause causing the other.  It seems highly unlikely that the allegations were that the mold illness caused the bacterial illness or vice versa. 

So the question for anti-concurrent cause is this — can the allegations be read only one way, that is to say, that no illness at all would have occurred but for the combination of mold and bacteria?  It the allegations can be read to say that harm would have occurred because of bacteria alone, then we are talking about two separate single causes of two separate harms, not multiple causes of one harm.  If the allegations can be read that way, a powerful argument exists that anti-concurrent cause language is not relevant. 

As I mentioned, I’m not sure the anti-concurrent cause language added anything here.  The insurer admitted that if bacterial harm were proven, the insurer would have to pay for the liability.  From what I can see of the allegations from the court’s analysis, it is dubious whether a denial of the duty to defend can stand under such circumstances.  There may be things I don’t know about this case that were not in the opinion, but from what I see here the court’s call is well-reasoned.  I would have liked to see an analysis closer to the one I have explained above — then I could see if my assumptions about the case are correct.  If courts would use an analysis similar to the one I propose here, their jobs would be easier and their opinions clearer and more bulletproof. 

 

 

3 Comments

Filed under Duty to Defend, Duty to Indemnify, Liability Policies

3 Responses to Anti-concurrent cause, Ontario style

  1. Entertained

    I notice these [okay, somewhat dry] posts about such [admittedly tedious] topics as anti-concurrent cause provisions never get comments posted. But, I’m here to say that these posts are really important and extremely useful (and are the reason why I first started reading this blog in the first place). Even though I really like reading about Scruggs, I really need to read about insurance issues, so please don’t stop blogging about ’em. Thanks! Now back to our Regularly Scheduled Scruggramming.

  2. Rob

    I agree: good post. I’m happy you’re back to posting about more than just Scruggs.

  3. James P. Reilly

    Hey 98.6, it’s good to see you back again (lyrics by Donovan in praise of normal [98.6])
    I love the ‘Scruggs Nation’ stuff, but am one of “those interested in reading a post on anti-concurrent cause language (who) are by definition not normal people.”
    As always, I start by accepting your position that these events are neither “concurrent, nor sequential” and that therefore, the clause (however entitled) is not applicable.
    I must again revert to MY argument that somebody is reading the clause and is coming to a conclusion that is not supported by the language. The clause excludes damages caused by ‘mould’. The verbiage is a pretty darned comprehensive method of ABSOLUTELY excluding coverage for mould. IT DOES NOT exclude either indemnity, or the obligation to defend for damages caused by ‘bacteria’.
    It appears that some adventurous soul representing the insurance company has decided that indemnity and the obligation to defend against an allegation of damages caused by ‘bacteria’ are negated because there is ALSO an allegation of damages caused by ‘mould’. When are these eejits (an Irish colloquialism for ‘idiots’) going to stop doing this??? That is NOT what the clause says. If you keep trying to steal coverage from the policyholder, there is going to be more trouble than you care to address. At least when State Farm’s counsel raised this (specious) defense they were immediately slapped down by State Farm, who made it abundantly clear that this was NOT State Farm’s position. Come on guys and gals. Read what’s going on and learn from other peoples mistakes.
    There is a price to pay for ‘adventurous’ interpretations of the law, documents, facts, relationships, etc. Jim Hood is going to be able to write a book about the price paid for adventurous interpretations.