I am a landlord by insurance has denied liability claim and I have been sued by a fraudulent slip & fall, what options do I have?

[Osman]

I am a landlord whose insurance has denied a liability claim and I have been sued for a fraudulent slip & fall, what options do I have? These tenants are claiming that the sheetrock in the garage fell due to water leakage and she slipped due to that. Infact they overflowed the toilets to which I have the HOA manager as a witness and had their son and son-in-law living at the premises, without my knowledge. What options do I have in state of CT?

 

[quincy]

I am a landlord whose insurance has denied a liability claim and I have been sued for a fraudulent slip & fall, what options do I have? These tenants are claiming that the sheetrock in the garage fell due to water leakage and she slipped due to that. Infact they overflowed the toilets to which I have the HOA manager as a witness and had their son and son-in-law living at the premises, without my knowledge. What options do I have in state of CT?

Why did your insurer deny the claim?

 

[Taxing Matters]

Was the water she claims to have slipped on the water from the overflowing toilet? How long had it been between when the overflow started and when she says she slipped. How and when were you notified of the water problem? Are the tenants asking for money to cover medical bills incurred in this slip and fall? How is your rental organized (e.g. corporation, LLC, sole proprietorship)?

You are not automatically liable for whatever injuries or property damage the tenants claim they suffered. The tenants will need to prove negligence on your/your entity's part and that the injuries they suffered were because of that negligence, and prove the dollar amount of the damages they are seeking. If they do that, your insurance company still have a duty to defend you. The Connecticut Supreme Court decided a case in 2020 in which it held an insurer has an obligation to defend if there is legal or factual uncertainty as to whether defendant is liable for the claim. That means it will have to be on pretty solid ground that properly denied coverage on whatever policy exception the company is relying upon.

If you can prove that they caused the problem with the overflow you may have a claim or counterclaim against the tenants for the damage done to your property and/or a good contributory negligence defense.

If you can prove fraud that may entitle you to extra damages on top of what they owe you for the damage done to your property.

In short there are a lot factors that have to be considered in evaluating just how strong the tenant's claim is. I agree with adjusterjack that the first step here is notifying the insurance that you've been sued and give it a copy of the complaint. If the insurance company doesn't have a strong case that whatever policy exception they want to use to deny the claim they may have to defend the case anyway, and that includes assigning lawyer to the case that you don't have to pay for.

 

[Osman]

Why did your insurer deny the claim?

Thank you very much for you're response. I am qouteing the exact denial letter words" Based on our understanding of the facts as presented there is no coverage for this claim as per the aforementioned exclusionary language, namely with respect to" bodily injury", property damage and personal injury arising out of or in connection with a business engaged in by an insured, in this instance, it is our understanding that the loss location, which is not an insured location, is a property owned by the insureds and is operated by the insureds for business purpose for renting bomes to others, on a regular , not an occasional basis. Coverage for this matter is there fore excluded pursuant to the Business exclusion and would otherseise be excluded as noted above. Addtional, Medical Payments coverage is not available to any Person regularly residing on any part of the insured location and there is no coverage for property damage to Prperty owned or rented to tenant. For the foregoing reasons Utica National must therefore deny coverage and disclaim any obligation for defence and indemnification of this claim according. " I insured the place as a non living landlord living in Florida and paying my premiums and they have denied me with this reasoning where as on the other had I they did pay for the property damages which is totally opposite to what this is. Basic landlord insurance gives libality insurance and they are denying me this. what are you thoughts on that as to how should I approach this.

 

[Osman]

Was the water she claims to have slipped on the water from the overflowing toilet? How long had it been between when the overflow started and when she says she slipped. How and when were you notified of the water problem? Are the tenants asking for money to cover medical bills incurred in this slip and fall? How is your rental organized (e.g. corporation, LLC, sole proprietorship)?

You are not automatically liable for whatever injuries or property damage the tenants claim they suffered. The tenants will need to prove negligence on your/your entity's part and that the injuries they suffered were because of that negligence, and prove the dollar amount of the damages they are seeking. If they do that, your insurance company still have a duty to defend you. The Connecticut Supreme Court decided a case in 2020 in which it held an insurer has an obligation to defend if there is legal or factual uncertainty as to whether defendant is liable for the claim. That means it will have to be on pretty solid ground that properly denied coverage on whatever policy exception the company is relying upon.

If you can prove that they caused the problem with the overflow you may have a claim or counterclaim against the tenants for the damage done to your property and/or a good contributory negligence defense.

If you can prove fraud that may entitle you to extra damages on top of what they owe you for the damage done to your property.

In short there are a lot factors that have to be considered in evaluating just how strong the tenant's claim is. I agree with adjusterjack that the first step here is notifying the insurance that you've been sued and give it a copy of the complaint. If the insurance company doesn't have a strong case that whatever policy exception they want to use to deny the claim they may have to defend the case anyway, and that includes assigning lawyer to the case that you don't have to pay for.

Thank you for you're helpful reply. There are number of things which need to be looked into. From day one these tenants never paid rent on time. Then they said the place needs to be painted and since the husband is from construction industry he can paint the place for certain about of price to which I agreed but he never did the paint. Then they brought in their son and grandson to live in the same room toilet which had issues without informing me or the HOA which was required. They never notified me of any problem it was not until the incident happed and the HOA community manager went to check the place, he would out they overflowed the toilet as they told him. They never told me this.

I notified the insurance and this is what what they responded back to me with " Thank you very much for you're response. I am qouteing the exact denial letter words" Based on our understanding of the facts as presented there is no coverage for this claim as per the aforementioned exclusionary language, namely with respect to" bodily injury", property damage and personal injury arising out of or in connection with a business engaged in by an insured, in this instance, it is our understanding that the loss location, which is not an insured location, is a property owned by the insureds and is operated by the insureds for business purpose for renting bomes to others, on a regular , not an occasional basis. Coverage for this matter is there fore excluded pursuant to the Business exclusion and would otherseise be excluded as noted above. Addtional, Medical Payments coverage is not available to any Person regularly residing on any part of the insured location and there is no coverage for property damage to Prperty owned or rented to tenant. For the foregoing reasons Utica National must therefore deny coverage and disclaim any obligation for defence and indemnification of this claim according. " I insured the place as a non living landlord living in Florida and paying my premiums and they have denied me with this reasoning where as on the other had I they did pay for the property damages which is totally opposite to what this is. Basic landlord insurance gives libality insurance and they are denying me this. what are you thoughts on that as to how should I approach this.

 

[LdiJ]

It appears that they are saying that when you got the insurance you did not tell them that it was a rental property with tenants living there. Apparently you purchased the insurance as regular homeowners insurance. That is why they are denying coverage. You need a different kind of insurance, with a different price, to cover a rental property.

If that is the case they are unlikely to defend you against a lawsuit either. However that shouldn't stop you from informing them and seeing if they will help you.

 

[adjusterjack]

Osman, you should have told us the reason for the denial when you first posted. I deleted my answer because it no longer applies.

Basic landlord insurance gives libality insurance

You apparently don't have "basic landlord insurance" because the business exclusion appears in the standard homeowners policy.

You can verify the following by reading your own homeowners policy. Your policy may vary.

"Business" means: a. A trade, profession or occupation engaged in on a full-time, part-time or occasional basis; or b. Any other activity engaged in for money or other compensation, except the following: (1) One or more activities, not described in (2) through (4) below, for which no "insured" receives more than $2,000 in total compensation for the 12 months before the beginning of the policy period."

 

[Osman]

Osman, you should have told us the reason for the denial when you first posted. I deleted my answer because it no longer applies.



You apparently don't have "basic landlord insurance" because the business exclusion appears in the standard homeowners policy.

You can verify the following by reading your own homeowners policy. Your policy may vary.

"Business" means: a. A trade, profession or occupation engaged in on a full-time, part-time or occasional basis; or b. Any other activity engaged in for money or other compensation, except the following: (1) One or more activities, not described in (2) through (4) below, for which no "insured" receives more than $2,000 in total compensation for the 12 months before the beginning of the policy period."

Thank you for your response, but this is the case. I specifically asked my agent for the landlord's insurance. As I had moved to Florida and had rented the unit. Now if it was not correctly issued to me. Interestingly when I emailed the agent for the claim he needed to add rented out to others for which I have to pay additional premium. To which I emailed him again that will it have an impact on the coverages to which he replied back to me no. I got the policy while living in Floriday and clearly discussed with them that I need a landlord insurance policy. So the issue is how will this be handled.

 

[adjusterjack]

You might have a case against the agent for "errors and omissions."

You going to need a lawyer to defend you against the lawsuit if the insurance company won't. That's priority.

You may, at some point, need a second lawyer, one who specialized in "errors and omissions" claims against insurance agents. Most lawyers don't. You want to avoid lawyers who say "I can do it" and get one who says "I have done it, successfully."

 

[Litigator22]

Thank you for your response, but this is the case. I specifically asked my agent for the landlord's insurance. As I had moved to Florida and had rented the unit. Now if it was not correctly issued to me. Interestingly when I emailed the agent for the claim he needed to add rented out to others for which I have to pay additional premium. To which I emailed him again that will it have an impact on the coverages to which he replied back to me no. I got the policy while living in Floriday and clearly discussed with them that I need a landlord insurance policy. So the issue is how will this be handled.

If the responder proposing that you sue the insurance agent for "errors and omissions" had an inkling of the laws of agency, he or she would be aware of this:

That given the circumstances as reported - particularly the presence of the principal/agent relationship - the same evidence that would render the agent personally liable would also serve to hold his principal responsible.

Your attorney will explain.

 

[STEPHAN]

You need a lawyer. Now. Fast.

 

[adjusterjack]

f the responder proposing that you sue the insurance agent for "errors and omissions" had an inkling of the laws of agency, he or she would be aware of this:

Fair point. And I am aware.

 

[Litigator22]

Fair point. (?) And I am aware. (?)

Do you mean "fair" as in "love and war", "impartial", "sportsmanship" or as in ""fairground"?

Also, if your so-called awareness of applicable law could permit the OP to kill two birds with one stone, why did you sic the OP on the smallest of the two?

Fini

 

[adjusterjack]

Ah, so you are one of those people who are psychologically obsessed with having the last word. Knock yourself out.

 

[Osman]

You might have a case against the agent for "errors and omissions."

You going to need a lawyer to defend you against the lawsuit if the insurance company won't. That's priority.

You may, at some point, need a second lawyer, one who specialized in "errors and omissions" claims against insurance agents. Most lawyers don't. You want to avoid lawyers who say "I can do it" and get one who says "I have done it, successfully."

Thank you for the advise. I reached out to the agent and he has filed for the E&O insurance. I have requested him for the claim copy, claim number and the agency. What are the next steps for me do I still engage lawyers to follow up on it or the feedback. As my case return date is the 3rd. Can you guide what to do and what is the best course of action for me.