This document discusses several issues that homeowners may face when making earthquake damage insurance claims:
1. Insurers are obligated to settle claims within a reasonable time but often cite regulatory delays, workforce shortages, and workload as reasons for delays in settling claims. This delay can result in losses for homeowners.
2. When insurers elect to repair or rebuild damaged homes, the policy becomes a building contract where the insurer controls the project, but the homeowner has no liability for costs. Reinstatement is usually to "as new" condition according to common building methods and materials.
3. In practice, insurers often take a cost-sensitive approach that leads them to impose design changes on homeowners and settle claims
5. Delay
Insurer must settle claim within a reasonable time.
Alleged roadblocks:
Regulation (red zone review, MBIE guidelines, s 124
notices, consenting)
Workforce shortages
Internal workload constraints
Query is obligation to be viewed at time the obligation
was assumed (renewal) or time of performance?
Note: most policies have provisions under which
settlement could occur immediately (pay cash)
Query whether s 30 of the CGA is applicable?
6. Delay: Loss / Remedy
Direct costs:
mortgage / rent alternative accommodation
Stopgap measures temporary repair
Indirect loss
Loss of amenity / aesthetic
Stress / anxiety
Damages
Specific damages
General damages (aggravated?)
Exemplary damages (probably not)
7. Reinstatement
Insurer to arrange / undertake project
Contract becomes a building contract
Must complete regardless of cost / sum insured
Robson v New Zealand Insurance Co Ltd [1931]
NZLR, 35).
Insured does not have right to control project
Insured has no liability to builders / contractors
Reinstatement of earthquake damage in terms of policy:
Usually to as new
Query design changes is there a good faith duty
8. Reinstatement Standard
We will pay to repair or rebuild your house to an as new condition
Repair:
Query where only a part of an element is repaired (e.g. a portion
of the foundation or a portion of a drive).
As new is more than just appearance as strong / durable /
functional / aesthetically pleasing as new
May be more than MBIE guidelines (especially for premium
homes or homes that were new at the time of loss).
We will use building materials and construction methods in common
use at the time of repair or rebuilding:
Open fires / Wooden glazing / Tile roofs / Brick homes
The relevance of building rules - The Act / The Code / MBIE
Guidelines
9. Reinstatement reality
Insured generally involved in some way with design /
costing
Insurer highly cost sensitive
Query right to place hold on projects due to cost
blowout / unforeseen problems (e.g. leaky home)
Insurers generally require insured to be party to bespoke
building contract no terms negotiable
Oftentimes insurer seeks to impose design changes
(stud height, detached garage, off the rack homes
TC3 Friendly)
Frequently tradeoff in rebuild of pro and con design
improvements
10. Some concerns
Take it or leave it approach
No duty to explain misrepresentations / Fair
Trading issues?
Sometimes significant alteration of policy rights
Land payment assignments
Significant design changes
Insureds giving away rights (e.g. against
builders and contractors)
Express or implied threats of the queue.
11. Elections: A contractual crossroad
Insurer election to reinstate by either repair/rebuild or
pay cash.
Obligation to elect within a reasonable time
Insurers tend to equivocate for as long as possible
Arguable that a failure to elect / repair can be taken
as either a breach of the contract, or an election to
pay cash?
Effect of election to change the rights and obligations of
the parties
Must be unequivocal
12. The insureds election
Insured may have an election (triggered generally by insurer
deeming a rebuild)
If your house is damaged beyond economic repair you can
choose any one of the following options..
No particular form of election needed (but insurers often use a
settlement election form).
When does insurers conclusion that it is beyond economic
repair / a total loss become binding?
Duty to decide in good faith (at least without malice or
caprice)
Query: Can insurer unelect once they have offered an
insured an election that has been made?
13. Cashing out
If your house is damaged and can be repaired, we can choose
to pay you the cash equivalent of the cost of repairs.
Assumes that repairs are / will be undertaken
Query whether payment in advance required to facilitate works
Not cash equivalent of our estimate of what the repairs would
be completed for by our contractors
By electing cash insurer relinquishes control over
Cost reinstatement
Repair methodology
Must pay all reasonable costs of repair.
Court likely to err in favour of insured
14. Cash Settlements Outside of Policy
Insurer pays cash equivalent of their own costings.
Often reduces / does not pay for some potential costs.
Full and final
Avonside Holdings Ltd v Southern Response Earthquake Services
Ltd [2013] NZHC 1433
Contingency (no)
Builders margin (yes)
Professional fees (yes)
Costs of demolition (if to be incurred)
Project management (yes)
Tradeoffs:
no obligation to repair (check terms of settlement)
Control of design / improvements
15. Conclusions
Insurers have a control approach
Fundamental problem with delay (which could be solved
by cash election)
Many / most settlements are outside of policy
Not objectionable in principle but:
Often contains significant concessions
No meaningful legal advice
Legal advice cannot overcome realities of absence of
choice
Appropriate out of policy settlements can suit many
insureds