Investigative Engineering – Insurance Peril Claims
Fire and Explosion
Fire has been defined by the courts as “combustion sufficient enough to produce a spark, flame or glow.” By definition, a fire is not smoke or charring. A claim we had was quite interesting, tenants left for a weekend, an owners’ policy changed from one insurer to another and a fire occurred at 3 am the day of the new policy. We found compelling evidence that once the event progressed to a “glow”, the fire would have spread quickly, therefore the fire occurred the day of the new policy.
Over the years, the courts have distinguished between “friendly” and “hostile” fire. A friendly fire is one that burns where it was intended to burn: a flame on a gas stove; a fire in a fireplace; fire in an outdoor grill.
CIE determines if a fire is hostile to make the adjusters job easier to interpret the policy. A hostile fire is one that burns where it was not intended to burn: the living room drapes; the cabinets above the stove; a deck near the outdoor grill. Many policies cover only direct damage caused by hostile fire. CIE is often called to assess the cause and origin of soot damage. CIE has found many sources responsible for soot damage ranging from air pollution, furnaces, wood stoves, tobacco, candles and gas fired fire places.
CIE uses NFPA 921 guidelines to fully substantiate subrogation claims. Proper handling of the evidence is important in recovery as well as a thorough adherence to accepted procedures. We recently found a fire caused by faulty can light installations. When we checked other installations outside of the area of origin we found 4 others had defects that were causing charring.
In basic policies, explosion refers to any explosion that occurs within a structure that is covered by a given policy. However, explosive events usually are:
- bursting of water pipes
- electrical arcing
- explosions of steam boilers or pipes owned, leased or operated by the insured
- rupture or bursting of pressure relief devices
In more comprehensive polices, explosion also applies to events that originate externally
Lightning is “naturally generated electricity from the atmosphere.” Damage covered by the lightning peril may be the result of lightning itself or the result of a fire caused by the lightning. Lightning produces several common effects:
- Direct discharge – usually pretty obvious
- Ground current surge – this effect is caused by the movement of electrical ions in the ground that flow towards the ground strike. Wires within this area has an induced current caused by the electrical flow of ions and can often affect building wiring. We’ve observed several fires caused by this phenomena. Well pumps have large runs of wire in the ground and often will be the conduit into the buildings electrical panel.
- EMP – electro-magnetic pulse is found emanating from the strike and frequently affects microprocessors
- Electrical surges caused by power company equipment failures from strikes. If the failure is purely from a power company equipment failure, some policies do not cover.
The peril of windstorm involves damage caused by direct action of the wind, including high winds, tornadoes and hurricanes. Windstorm damage to an exterior is usually evident, there is often a question to the structural integrity of a building. Frequently, water damage inside a structure is often claimed as a result of wind driven rain. CIE checks the weather for the area, particularly sustained maximum winds and gust velocity and their direction. We also determine if the storm produced other evidence of high winds in the area.
Wind must reach sufficient velocity to have caused direct damage at more than one location to establish a “windstorm” loss. Basement flooding and leaks through an aged roof are not a windstorm loss. Although windstorm peril may not cover losses to items outside of the insured building: awnings, signs, plants, shrubs or trees, we observe them and document them as an indicator of a windstorm.
When we find windstorm related water intrusion it is often the result of recent poor workmanship and/or product liability issues. If similar work was done on the property, CIE checks for hidden conditions similar to the loss sustained.
Roofing failures are often blamed for many water intrusion and mold claims. Contractors often blame the roof and most homeowners simply don’t know. Frequently, CIE finds poor ventilation and/or insulation issues causing the problems. Our knowledge of roofing, HVAC engineering combined with thousands of investigations allows us to quickly and accurately determine the cause or often causes.
A claim we investigated was initiated by a new homeowner, the attic was a mess, heavy mold contamination on a newly installed roof deck, water was dripping from the shingle nail penetrations. The roof shingles were installed by previous owner the year before. Cause, inadequate attic ventilation. The roofing contractor was, in our opinion, responsible to inform the owner of the need, failure to inform is negligible.
Another claim found a converted cottage with an elderly couple using unvented propane and kerosene fueled heaters with extensive water dripping from the ceiling. The roof was nearly flat and recently shingled, CIE found evidence of some minor seepage through the roof due to ice dams, however, the saturation of the roof deck was extensive with frost and water dripping from everywhere. The unvented combustion was converting about 90% of its weight in fuel to water vapor!
CIE has also saved many insurers from needlessly replacing roofs and eliminating the problems with simple changes in ventilation or insulation. We have also found cases where the shingles are defective.
Although the New England area is not widely known for large hail storms, CIE encounters these claims routinely. Hail is formed in thundercloud cells, cumulonimbus, updrafts carry rain higher into the cloud where it freezes and drops and can pick up more rain and then be caught by another updraft, sometimes this cycle occurs several times and results in large hail stones. Eventually the hail falls and can cause severe damage. Fortunately, the thunder cells in New England infrequently produce hail of sufficient size to cause damage.
CIE evaluates these claims through several methods, forensic meteorologists are consulted as needed, but often we only need to look for the patterns consistent with hail strikes. Hail damage has an escalating profile depending on the size of the hail. Patterns of damage for the lesser profiles must accompany major damage.
HAIL DAMAGE PROFILE
0.5″ – bushes and leaves stripped, “skid” marks on siding where hail removes oxidation
0.75″ – threshold damage to rolled roofing, some denting to flashing and thin metal surfaces
1.0″ – threshold damage to composite shingles, vinyl siding, windows and thin skylights damaged
1.25″ – auto’s light damage, heavy shingles damaged
1.5″ – heavy auto damage, wood shakes damaged
Weight of Ice, Sleet, and Snow
The most common problem encountered are trees that fall impacting the roof and affecting the structure much like an earthquake shock. The ensuing damage often affects areas outside the immediate impact area. Snowloads can trigger a collapse of a weakened or overloaded structure.
CIE has found many structures affected by abnormal loads that contributed to failure. The engineering comes in to assess the proximate cause of the loss, was the load abnormal, was there decay, poor construction, inadequate support or any of a number of multiple considerations. One failure that we examined occurred when a moderate ice and snow load fell 15′ onto a new addition, collapsing the structural panel roof, a foreseeable event in New England. The contractor was identified as a subrogation target as there was no protection afforded against falling snow.
As professional engineers, if we detect a condition that may be in imminent danger of collapse we inform the insured and often make recommendations on how to temporarily support the structure against further collapse.
Smoke and Soot
CIE doesn’t try and interpret policies or give advise on coverages. Our role is to determine origin and cause. We understand that many policies cover a hostile fire and ensuing damage and delayed ignition, aka the puff back. Our experts examine the patterns to determine the origin. We’ve encountered a number of life threatening causes, unrelated to the claimed cause as a result of using our approach. Subrogation is uncovered frequently as well as educating the insured as to the effects of some of their habits. A laser particle counter is used to document our findings as well as provide a positive feedback to the insured. When a boiler or furnace is involved, our master licensed technician has over 35 years of experience with all types of HVAC equipment, residential to industrial, to conclusively determine the cause and find supportable subrogation.
Accidental Discharge – Water and Steam
Most of the time the origin of the damage is apparent. Determination of the cause is where engineering expertise helps. Damage to insured property caused by accidental discharge or overflow of water or steam from within a plumbing, heating, air-conditioning or automatic fire protective sprinkler system or household appliance is covered. Coverage includes the cost of tearing out and replacing any part of the building on the residence premises necessary to repair the system or appliance from which the water or steam escaped. We often can find alternatives to replacing the failed component with an equally acceptable alternative but at far less cost.
Damage caused by continuous or repeated seepage or leakage are often not covered; the cause must be sudden and unforeseen. Damage caused by freezing is not covered under this peril. Further, this type of loss is not covered if the dwelling has been vacant for more than 30 days immediately before the loss. A dwelling being constructed is not considered vacant.
A case we were called in on involved a basement that flooded and went undiscovered until a water company person found water flowing out a basement window, about 7 feet off the floor. CIE was able to pinpoint the day of the freeze-up, the day of the thaw and estimated day that the furnace was drowned – 120 days before it was discovered! Conclusion – vacant house, lack of heat
Another case appeared to be a basement seepage problem, however, we discovered some slight staining around the discharge end of the hot water heater relief valve. Testing showed the valve to intermittently fail on temperature, had the claim been denied because of seepage, repairs may have been made and the valve would have taken out the finished area again.
Washing machines commonly fail and when the machine is fairly new, subrogation potential is high. The two most common problems found are the level controller and the water supply valves. Subrogation investigations require ruling out other potential causes. It is also important to minimize the movement of the machine. We perform and document a couple of tests prior to securing the evidence.
Sudden HVAC and Fire Protection Failure
CIE is fortunate to have two seasoned experts on these issues. One expert holds and maintains licenses on HVAC, plumbing, boilers and furnaces. Experience in the energy delivery and system maintenance is invaluable. His almost encyclopedic knowledge of discontinued systems provides a tremendously efficient service to our clients. The professional engineer gained most of his experience on power plant systems, trouble shooting startups and failures. Together, they are an extremely efficient team, capable of resolving complex failures as well as the more routine.
The common Fire Protection systems, other than kitchen hood, are either usually wet or dry water systems. Most of the problems CIE has found with these systems are with the dry systems staying flooded and freezing. We frequently find simple design or installation errors that prevent proper draining after testing. CIE has frequently uncovered design flaws that would have prevented proper operation of the system during freezing weather.
Kitchen hoods an suppression systems are examined when a fire escapes the hood area and causes an uncontrolled fire. CIE has found sign-offs by technicians where the system didn’t contain all of the heating appliances, and where the system was designed for lard fire suppression but not for vegetable oil. Examination of several exhaust ducts found them too close to combustibles and a number of other failures.
Adjusters often miss opportunities for investigating the cause of a freeze-up. We frequently find cause for filing a subrogation claim against a responsible party and have had numerous successful construction defect recoveries. Some firms send a boiler technician to examine a boiler as the proximate cause. CIE sends an engineer that is trained to examine boilers, all too often we find the cause an insulation problem, no heat and delivery issues. We take surface temperatures of walls and floors and examine thermographs and furnace operation; coupled with weather, water and fuel records we’re able to determine, with confidence, the times of freeze-up and thaw. Was the oil delivery timely? Did the furnace/boiler flame out while on vacation? Was the house vacant? Was there sufficient heat? Are there insulation problems? The most common problems we find are with construction problems.
CIE’s engineers have the prerequisite HVAC, heat transfer, energy audit experience to quickly and confidently determine the cause.
Today’s equipment is extremely vulnerable to voltage surges and electrical transients. Many of the components that make up the integrated circuits operate at low voltage, making them particularly vulnerable. Voltage surges and transients cause degradation of these circuits and eventually will lead to a failure.
Common causes are lightning strikes, Electrostatic discharge and operation of large electrical motors. Power company equipment failures, line failures and even neighbors with large power equipment can cause voltage surges, drops, ground potential changes are all possible causes of damage to electrical equipment.
Equipment has two sources of potential surges, the power supply and the communication lines.
Most flood events are excluded, however, investigations are often needed to determine a flood was caused by surface water flow (rising water versus falling water). Claims often arise from third party claimants after a new construction project occurs. Floods also cause a rise in the groundwater level, often days after a storm event. Piping connected to the storm drainage system can become inundated by storm surges and backflow into an insured premises. New planning and zoning regulations requires that much of the storm water be detained in underground seepage structures, causing temporary rises in groundwater and potential seepage.
CIE’s engineers recognize the problems during the first investigation and have been instrumental in not only determining the cause but offering solutions to prevent reoccurrence. Builders are not accustomed to the potential effects of building infiltration structures next to a foundation, we have observed underground electric conduits spouting like a fountain next to an electrical meter. Our seasoned engineers are trained to recognize the source of the water, follow the patterns to the sources and determine the cause.
Earthquakes and Vibrations
The most common complaint CIE services is from construction activities. These claims are also the most delicate. Most persons submitting a claim due to construction activities or blasting have felt a shake. Humans are quite sensitive to vibrations and detect a vibration at thresholds less than 10% of the value where threshold damage may occur. Previously undiscovered defects are claimed and CIE sorts through the claims, analyses the patterns against our research, and assesses the potential validity. When records are made available we’re able to calculate the potential for defects to occur.
Obtaining records from the blasting company and interpreting the results is often a contentious effort and before we attempt to obtain this information, we qualify the damage that is observed. We examine the patterns of damage and compare that to scores of previous investigations and research to assess the potential. Most of the time we are able to determine the cracks are related to other causes. We frequently suggest some simple fixes to reduce the cause of cracks.
Complex cases, particularly with multi-family or commercial/industrial building impacts require that we validate the seismic readings. CIE has experts with extensive experience with vibrations, blasting and construction to provide subrogation, and defense support when justified.
CIE services range from determining the cause to evaluating the damage extent due to a tree or third party incident. Construction defects are commonly faulted when failures occur. CIE maintains a historical building code database to compare the cause determined with the codes required. Frequently CIE finds decay as a contributing cause of a collapse.
CIE is often asked to assess historical structures. Often, remodeling that occurred decades earlier begin to show deformations and structural responses. A recent claim involved a church, the sidewalls were leaning out and there were several beams showing stress. CIE quickly determined that the roof was not adequately supported and the horizontal forces at the eaves of the roof relied on cables located in the upper third of the rafter. Originally, the roof was supported by walls, now there are only columns.
Bodily Injury – Slip and Fall
There are a number of factors that can affect an accident. It is important to evaluate the human factors as well as the equipment or site factors where the accident occurred. Premises liability benefits from examining the cognitive capabilities of the injured as well as the limitations presented at the scene. The CIE team includes resources in safety engineering, building code compliance, site design, and human factors. CIE is on the alert for other potential risk management issues whenever we investigate a claim. A Workman’s Comp claim investigated found a serious issue with a piece of equipment, the machine shop had 12 of these machines operating in the same condition.
The interaction of the human subject to the environmental condition at the time and season of the incident helps determine the cause. Once the cause is fully understood, the degree that the premise is liable can be examined. Friction, lighting, obstacles, site lines, code compliance, construction and maintenance are all factors considered.
Mold and Water Intrusion
The investigation of mold and water intrusion claims follows a protocol similar to fire investigations. CIE examines the patterns, whether it is water stains, moisture readings, humidity, efflorescence, mold patterns, mold colony size or decay. The purpose is to determine the origin which in turn help limit the potential sources of moisture. Failure to identify the source of the moisture will lead to continued problems with mold contamination. We are often called to a claim where a problem occurs for the second time.
CIE engineers trace and interpret the patterns to determine potential causes. Non-destructive testing and thermal imaging allow our engineers to quickly assess the origin of the problem. Common causes:
- Poor Ventilation
- Insulation problems
- Plumbing failures
- Appliance failure
- Roofing, window and flashing problems
- Construction defects
- Soil Moisture, Downspouts, groundwater
Product Liability – Mechanical and Electrical
Multi-disciplined engineers identify a potential defect. CIE offers a range of engineering services including analysis of components, structural integrity evaluations, fatigue/ failure analysis, vibration analysis, metallurgy, corrosion analysis, troubleshooting, materials testing, xray and electrical testing. The vast resources in our network of affiliates allows us to have access to expertise from every discipline.
Successful recoveries and defenses on furnaces, boilers, switchgear, consumer products and small appliances, dishwashers, washers, dryers, HVAC equipment, service contractors, tools, vehicles, golf carts, wood stove, alternative fuel systems and various plumbing equipment.
Construction and Design Defects
CIE grew out of a design firm with many years of experience in design and construction. The principal had worked for a number of years with a major engineering firm with significant responsibility at a nuclear power construction project during the startup phase of construction. Years of experience provided the fundamental background needed to understand the dynamics of design and construction. While it is impractical to expect perfection, there is a duty to provide quality workmanship and expertise.
Fire and Arson Investigation
NFPA 921 is the guideline used to shape our investigations. Recognition of signs indicating potential subrogation or arson is our hallmark. CIE commonly performs the Origin and Cause Investigation leading to substantial recoveries. Full arson and subrogation investigations can be exhaustive and usually reserved for high value fires and likely subrogation or arson outcomes. CIE’s value to you supports both sides of an investigation. Frequently CIE investigates products believed to be a cause of a fire. One recent case involved a a cooking appliance in a restaurant fire, the fire event had investigators from three other principals. Reconstructing the fire scene found one cooking appliance outside the hood where a pan of oil was used for frying foods. It was found that the fire originated in the open pan, spread to the “suspect product”, then the cook used water on the oil fire where the splatter caused the fire to spread further. Also, CIE determined that the installation didn’t meet the Fire Code, the HVAC system had a number of combustible separation issues, and the pan frying was frequent and outside the hood causing oily vapors to condense inside the HVAC system.
Part of our investigations frequently involves determining the reason for the extent of damage. CIE often finds building code violations, maintenance issues, installation errors, fire suppression system failures and many other subrogation opportunities.
Traffic Accident Reconstruction
Years spent designing roads and highways, directing public works and responsibilities for safe highways is the foundation for investigating the scene of an accident. Coupling this past experience with the mathematical analysis of vehicle crashes and examination and training at Northwestern Universities Traffic Institute bestows great confidence in determining the various factors involved in an accident.
Types of accidents investigated:
- Autos, SUV’s, small trucks
- Large Trucks, trailers
CIE examines the scene of the accident to evaluate environmental factors, Visual factors ( sun, obstructions, sightlines, distractions etc.) , highway tort issues, signs, grades, hydroplaning, drainage, surfaces, vegetation, lights and a myriad of incidental items. The scene is also checked for physical evidence and compared with the police report. Vehicles, tires, lights and statements are all factored into the reconstructions. When necessary, specialized experts within our affiliates are called in for further consultation.
CIE’s analysis will determine all likely factors involved in the accident, vehicle speeds, energy transfers and external causes. Slow speed collisions are evaluated for energy transfer to allow comparison with common human activities.