This column for National Underwriter P&C discusses the concept of "sudden and accidental" and how it is not required for most covered losses.
May 28, 2019 at 09:57 AM
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If you’ve been in insurance for any length of time, you’ve heard the phrase “sudden and accidental”, meaning that the cause of loss must be just that, sudden and accidental. It is routinely tossed around as if it has been standard wording forever, and is a key factor in determining whether a loss is covered. Adjusters and agents often use the term sudden and accidental, in particular when setting parameters as to why a loss should or should not be covered.
The truth however, is surprising, if not downright startling. Sudden and accidental are not widespread parameters for covered losses; in fact, the term appears rarely, if at all, in most policies. Let’s look. In the ISO homeowners form HO 00 03 05 11, the terms ‘sudden and accidental’ appear together only three times. Under Perils Insured Against, which lists coverages for A and B, it states, “we insure against direct physical loss to property described in Coverages A and B.” The direct physical loss doesn’t have to be sudden, it doesn’t have to be accidental, and it certainly doesn’t have to be both sudden and accidental. The loss has to be direct, but direct is not a defined term. If a claim goes to court, courts typically refer to a standard desk reference for terms that are undefined in the policy. A desk reference is what an average policyholder has access to and will be most likely to use. Merriam Webster online defines direct as, proceeding from one point to another in time or space without deviation or interruption; stemming immediately from a source; having no compromising or impairing element. Nothing in any of those definitions has anything to do with suddenness or an accidental occurrence. The definitions indicate that direct is acting in an immediate or primary way, not as a consequence or result of something else. Therefore, under Perils Insured Against for coverages A and B, sudden and accidental is not required.
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