{"id":41161,"date":"2024-05-22T06:00:52","date_gmt":"2024-05-22T10:00:52","guid":{"rendered":"https:\/\/www.propertyinsurancecoveragelaw.com\/?p=41161"},"modified":"2024-05-22T01:14:18","modified_gmt":"2024-05-22T05:14:18","slug":"cosmetic-and-functional-damage","status":"publish","type":"post","link":"https:\/\/www.propertyinsurancecoveragelaw.com\/blog\/cosmetic-and-functional-damage\/","title":{"rendered":"Cosmetic and Functional Damage"},"content":{"rendered":"

The Georgia Association of Public Insurance Adjusters<\/a> (GAPIA) held what I thought was its best meetings ever. One speaker, Mathew Mulholland<\/a>, was discussing an upcoming paper he and a distinguished engineer will soon have published regarding hail damage when Mulholland raised the issue of cosmetic and functional damage.<\/p>\n

This topic is not new and reminded me of a post written eight years ago, Cosmetic and Functional Damage \u2013 An Academic Discussion by Neil Hall<\/em><\/a>. I stated the issue as follows:<\/p>\n

Insurance companies have turned the property insurance world upside down by denying claims based on engineers who claim that no \u2018functional damage\u2019 occurred and only \u2018cosmetic damage\u2019 was sustained at the insured property. Most of us in the property insurance claims business have been taught that any \u2018physical damage\u2019 is covered by a property insurance policy. This concept of \u2018physical damage\u2019 as the bell weather proof of the type of damage covered under property insurance policies is changing and challenged by some insurers and their forensic vendors who claim that \u2018cosmetic damage\u2019 is not really the type of \u2018physical damage\u2019 covered under insurance policies.<\/p><\/blockquote>\n

Neil Hall provided an engineer\u2019s assessment of the issue, writing a paper that pointed out how many insurance company engineers refuse to properly consider that cosmetic damage to property is still damage: <\/a>1<\/sup><\/a><\/p>\n

Generally speaking, a forensic engineer (FE) is charged with finding \u2018direct physical loss\u2019 to a building or structure, identifying the causal events associated with that loss (what, how, where, when, why), and recommending a protocol to restore the building or structure to a pre-loss condition. Although many FEs tailor their repair recommendations to the prescriptive cut of \u2018like kind and quality\u2019, this reflects the limitations of certain insurance policies rather than the real-world requirements of model building codes. The FE\u2019s scope should always include all work necessary for planning, permitting, and lawful construction of the rebuild through the Certificate of Occupancy.\u2026.<\/p>\n

It is curious to hear FEs pontificate about \u2018cosmetic\u2019 and \u2018functional\u2019 damage when rarely do the same speakers acknowledge the broader term \u2018direct physical loss\u2019 which (it can be assumed) is the etymological root of the neologisms they so warmly embrace. Most FEs assert \u2018functional\u2019 damage (and by association \u2018cosmetic\u2019 damage) as engineering terms yet hold \u2018direct physical loss\u2019 taboo because it is an insurance term-of-art used to establish coverage. The mere utterance of \u2018direct physical loss\u2019 by a FE can raise eyebrows among peers, let alone accusations of collusion based on the preposterous notion that FEs best serve their clients when they are ignorant of their client\u2019s workaday vocabulary.<\/p>\n

The lack of communication is a two-way street. Consider an Insurance Adjuster who retains a FE to identify \u2018structural damage\u2019 to a given property. The Adjuster means direct physical loss to the building\u2019s structure as opposed to the building\u2019s contents, but the FE presumes this to mean \u2018structural damage\u2019 as opposed to \u2018non- structural\u2019 or \u2018cosmetic\u2019 damage. With her head buried in SEI\/ASCE-7, the FE tediously investigates the Main Wind Force Resisting System (MWFRS) while ignoring the cracked Venetian plaster. The FE reports \u2018no structural damage\u2019, the Adjuster hears \u2018no damage\u2019, the claim is denied, and all Hell breaks loose. As this author previously noted:<\/p>\n

putting aside the broad definition of structure as \u2018that which is built or constructed\u2019 (IRC, 2009), structural elements (framing and trusses) only represent 15.6% of new homebuilding cost (NAHB, 2009). What insurance engineers often trivialize as \u2018aesthetic damage\u2019 to architectural components can nevertheless entail serious economic consequence for the homeowner (Hall, 2012).<\/p>\n

This author has heard more than a few FEs snidely remark \u2018engineers don\u2019t do pretty\u2019. This is the ignorance of a forensic investigator who has never worn a hard-hat, swung a hammer or worked a construction job. FEs familiar with the trades know and understand that crown molding costs more per linear foot than the framing studs, and conduct their investigations accordingly.<\/p><\/blockquote>\n

While we will have to wait until this fall for the publication of Mulholland\u2019s paper, I am sorry to say that Part 2 of Neil Hall\u2019s publication was never published.<\/p>\n

I encourage those interested in cosmetic and functional damage to read the full post from the prior blog and other posts noted within it, as well as Neil Hall\u2019s paper.<\/p>\n

Thought For The Day<\/strong><\/p>\n

Architecture is really about well-being. I think that people want to feel good in a space… On the one hand it’s about shelter, but it’s also about pleasure.<\/strong><\/em>
\n\u2014Zaha Hadid<\/em><\/p>\n

\n

<\/a>1<\/sup><\/a> Nei Hall, Ph.D., P.E., Cosmetic and Functional Damage, Part One, (presented at the First Party Claims Conference, Warwick, Rhode Island, October 2016)<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

The Georgia Association of Public Insurance Adjusters (GAPIA) held what I thought was its best meetings ever. One speaker, Mathew Mulholland, was discussing an upcoming paper he and a distinguished engineer will soon have published regarding hail damage when Mulholland raised the issue of cosmetic and functional damage. This topic is not new and reminded …<\/span><\/p>\n","protected":false},"author":11,"featured_media":41164,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","footnotes":""},"categories":[12],"tags":[],"class_list":["post-41161","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-public-adjusters"],"acf":[],"yoast_head":"\nCosmetic and Functional Damage | Property Insurance Coverage Law Blog<\/title>\n<meta name=\"description\" content=\"May 22, 2024 The Georgia Association of Public Insurance Adjusters (GAPIA) held what I thought was its best meetings ever. 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