A little help in Mississippi?

I am a university professor; my wife is a social worker. We lived on the Gulf Coast of Mississippi, when hurricane Katrina made landfall. We had hurricane insurance (MetLife) on the contents of our home and loss of use coverage. MetLife denied our claim. This is our story.

My wife, Cynthia, and I moved to Mississippi in August of 2003. Prior to our move, Cynthia worked as a Licensed Clinical Social Worker (LCSW) at the University of California, San Diego (UCSD) Cancer Center, and I was teaching Psychology at UCSD and the University of San Diego. We moved to Mississippi hoping we could make a difference. Cynthia works as an LCSW at a dialysis clinic on weekdays and as a psychotherapist at two counseling agencies and a nursing home on nights and weekends. I teach at the University of Southern Mississippi Gulf Coast.

If you are reading this, I assume you have much in common with Cynthia and me. We work hard. We DO have insurance on our cars, in case we accidentally bump you. We DO have insurance on our oceanfront condominium. We DO have insurance on the contents. We DO trust in our insurance companies to cover our losses in the face of a catastrophe.

When we moved to our home (a condo on the Gulf Coast), Cynthia called MetLife Auto and Home to get coverage on the contents of our home (insurance premiums for the actual structure were taken out of our $300-a-month homeowner’s association dues). Given we were from California, where we were unable to include earthquake coverage of any consequence for contents in our policies, Cynthia was apprehensive about our being able to secure hurricane coverage for an oceanfront condo. Our view was impressive; however, we were immediately struck by how vulnerable we were to hurricanes. The possibility of a hurricane destroying the coast was made even more salient during our visit to a coast museum devoted to the destruction caused by hurricane Camille some 30 years ago. The thought of catastrophic losses loomed large in our minds.

To our surprise (and relief), the MetLife representative told Cynthia we could get hurricane coverage, which was the reason why our premiums would be higher than we paid in California. In addition, we would have an additional hurricane loss deductible, but would also have loss of use coverage to provide us with $23,000 for temporary housing in the event our condo was made uninhabitable by a hurricane.

This was a group policy offered through Cynthia’s primary employer. The entire conversation with MetLife took place over the phone. There was no contract to sign - no policy to read - no exclusions to see - no discussion of the effect of exclusions. Cynthia based her acceptance decision on the reasonable expectation that the MetLife representative was being forthright and not omitting any pertinent information that might lead us to shop elsewhere. She entered into the agreement in good faith and had a reasonable expectation to believe MetLife was doing the same, given they advertise their integrity. To be sure, she (we) believed hurricane coverage meant we would be protected from loss in the event of a hurricane. To support her (our) belief, when we logged onto MetLife’s web site, we saw that our cover page (here) clearly states “loss deductible, $500" and “hurricane loss deductible, $500.” There is/was no WIND loss deductible.

Often we see people saying coastal residents knew they had no coverage against the storm surge. We firmly believed we had coverage against anything having to do with a hurricane - both the windy and the watery parts (they do, after all, combine to make a hurricane). We also have coverage against fires and fully expect to be covered for damages that result from both the flame and the heat.

When hurricane Katrina hit, except for our cars and financial accounts, we lost practically everything we owned. The loss was devastating! We thought we had done everything responsible people should do. Katrina hit on Monday. Sunday morning, I drove west to the university (it was 20 miles closer to predicted landfall) and retrieved two teaching awards I had received from my former students at UCSD. For a university professor, who values teaching and has the greatest respect for students, teaching awards are priceless - there is no greater professional recognition I can imagine.

On the way home, I heard the radio announcer say a surge of "eight to nine feet" was being predicted for Biloxi and reasoned our condo (22 feet above sea level) would provide safe haven for our possessions. Nevertheless, I placed my teaching awards on top of book shelves, computers on counter tops, and covered furniture we had just purchased with drop cloths. The entire south facing (Gulf facing) wall of our unit was comprised of floor-to-ceiling glass panels and glass doors, all of which a strong wind (Category 2) might destroy. Of course, we had boarded up with the obligatory sheets of plywood (we took all reasonable precautions).

We evacuated to Pensacola in two cars that were virtually empty. All we took with us were the necessities we would need for motel living over the next few days and a laptop computer. I certainly did not want to show up at a lower scale motel with thousands of dollars worth of computer equipment ripe for stealing out of our cars/room we would leave to take our meals. We took both cars, because we were told the parking lot for the condominium would probably be under water, given the predicted storm surge (eight to nine feet above normal) would surround our building. We believed we had covered all our bases. We trusted in the information provided by the National Hurricane Center. We trusted in MetLife to protect us from loss in return for the money they were deducting from Cynthia’s paycheck.

We learned on Monday (almost immediately) that our condo had been destroyed. All that remained were the east/west walls, the floor, and ceiling. There was a picture of our condo on CNN - an example of the devastation caused by Katrina. Tuesday night, as I lay on the motel bed watching the news coverage fade in and out (satellite), I noticed Cynthia had logged on to the Internet and was clicking away with the mouse. I asked what she was doing, and was told she was donating money to the Red Cross to help the hurricane victims. With just a hint of sarcasm, I suggested, when she was finished giving our money away, she might consider logging onto FEMA to tell them we just lost everything we owned! She gave me that look they must teach in Social Work School that makes you feel like someone else needs your last dollar more than you.

We filed our claim immediately with MetLife. They took about two months to deny it. They denied the claim based on the following exclusion and finally sent us a policy (after several requests) that included the exclusion. This is how it reads:

1.         WE do not insure under any Section I coverage for any loss which would not have happened in the absence of one or more of the following excluded events. We do not insure for any such loss regardless of: (a) the cause of the excluded event; or

(b) other causes of the loss; or (c) whether such causes acted at the same time or in any other sequence with the excluded event to produce or contribute to the loss.

D.        Water Damage, meaning any loss caused by, resulting from, contributed to or aggravated by: 1. Flood, surface water, waves, tidal water or overflow of any body of water, or spray from any of these, whether or not driven by wind;

After reading the exclusionary statement over and over, Cynthia and I looked at each other and asked “just what kind of hurricane loss were we insured against?” Apparently, MetLife wants to argue we are/were only covered for wind damage, but then only if there is no water damage that contributes to or aggravates the wind damage regardless of time line, which brings up the following points:

1. Winds must be at least 74 mph to be considered hurricane force, anything less would be called a tropical storm. This convention is based on the Saffir-Simpson Hurricane Scale provided by the National Hurricane Center and is easily accessible here. You are welcome to visit the site and confirm the relevant information I am about to cite.

2. According to this scale a Category 1 Hurricane has winds from 74-95 mph and generates a storm surge of 4-5 feet. That’s right, even with minimum hurricane force winds one should expect a storm surge (on the coast) to "contribute to and aggravate" any possible damage. Interestingly, one can expect NO real damage to building structures from winds at these speeds. Bear in mind we lived on the coast (Beach Boulevard), a fact that Cynthia and the MetLife representative discussed at the time we were offered hurricane coverage, and this particular policy is for contents only, which means the building must be compromised before the hurricane can damage the contents inside.

3. Clearly, no one on the coast needs hurricane coverage for wind that would cause NO damage. The next level, Category 2, consists of winds from 96-110 mph with a surge “generally 6-8 feet above normal.” At this point, according to the information available at the above-mentioned web site, one can expect “Some roofing material, door, and window damage of buildings.” Incredibly, by the time one begins to need wind coverage, the surge is already perilously high. Coastal residents would be surrounded by surge, and spray (driven by 100+ mph winds) would be "contributing to and aggravating" damage everywhere! Of course, if any item should be blown out of a home, it would have to land in the surge surrounding the home - oops, no coverage there (remember "contributes to or aggravates").

In essence, it is our opinion MetLife sold us wind coverage under the ruse of hurricane coverage that EXCLUDED any damage due to a hurricane of sufficient force to cause any wind damage to the contents of our condo that would not be "contributed to or aggravated by" surge or spray from surge. Is that not fraud?

4. These facts are even more staggering in view of our loss of use coverage, which (for all intents and purposes related to hurricanes) was completely non-existent. According to the Saffir-Simpson Scale, for a storm to be so powerful that the wind destroyed buildings, it would need to be a Category 5 hurricane, with winds greater than 155 mph and a storm surge greater than 18 feet above normal. Such a hurricane would cause “Complete roof failure on many residences and industrial buildings. Some complete building failures with small utility buildings blown over or away.” Note, this wind force is accompanied by a storm surge "greater than 18 feet above normal."

5. MetLife seems to have insured us against losses that would/could never occur. For example, if a family were living on the first floor, they would have drowned from the surge long before the wind was strong enough to cause loss of use – no need to pay a claim there! A surge greater than 18 feet that accompanies loss-of-use force winds would not only "contribute to and aggravate" wind damage, but would completely overwhelm any wind damage and that is what MetLife is relying on to deny coverage. For MetLife’s coverage to be REAL and in good faith, it seems they would only be able to sell such a policy to people living on those floors clearly higher than any possible storm surge one would reasonably expect to accompany winds strong enough to cause loss of use. Even then, storm surge would destroy the bottom floors of a condominium building, and the pump room and electrical room that supplies water and electricity to the higher floors would have already been destroyed by surge. Is this not fraud?

MetLife relied on an engineering report that claimed sustained wind speeds of 54 mph that somehow managed to drive a surge 30 feet high. Do you believe that is even possible? Here is a picture of a cabinet and its contents in an adjacent condo on the same floor as our condo. Notice the plastic cups are upside down. Do you really think water was that high? Wind can blow the doors off the cabinets, but leave the contents untouched. Water floats all boats. If there was water that high, it would have turned the cups rightside up to allow the air to escape (you are welcome to do the experiment). The ceiling of that condo is 30 feet high. Do you believe the surge was 30 feet high? Do you believe any surge of any height was caused by 54 mph winds? Nevertheless, that is exactly the level of care, due diligence, and "integrity" Metlife provided its customers. Their claim is that the "worst natural disaster to ever hit the United States" was caused by winds 20 mph less than "hurricane" force. Their claim, apparently, is that there really was no "hurricane" where we lived. Most wind estimates we have seen are well above 100 mph - 125 mph at our location (it only makes sense), and we have heard some estimates may be as high as 145 mph.