TL;DR:
- The Trap: If two events damage your home (e.g., Wind and Flood) and one is excluded, the ACC clause allows the insurer to deny both claims.
- The Counter: Do not file a "general" claim. You must hire a forensic engineer to prove "Segregation of Damages"—isolating the covered loss from the excluded one.
The "Wind vs. Water" Trap
A hurricane hits.
- Wind (Covered): Rips off your roof shingles. Rain soaks the attic.
- Flood (Excluded): Rising water floods your basement.
You expect a check for the roof and attic. The basement is your loss. Fair, right? Wrong.
If your policy has an Anti-Concurrent Causation (ACC) clause (and 90% of policies in FL, TX, and LA do), the adjuster can deny everything.
The Clause Logic:
"We will not pay for loss or damage caused directly or indirectly by an excluded event, regardless of any other cause or event that contributes concurrently or in any sequence to the loss."
Translation: Because the "Flood" (excluded poison) touched the house at the same time as the "Wind" (covered event), the entire claim is poisoned. You get zero.
Case Law: The 2025 Precedent
Insurers are emboldened by recent wins. In the late 2025 ruling Dalmac Realty LLC v. Scottsdale Insurance Company, a pipe burst (Covered) under a building, causing the earth to settle (Excluded).
- The Logic: The pipe caused the settling.
- The Ruling: Because the policy excluded "Earth Movement," and the ACC clause linked them, the entire claim was denied. Even the pipe repair.
This "poison pill" logic is now standard operating procedure for claims involving Hurricanes, Mudslides, and Sewer Backups.
The Defense: "Segregation of Damages"
You cannot argue fairness. You must argue physics. To beat an ACC denial, you must prove the two events were separate occurrences, not a single "concurrent" event.
The Strategy:
- The Timeline: Prove the wind happened before the flood.
- Evidence: Doppler radar timestamps showing wind gusts at 4:00 PM and storm surge arriving at 6:00 PM.
- The Structural Break:
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- Show that the water in the attic came from above (gravity/wind), not below (flood).
- The "Ensuing Loss" Exception:
- Many policies have a hidden "Ensuing Loss" provision. It says: "If an excluded peril causes a covered peril, we cover the ensuing loss."
- Example: If an earthquake (excluded) breaks a gas line and causes a Fire (covered), the Fire damage is paid.
Comparison: Standard vs. ACC Policies
| Feature | Standard Causation Policy | Anti-Concurrent Causation (ACC) |
|---|---|---|
| Scenario | Wind + Flood happen together | Wind + Flood happen together |
| Outcome | Wind damage paid; Flood denied | Everything Denied |
| Burden of Proof | Insurer must prove exclusion | You must prove separation |
| Risk Level | Moderate | Critical (Total Loss) |
2026 Denial Tactics to Watch
- "The Sequence" Trick: Adjusters will ask leading questions: "So the wind was blowing while the water was rising, right?" Say "No." State clearly: " The wind damaged the roof first. The flood arrived later."
- The "Sewer" Gimmick: If your roof leaks but your sewer also backs up, they will try to link them as "Water Damage" and use the Sewer exclusion to kill the Roof claim.
Your Next Move
If you receive a "Reservation of Rights" letter, the denial is coming.
- Do Not Talk: Stop giving recorded statements to the adjuster. They are fishing for a "concurrent" admission.
- Hire a Forensic Engineer: You need a stamped report stating: "The wind damage occurred at 14:00 hours and is physically distinct from the flood damage."
- Check Your Policy: Search for "Concurrent" or "Ordinance or Law." If you see it, you need a Public Adjuster immediately. Contact Leon Staff for a referral to a "Bad Faith" specialist.