Allianz Australia Insurance Limited v Rawson Homes Pty Ltd

Case

[2021] NSWCA 224

20 September 2021

No judgment structure available for this case.

Court of Appeal


Supreme Court


New South Wales

Medium Neutral Citation: Allianz Australia Insurance Limited v Rawson Homes Pty Ltd [2021] NSWCA 224
Hearing dates: 29 June 2021
Date of orders: 20 September 2021
Decision date: 20 September 2021
Before: Meagher JA at [1]
Leeming JA at [9]
White JA at [15]
Decision:

(1) Appeal allowed.

(2) Set aside the orders of the primary judge of 20 November 2020.

(3) In lieu thereof order that there be judgment for the respondent in the sum of $266,671, together with interest pursuant to s 57 of the Insurance Contracts Act 1984 (Cth) from 29 March 2018.

(4) The respondent pay the appellant’s costs of the appeal.

(5) Within 14 days the respondent file and serve written submissions (of no more than 7 pages) as to the orders that should be made as to the costs of the proceedings below in accordance with these reasons.

(6) Within 7 days thereafter, the appellant file and serve written submissions (of no more than 7 pages) as to the orders that should be made as to the costs of the proceedings below.

(7) Any submissions in reply (of no more than 5 pages) be filed and served within 7 days thereafter.

(8) Reserve the question of costs of the proceedings below.

Catchwords:

CONTRACTS — Construction — Construction of insurance contract — Where policy insured against damage to construction projects — Where houses under construction damaged in hailstorm — Where policy provided for application of “deductible” — Whether “deductible” to be applied in respect of each house under construction, or whether to be applied only once to the total sum to be paid for damage caused by the hailstorm

Legislation Cited:

Insurance Contracts Act 1984 (Cth)

Cases Cited:

FAI Insurance Ltd v Aust Hospital Care Pty Ltd (2001) 204 CLR 641; [2001] HCA 38

Lake v Simmons [1927] AC 487

Malamit Pty Ltd v WFI Insurance Ltd [2017] NSWCA 162

Rawson Homes Pty Ltd v Allianz Australia Insurance Limited [2020] NSWSC 1654

Selected Seeds Pty Ltd v QBEMM Pty Ltd (2010) 242 CLR 336; [2010] HCA 37

Wilkie v Gordian Runoff Ltd (2005) 221 CLR 522; [2005] HCA 17

Texts Cited:

FD Rose, Marine Insurance: Law and Practice (LLP, 2004)

WIB Enright and RM Merkin, Sutton on Insurance Law (Lawbook Co, 4th ed, 2015)

Category:Principal judgment
Parties: Allianz Australia Insurance Limited (Appellant)
Rawson Homes Pty Ltd (Respondent)
Representation:

Counsel:
T M Faulkner SC with C P O’Neill (Appellant)
M R Elliott SC with P Mann (Respondent)

Solicitors:
Carter Newell (Appellant)
LMI Legal (Respondent)
File Number(s): 2020/354592
 Decision under appeal 
Court or tribunal:
Supreme Court of NSW
Jurisdiction:
Equity
Citation:

[2020] NSWSC 1654

Date of Decision:
20 November 2020
Before:
Henry J
File Number(s):
2018/343087

HEADNOTE

[This headnote is not to be read as part of the judgment]

The respondent, Rawson Homes, took out a construction insurance policy with the appellant, Allianz. It insured Rawson Homes’ construction projects against material damage and for third party liability. Rawson Homes claimed under the policy in respect of damage to over 100 houses damaged by a hailstorm on 18 February 2017.

The policy made provision for the application of deductibles to certain claims. It provided that there should be a deductible of $10,000 for “Any One Event” applicable to “Material Damage” claims for “Major Perils”, which the parties agreed included the storm. In the court below, Rawson Homes contended that the deductible was to be applied only once; Allianz contended that the deductible was to be applied in respect of each building contract, each of which pertained to one of the damaged houses. The question turned on the construction of a number of terms in the policy.

The primary judge decided in favour of Rawson Homes. Her Honour held that Rawson Homes had made one claim and not multiple claims under the policy in respect of each insured contract, and that “a claim” described what springs from the “event”. Her Honour explained that there was only one “event” – the hailstorm – so that only one deductible was to be applied.

At issue on appeal was whether the relevant deductible was to be applied only once, or to each building contract.

The Court (per White JA, Meagher and Leeming JJA agreeing) held:

Per Meagher JA, agreeing with White JA at [1] but adding: The policy in question was in some respects like an “open cover”: at [5]. Whilst no separate policy is issued in relation to each commenced construction contract, the position of Rawson Homes is essentially the same as it would have been had a separate policy been issued for each contract: [6].

Per Leeming JA, agreeing with White JA at [9] but adding: Once it is seen that the Inuring Clause operates with respect to each Insured Contract, then the other provisions of the policy, including the “Application of Deductible”, are to be understood as being applicable per Insured Contract and read accordingly: at [12].

Per White JA: The starting point for the construction of the policy is the insuring clause, which provided for cover for “Contract Works against an Indemnifiable Event”. That cover was provided in respect of works described in an “Insured Contract” and the indemnity was provided in accordance with the “Basis of Settlement” which in turn provided cover to the extent that losses were included in the “Sum Insured”. The “Sum Insured” was the amount specified in the Schedule for any one loss or series of losses arising out of one event covered by the policy for any one “Insured Contract” after deduction of the relevant Deductible: at [49]. The scheme of the policy was that there was a relevant Deductible for the cover provided against losses arising from an Indemnifiable Event for each Insured Contract: at [50].

Judgment

  1. MEAGHER JA: I agree with the reasons of White JA and additional observations of Leeming JA which require that this appeal be allowed, and that the orders proposed by White JA be made.

  2. As the schedule to the policy records, the business of the insured, Rawson Homes, includes as a residential builder undertaking construction work at different sites in New South Wales and the Australian Capital Territory. The schedule refers to “Material Damage” (Section 1) and “Third Party Liability” (Section 2). That cover is geographically limited to the insured’s construction activities at “Contract sites” in Australia “below Carnarvon WA, below Rockhampton QLD & excluding NT”.

  3. The standard form policy wording describes itself as “Allianz Construction Insurance – Annual”. The schedule identifies the policy as insuring “Contract Works commencing during the Period of insurance, and continuing until completion, subject to the maximum construction period and maintenance period provided”. The schedule fixes that maximum period as three years. Accordingly, whilst the policy was current for the period of 12 months expiring at 4pm on 30 June 2017, it provides insurance cover for periods up to three years from the commencement of Contract Works and does so by reference to the contract or agreement under which those works are commenced, itself defined in the standard form as an Insured Contract.

  4. The matter in contest is whether in circumstances where more than 100 residences under construction (each the subject of a separate building contract which commenced during the period of insurance) suffered damage in a single hailstorm, the applicable deductible of $10,000 “Any One Event” applies separately to damage to each residential site, or to the aggregate of the damage to all of them.

  5. The resolution of that question turns on an understanding of the way in which Rawson Homes’ residential construction activities are insured by the policy. The policy is in some respects like an “open cover” in that it insures on the terms of the standard policy wording, and subject to the limits and sub-limits in the schedule, each Insured Contract which Rawson Homes commences during the 12 month policy period.

  6. The benefit of that insurance is extended to contractors and sub-contractors who are engaged in the Contract Works undertaken under the Insured Contract, and the period of that insurance is fixed by reference to the construction and maintenance periods for that contract. Thus, whilst no separate policy is issued in relation to each commenced contract, the position of Rawson Homes is essentially the same as it would have been had a separate policy been issued for each construction contract, the Schedule not providing for the application of any aggregate deductible or limit beyond that applicable to each Insured Contract. As to what is understood in this context by the term “open cover”, see FD Rose, Marine Insurance: Law and Practice (LLP, 2004) at [6.70]; and WIB Enright and RM Merkin, Sutton on Insurance Law (Lawbook Co, 4th ed, 2015) at [420].

  7. Turning briefly to the provisions of the standard wording, the insuring clauses provide cover with respect to each Insured Contract commenced in the policy period. That contract in turn identifies the Contract Works, Contract site, Construction Plant and Machinery and temporary buildings which are insured against material damage under Section 1. The definition of The Insured extends the benefit of that insurance to the contractors and sub-contractors undertaking work under that Contract.

  8. The activities covered under Section 2 are also described by reference to an Insured Contract which is also insured under Section 1, confirming that the whole of the cover under Sections 1 and 2 applies separately to each Insured Contract. Section 2 indemnifies against legal liability to pay compensation for Personal Injury and/or Property Damage as a result of an event occurring in the Period of Insurance. As already noted, that period is defined by reference to the Construction Period and Maintenance Period under the Insured Contract, and limited to a maximum period of three years. Property Damage as defined excludes physical damage to, or loss of use of, the Contract Works or other “property covered under Section 1”. Finally, the persons entitled to the indemnity under Section 2 include the Insured, and accordingly contractors and sub-contractors under the relevant Contract.

  9. LEEMING JA: I agree with White JA, for the reasons his Honour gives, that the appeal must be allowed, the orders made on 20 November 2020 set aside, and judgment in the agreed amount of $266,671 plus interest be entered for the respondent. Without qualifying that agreement, I would add the following out of deference to my having differed from the primary judge in this well argued appeal.

  10. The starting point is the insuring clause. Accepting as I do that the contract is to be read as a whole, that does not entail that each provision is equal. Rather, there is an inherent hierarchy between the insuring clause and other clauses which qualify that clause. That is because until and unless the insuring clause is engaged, the other clauses which qualify the indemnity granted in the insuring clause are inapplicable. Another way of making this point is that a premise of such other clauses applying is that the insuring clause is engaged. The need to read other clauses by reference to the insurance clause may be seen in FAI Insurance Ltd v Aust Hospital Care Pty Ltd (2001) 204 CLR 641; [2001] HCA 38 at [5] and [10]; in Wilkie v Gordian Runoff Ltd (2005) 221 CLR 522; [2005] HCA 17 at [19] and [32] and in Selected Seeds Pty Ltd v QBEMM Pty Ltd (2010) 242 CLR 336; [2010] HCA 37 at [28]-[30]. This Court proceeded on the same basis in Malamit Pty Ltd v WFI Insurance Ltd [2017] NSWCA 162 at [21]-[22], applying Viscount Sumner’s observation in Lake v Simmons [1927] AC 487 at 507 that exclusions are to be construed on the basis that they “cut out something already included by the general recitals and provisions”. The same is true of the clauses involved in the present appeal.

  11. In a variety of ways as explained by White JA, the wording of the insuring clause makes it clear that it turns upon each Insured Contract. The latter term determines the “Contract Works” and therefore the “Contract Site” and the “Contract Construction Period”. It follows from the definition of “Sum Insured” and “Total Sum Insured”, as well as the Schedule, that the Total Sum Insured (of $2,732,000) was an amount per Insured Contract.

  12. Once it is seen that the Insuring Clause operates with respect to each Insured Contract, then the other provisions of the policy, including the “Application of Deductible” which was central to Rawlinson’s construction, are to be understood as being applicable per Insured Contract and read accordingly. I respectfully disagree with the primary judge at [75] that it would have been necessary for the words “Insured Contract” to appear in the definition of Deductible or in the Application of Deductible clause.

  13. It is possible in principle for there to be a single (aggregated) deductible applicable to the distinct indemnities arising out of the same peril. But for the reasons given above and more fully by White JA, that is not the proper construction of this contract. I would also add that the Schedule identifies a series of limits for “Any One Event”. It was common ground that “Any One Event” for the purposes of the indemnities and additional benefits applied for each Indemnifiable Event (were this not so, then Allianz’s total liability for the more than one hundred homes damaged by the single hailstorm would have been limited to little more than $2m). The same words on the same page under the heading “Deductible” (“$10,000 Any One Event”) should be given the same meaning.

  14. I agree with the orders proposed by White JA.

  15. WHITE JA: This appeal is about the construction of an insurance policy. The appellant (Allianz) is the insurer. The respondent (Rawson Homes) is the insured. Rawson Homes carries on business as a residential builder on a substantial scale. It entered into a construction insurance policy with Allianz called an “Annual (Contracts Commenced Basis)” policy. The policy commenced on 30 January 2016 and was current for one year. It insured Rawson Homes’ construction projects against material damage and for third party liability.

  16. On 18 February 2017 there was a hailstorm that caused damage to over 100 residential houses that were in the course of construction by Rawson Homes in Rouse Hill and Kellyville.

  17. As explained below, the policy provided cover of up to $2,732,000 for damage to Contract Works (a defined expression) in respect of an Insured Contract (also a defined expression).

  18. Rawson Homes entered into a separate building contract for each house. It was common ground that each such building contract was an “Insured Contract” within the terms of the policy.

  19. A schedule, which formed part of the policy, provided there should be a Deductible of $10,000 “Any One Event” applicable to Material Damage claims for Major Perils and Minor Perils. Major Perils included storm.

  20. The principal issue before the primary judge, and the only issue on appeal, is whether only one deductible of $10,000 was applicable in respect of the damage to all the houses that were damaged, or whether that deductible was applicable to the claim arising from the damage to each house that was the subject of an individual Insured Contract. Rawson Homes contended for the former construction. Allianz contended for the latter. The primary judge decided that issue in favour of Rawson Homes and entered judgment against Allianz for $1,400,678 plus interest. (Rawson Homes Pty Ltd v Allianz Australia Insurance Limited [2020] NSWSC 1654 at [112]). The parties agree that if Allianz’s construction of the policy is correct, judgment should instead be given for Rawson Homes in the sum of $266,671 plus interest.

  21. In order to explain the parties’ contentions and address the reasons of the primary judge it is necessary to set out the terms of the policy in detail.

  22. The policy is in four parts. The policy terms include a general section that includes general definitions applicable to all sections of the policy: Section 1 headed “Material Damage”; and Section 2 headed “Third Party Liability”. In addition there is a bespoke schedule in which individual items are specified, particular to the individual insured.

  23. The insuring clause in Section 1 provides:

The Cover

Insuring clauses

In respect of an Insured Contract only, We will indemnify the Insured in accordance with the Basis of Settlement and subject to the other Policy terms, for the following:-

1. Construction

for Contract Works against an Indemnifiable Event that occurs and is discovered both at the Contract Site and during the Insured Construction Period.

…”

  1. Following clauses provide cover during a maintenance period or after partial handover, and for damage to or loss of plant and equipment, temporary buildings, materials in transit or in storage. Another clause provides additional benefits if these are included in the Schedule, such as costs of removal of debris, or professional fees incurred for restoration or repair of destroyed or damaged property.

  2. The cover was given “in respect of an Insured Contract only”.

  3. The definition of “Insured Contract” was included in the general definitions. It was relevantly defined as follows:

“‘Insured Contract’ means the contract or agreement entered into by the Named Insured which gives rise to the Contract Works.”

  1. The definition of “Contract Works” was included in the general definitions. It was relevantly defined as follows:

“‘Contract Works’ means the whole of the works described in the Insured Contract as required for the performance of the Insured Contract.”

  1. “Indemnifiable Event” was defined in Section 1. It was defined as follows:

“‘Indemnifiable Event’ means any sudden and unforeseen physical damage to, physical destruction of or physical loss of, the relevant insured property specified in the relevant Insuring clause, resulting from any cause not otherwise excluded, that occurs during the Period of Insurance.”

  1. “Contract Site” was defined in the general definitions as follows:

“‘Contract Site’ means the contract site anywhere within the area stated in the Schedule (but always within the Commonwealth of Australia), where the Contracts Works are carried out, and in respect of materials, whilst stored on adjacent property.”

  1. “Insured Construction Period” was defined in the general definitions. It was defined as meaning “… for each Insured Contract, the period starting on the date of possession of each Contract Site by the contractor or the commencement date of the Contract Works at the Contract Site …” and ending at times variously specified.

  2. As can be seen from the insuring clause quoted at [23] the indemnity was provided “…in accordance with the Basis of Settlement”.

  3. Section 1 of the policy included a provision entitled “Basis of Settlement applicable to this Section”. It provided for the basis of any settlement under the section (being insurance against Material Damage) either on the basis of cost of repairs or on the value of items the subject of a total loss “…only to the extent to which the costs claimed had to be borne by the Insured and to the extent to which they are included in the Sum(s) Insured”.

  4. “Sum Insured” was defined as follows:

“‘Sum Insured’ means the amount(s) specified in the Schedule as the Sum Insured which will be the maximum amount that We will pay for any one loss or series of losses arising out of the one event covered by this Policy for any one Insured Contract, which may be determined after consideration of any special condition or sub-limit contained either in this Section or as shown as an item in the Schedule and after deduction of the relevant Deductible.”

  1. Under the heading “Sum(s) Insured and Total Sum Insured” the policy provided:

“Our liability under this Section 1 of the Policy will not exceed the Sum(s) Insured stated in the Schedule for the respective cover, benefit(s) or item(s) of the property insured (subject to the escalation allowance specified above for Contract Works only) and less any applicable Deductible.

Our maximum liability for any one loss or series of losses arising out of the one event covered by this Section 1 for any one Insured Contract, will never exceed in all, the Total Sum Insured specified in the Schedule, less the highest applicable Deductible.”

  1. “Deductible” was included in the general definitions (and hence was applicable to both sections) and was defined as follows:

“‘Deductible’ means either the amount of money specified in the Schedule or stated in the Policy for each applicable Section or type of loss as specified, that the Insured must contribute as the first payment for all claims arising out of one event or occurrence.”

  1. Under the heading “Basis of Settlement applicable to this Section” (viz Section 1) the policy provides:

Application of Deductible

The amount of the Deductible will be subtracted from the amount payable by Us for each event giving rise to a claim under this Section. If a claim arises from a single event and the Insured can obtain cover under more than one benefit in this Section, the Insured will only be required to pay the highest single Deductible applicable regardless of the number of Deductibles applying to this Section.

Only for the purpose of the application of any Deductible, any loss, destruction or damage to the Contract Works or other insured property arising during any one period of seventy two consecutive hours caused by water, flood, cyclone, storm, tempest, earthquake or bush fire shall be deemed to be a single event and therefore to constitute one occurrence. The Insured may select the time from which any such period shall commence but no two such selected periods shall overlap.”

  1. The Schedule is referred to in the policy in the definitions of Sum Insured, Contract Site, Period of Insurance and the clause headed “Sum(s) Insured and Total Sum Insured”.

  2. The Schedule included the following:

Section 1 – Material Damage

Item

Material Damage

Sum Insured

Contract Works (C.W.)

$2,000,000

Any One Event

Principal Supplied Materials

$20,000

Any One Event

Escalation Allowance (10%)

$202,000

Any One Event

Total Contract Works Value

$2,222,000

Any One Event

Removal of Debris

$200,000

Any One Event *

Professional Fees

$200,000

Any One Event *

Expediting expenses

$20,000

Any One Event *

Pre-existing property

Not Insured

Construction Plant & Machinery

$30,000

Any One Event *

Temporary buildings and Tools of Trade

$60,000

Any One Event *

Employees’ effects

Not Insured

Materials in transit

$100,000

Any One Event **

Materials in Storage Off-Site

$100,000

Any One Event **

Mitigation Expenses

$200,000

Any One Event **

Total Sum Insured

$2,732,000

* Additional to Contract Works Value

** Included within Contract Works Value

Deductibles

The following Deductibles are applicable to Material Damage claims

Major Perils

$10,000 Any One Event

Minor Perils

$10,000 Any One Event

Theft and / or Malicious Damage

$10,000

Site Preparation Excesses Major perils

$10,000

Site Preparation Minor perils

$10,000

Major perils are water, subsidence, collapse, flood, landslip, cyclone, storm, tempest, earthquake.

Minor perils covers all other risks.

  1. The respondent submitted and the primary judge held that although the Sum Insured was to be calculated by reference to each Insured Contract, it did not follow that there was a separate Deductible for each Insured Contract. The policy wording under “Sum(s) Insured and Total Sum Insured” referred to the deduction of “any applicable Deductible” or “the highest applicable Deductible”. The definition of “Sum Insured” referred to the “deduction of the relevant Deductible”. The respondent submitted that this left open the question whether, for any particular Insured Contract, there was any relevant or applicable Deductible. The respondent submitted that that question was answered by the clause “Application of Deductible” quoted at [36] above. It submitted that one Deductible was to be subtracted from the amount payable by the insurer for “each event giving rise to a claim”. The “event” was to be distinguished from an “Indemnified Event”. The latter refers to the damage, destruction or loss of insured property that does not result from an excluded case (such as war, nuclear radiation, dishonest conduct, computer viruses or terrorism). The respondent submitted that the relevant “event” (uncapitalized) in the clause headed “Application of Deductible” was the hailstorm and that under the definition of “Deductible”, one Deductible was payable for all claims arising out of that one event.

  2. To meet Rawson Homes’ reliance on the “Applicability of Deduction” clause Allianz submitted that the “event” giving rise to a claim was not the occurrence of a storm or other peril but the loss, destruction or damage to the Contract Works that was the “Indemnifiable Event”.

  3. In support of that construction Allianz relied on the syntax of the second paragraph of that clause (quoted at [36]) that for the purpose of the application of any Deductible it was the loss, destruction or damage to the Contract Works (caused by water, flood, cyclone, storm etc) that was deemed to be a single event.

  4. The primary judge rejected this submission. Her Honour held:

“[61] Event and occurrence usually have the same meaning. They are directed to the cause of loss, rather than the loss itself: David Kelly and Michael Ball, Kelly and Ball Principles of Insurance Law (2001, Butterworths Australia, looseleaf) at [8.0130.10].

[62] The ordinary meaning of the word “event” is something that happens at a particular time, at a particular place and in a particular way: Axa Reinsurance (UK) Plc v Field [1996] 1 WLR 1026 at 1035. Once loss or damage to property is observed, one may search for an event or state of affairs from which it results. Thus, the use of the word “event” invites focus on the proximate or immediate incident or underlying cause leading to the damage to the houses: Weir Services Australia Pty Ltd v AXA Corporate Solutions Assurance [2018] NSWCA 100 at [88]; Windsurf Pty Limited v HIH Casualty & General Insurance Limited [1999] QCA 360 at [9].

[63] Rawson Homes contends that the hailstorm was the “one event” in this case because it would not be sensible or correct to proceed as if there were a series of different hailstorms starting and finishing at each house. It also submits that the words "giving rise to" are apt to describe a relationship under which one thing (the claim for indemnity) originates or springs from the other (namely the hailstorm event), relying on Quintano v B W Rose Pty Ltd [2008] NSWSC 793 (Quintano) and Walton v National Employers' Mutual General Insurance Association Ltd [1973] 2 NSWLR 73. I agree, and note that Allianz advanced no submission to the contrary.

[64] In my view, the characterisation of the hailstorm as the one event that gave rise to Rawson Homes’ claim (or claims) conforms to common sense and the ordinary and natural meaning of the word “event”. The hailstorm cannot be broken up into different storms. There is also no doubt that there was a causal connection between the hailstorm and Rawson Homes’ claim (or claims) for indemnity under the Policy as the hailstorm was the incident that led to the damage to the tiled roofs of the partially constructed houses. In other words, the hailstorm event was the underlying fact and the foundation from which Rawson Homes’ claim(s) arose: Quintano at [8].

[65] The interpretation of the hailstorm as the “one event” is at odds with the meaning of “Indemnifiable Event”, which is the trigger for indemnity under the Insuring clause in relation to an Insured Contract. An Indemnifiable Event is any sudden and unforeseen physical damage to the relevant insured property resulting from any non-excluded cause during the Period of Insurance. Thus, an Indemnifiable Event is the damage to specific Contract Works caused by the hailstorm, rather than the hailstorm event itself.

[66] That said, in my view, the deliberate use of the defined term in the Insuring clause and the use of the word “event” in other parts of the Policy signifies an intention they are to have different meanings, with the undefined word “event” to be given its ordinary and natural meaning in the context of a policy of insurance and not read as limited or displaced by the defined term: Tempe Recreation (D.500215 and D.1000502) Reserve Trust v Sydney Water Corporation (2014) 88 NSWLR 449; [2014] NSWCA 437 at 462; Provincial Insurance Aust Pty Ltd v Consolidated Wood Products (1991) 25 NSWLR 541 at 554, 560.

[67] For these reasons, I consider the hailstorm to be the “event” and “one event” giving rise to Rawson Homes’ claim(s) under the Policy.”

  1. I agree with that reasoning.

  2. The primary judge’s dispositive reasoning for upholding Rawson Homes’ construction was as follows:

“[68] For the purposes of a deductible, ‘claim’ is the occurrence of a state of affairs which justifies a claim, rather than the assertion of a claim itself. It has also been described as a demand for payment, benefit or indemnity under a policy: Desmond Derrington and Ronald Ashton, The Law of Liability Insurance (3rd ed, 2013, LexisNexis Butterworths) at 8-537; Sutton on Insurance Law at [15.570].

[69] As noted above, Allianz contends that Rawson Homes has made 122 claims, one for each Insured Contract, and that a deductible is payable in respect of each claim. Rawson Homes’ primary submission is that it has made one claim under the Policy in respect of the damage caused by the hailstorm to the partially constructed houses.

[70] In my view, Rawson Homes’ submission is to be preferred. The circumstance that gave rise to its entitlement to seek indemnity under the Policy was the one hailstorm event that caused loss by way of damage to the partially constructed houses. Upon that happening, Rawson Homes had an entitlement to make a claim on Allianz under the Policy for indemnity in respect of its losses for multiple Insured Contracts within the limits of the Policy. While the Insuring clauses identify the cover provided on an Insured Contract basis, there is one Policy that insures against Material Damage to multiple works and contracts in respect of which a claim for cover for multiple losses may be made. Thus, I do not consider that the language of the Insuring clauses and structure of Section 1 mandates that ‘a claim under the Section’ is limited to a claim in respect of an Insured Contract.

[71] As noted above, the Application of Deductible clause provides for the Deductible to be payable for ‘each event giving rise to a claim under this Section” and, in respect of ‘a claim arising from a single event’, only the highest single applicable Deductible is to be paid. To my mind, the words ‘a claim’ describe what springs from the ‘event’, namely a demand for cover for damage for losses caused by the hailstorm. The words ‘under this Section’ identifies that a claim must relate to cover for ‘Material Damage’ but does not, in my view, mean that a claim is limited to an Insured Contract. In any case, as Rawson Homes submits, even if it has made multiple claims rather than a claim, they all arise out of the same hailstorm event and the Deductible definition refers to it being the first payment for ‘all claims’.

[75] It seems to me that for Allianz’s submission to be sustained the words ‘an Insured Contract’ need to be read into the definition of Deductible, so as to confine the meaning of the expression ‘all claims arising out of one event’ to each such contract for the purposes of Material Damage claims under Section 1 of the Policy. The difficulty I have is that the words ‘Insured Contract’ do not appear in the definition. Nor do they appear in the Application of Deductible clause.

[79] I accept that the Insuring clause and other terms of Section 1 could be read as reflecting an intention that the Deductible is payable per event per Insured Contract. In addition to the Insuring clause providing for cover for an Insured Contract and the meaning of Indemnifiable Event, the limit of Allianz’s liability is expressed as applying to any one Insured Contract and it is contemplated as being the difference between the Sum Insured and the relevant Deductible. The Sum Insured definition and Sum Insured clause refer to the ‘Sum Insured’ and ‘Total Sum Insured’ as the maximum amount that Allianz will pay for any one loss or series of losses arising out of the one event for any one Insured Contract after deduction of or less the relevant/highest applicable Deductible. The expressions ‘less the relevant Deductible’ and ‘less the highest applicable Deductible’ suggest an intention that Allianz would be liable for part, and not the whole, of the Sum Insured and Total Sum Insured specified in the Schedule for each Insured Contract and that a Deductible may be payable for each Insured Contract. That said, the words ‘relevant’ and ‘applicable’ leave open the possibility that the Deductible will be nil, as Rawson Homes submits.

[80] Regardless, an interpretation of the Sum Insured clause and definition as providing for a Deductible to be paid in respect of each of the 122 Insured Contracts is, in my view, at odds with the plain meaning of the Deductible definition, the Application of Deductible clause and the Schedule. The limits of Allianz’s liability may be fixed by reference to one Insured Contract and cover may be provided against an Indemnifiable Event but the $10,000 Deductible applicable to Material Damage claims under Section 1 is fixed and payable by reference to the one event which give rises to one or more claims under one or more Insured Contracts.”

Consideration

  1. In the clause headed “Application of Deductible” a “claim” refers to a claim for an amount payable for each event which gives rise to a claim. (“Claim” is not defined.) Unless Rawson Homes can obtain cover under more than one benefit in the Section, that is, can also claim one or more “Additional Benefits” consequent upon the admission of a claim (such as the cost of removing debris, professional fees, expediting expenses, employees’ effects, mitigation costs, temporary protection or government fees) the Deductible applies to each and every claim. In the absence of a definition of “claim” it must refer to a claim under the “Basis of Settlement” for the cost of repairs or the value of items damaged to the extent they are included in the Sum Insured. Such amounts are only included in the Sum Insured to the extent that the loss arises out of one event covered by the policy for any one Insured Contract after deduction of the relevant Deductible.

  2. The primary judge held that Rawson Homes had made one claim and not multiple claims under the policy in respect of each insured contract. ([69] and [70]). Her Honour said that “a claim” described what springs from the “event” and was a demand for cover for damages for losses caused by the hail storm. ([71]).

  3. But as the cover was provided for each Insured Contract there was one claim for each damaged house, not one claim for all damaged houses.

  4. The primary judge held that the meaning of the second sub-paragraph of the clause headed “Application of Deductible” was that losses to Contract Works or other insured property over a 72 hour period caused by a storm or other natural peril were to be a single event for the purposes of the Deductible (at [57]). This is true. But what is of more significance is the acceptance in this sub-paragraph that a Deductible is applicable to any loss, destruction or damage to the Contract Works. Contract Works are the works described in each Insured Contract, to each of which a deductible is applicable.

  5. As Allianz submits, the starting point for the construction of the policy should not be the clause headed “Application of Deductible”, but the insuring clause. The insuring clause provided for cover for “Contract Works against an Indemnifiable Event”. That cover was provided in respect of works described in an Insured Contract and the indemnity was provided in accordance with the Basis of Settlement which in turn provided cover to the extent that losses were included in the Sum Insured. The Sum Insured was the amount specified in the Schedule for any one loss or series of losses arising out of one event covered by the policy for any one Insured Contract after deduction of the relevant Deductible.

  6. The scheme of the policy was that there was a relevant Deductible for the cover provided against losses arising from an Indemnifiable Event for each Insured Contract.

  7. This was made clear by the Schedule. The Sums Insured were specified for “Any One Event” and the Deductible was applicable to Material Damages claims for “Any One Event”.

  8. The primary judge considered (at [75]) that for Allianz’s construction to be maintained the definition of Deductible would have to incorporate a reference to all claims under each Insured Contract arising out of one event.

  9. There are two answers to that. First, the definition of “Deductible” is contained in the general definitions and is applicable to the cover provided by both Sections 1 and 2. Section 2 provides cover against Third Party Liability as follows:

The Cover

Insuring clause

We will indemnify the Named Insured for all amounts which the Named Insured becomes legally liable to pay as compensation for Personal Injury and/or Property Damage occurring within the Territorial Limits as a result of an Occurrence in connection with the Named Insured’s Business described in the Schedule, up to the Limit of Liability.

We will also indemnify the Insured for all amounts which the Insured becomes legally liable to pay as compensation for Personal Injury and/or Property Damage occurring within the Territorial Limits as a result of an Occurrence in connection with the Insured Contracts described in the Schedule, up to the Limit of Liability.”

  1. “Occurrence” is defined in Section 2 as follows:

“‘Occurrence’ means an event, or series of events consequent upon or attributable to one source or originating cause, including continuous or repeated exposure to substantially the same general conditions, which results in Personal Injury or Property Damage and which is neither expected or intended by the Insured.”

  1. Section 2 provides that:

Deductible

The amount of Deductible shown in the Schedule shall be subtracted from the amount payable by Us for each and every Occurrence, other than as provided for below in respect of Personal Injury to contractors and/or subcontractors or their employees.”

  1. The suggested necessary inclusion in the definition of Deductible of a reference to an Insured Contract would be inappropriate given that the definition applies to both Sections.

  2. The second answer is that the definition of Deductible (as meaning either the amount specified in the Schedule, or stated in the Policy, as the amount the Insured must contribute for all claims arising out of one event) when applied to a claim for Material Damage refers to a claim in respect of an Insured Contract, because the insurance is provided in respect of an Insured Contract.

  3. Rawson Homes submitted, without elaboration, that a lack of clarity and any ambiguity should be resolved against Allianz or a contra proferentem basis.

  4. In stating the legal principles applicable to the construction of the policy, which were not in dispute, the primary judge said:

“[43] As a commercial contract, a policy of insurance is to be given a business like interpretation. The task of interpretation is an objective one that requires attention to the language used by the parties, the commercial circumstances which the document addresses and the objects which it is intended to secure. A preference is to be given to the construction supplying a congruent operation to the various components of the whole: McCann v Switzerland Insurance Australia Limited (2000) 203 CLR 579; [2000] HCA 65 (McCann) at 589; Mount Bruce Mining Pty Limited v Wright Prospecting Pty Limited (2015) 256 CLR 104; [2015] HCA 37 at 116; MetLife Insurance Ltd v RGA Reinsurance Company of Australia Ltd [2017] NSWCA 56 at [100]-[101]; Wilkie v Gordian Runoff Ltd (2005) 221 CLR 522; [2005] HCA 17 at 529.

[44] The meaning of words used in an insurance policy are to be construed in favour of an insured as far as the ordinary and natural meaning of the words used by the insurer allows: Australian Casualty Co Limited v Federico (1986) 160 CLR 513; [1986] HCA 32 at 520.

[45] This does not mean that a court can attribute a different meaning to the words of a policy simply because the court regards the meaning as otherwise working a hardship on one of the parties. Where words are unambiguous they cannot be ignored: Australian Broadcasting Commission v Australasian Performing Right Association Ltd (1973) 129 CLR 99; [1973] HCA 36 at 109.

[46] In McCann, Kirby J discussed (at 602) the principles applying to the construction of insurance policies and observed that the contra proferentem rule is one of last resort, but that:

"... it is not unreasonable for an insured to contend that, if the insurer proffers a document which is ambiguous, it and not the insured should bear the consequences of the ambiguity because the insurer is usually in the superior position to add a word or a clause clarifying the promise of insurance which it is offering."

(quoting Johnson v American Home Assurance Co (1998) 192 CLR 266; [1998] HCA 14 at 275 [19].)

[47] An insuring clause and any exclusion clause, such as a deductible clause, must be read together in a harmonious way so that due effect is given to both and the right conferred by the former is not negated or rendered nugatory by the construction adopted in relation to the latter: Woodlawn Capital Pty Ltd v Motor Vehicles Insurance Ltd [2016] NSWCA 28 at [133].”

  1. The natural and ordinary meaning of the words of the policy are that Allianz insured Rawson Homes against loss or damage in respect of each Individual Contract up to the limit of the Sum Insured subject to a relevant or applicable Deductible. The Schedule to the policy shows that each event that would give rise to a claim would also trigger the relevant Deductible.

  2. There is no ambiguity to be resolved in favour of the insured.

Orders

  1. For these reasons I propose the following orders:

  1. Appeal allowed.

  2. Set aside the orders of the primary judge of 20 November 2020.

  3. In lieu thereof order that judgment entered for the respondent for $266,671 plus interest.

  4. Order that the respondent pay the appellant’s costs of the appeal.

  1. Prima facie, the respondent should also pay the appellant’s costs (or a substantial part of those costs) of the proceedings below.

  2. But there was at least one substantial issue at trial on which Rawson Homes was successful (namely the date from which interest should run) which was not an issue on appeal. Allianz may have raised other issues that were eventually abandoned. For example, Allianz admitted that it had asserted that the Sum Insured of $2,732,000 was to be applied as a Total Sum Insured to all homes, although it did not maintain that position at trial.

  3. I would direct the parties to provide written submissions as to the orders to be made for the costs below.

  4. For these reasons I propose the following orders:

  1. Appeal allowed.

  2. Set aside the orders of the primary judge of 20 November 2020.

  3. In lieu thereof order that there be judgment for the respondent in the sum of $266,671, together with interest pursuant to s 57 of the Insurance Contracts Act 1984 (Cth) from 29 March 2018.

  4. The respondent pay the appellant’s costs of the appeal.

  5. Within 14 days the respondent file and serve written submissions (of no more than 7 pages) as to the orders that should be made as to the costs of the proceedings below in accordance with these reasons.

  6. Within 7 days thereafter, the appellant file and serve written submissions (of no more than 7 pages) as to the orders that should be made as to the costs of the proceedings below.

  7. Any submissions in reply (of no more than 5 pages) be filed and served within 7 days thereafter.

  8. Reserve the question of costs of the proceedings below.

**********

Decision last updated: 20 September 2021