Although the events that trigger winter claims take place during the winter months, most insurance companies deal with them throughout the year. Some winter claims focus on a specific winter weather event that triggered the loss, but many also revolve around damaging conditions that occur throughout the whole season. Claims may also be just days or weeks old, but in some cases, they require analysis for winter weather events that could be 10-15 years old. In any case, determining the exact conditions that existed at the time and specific location of the loss is crucial to properly managing winter weather claims.

Winter weather claims generally can be broken down into the following categories: slip-and-fall cases, motor vehicle accidents, property damage, roof and building collapse, frozen and burst pipes, personal injury, pedestrian accidents, and water intrusion. Slip-and-fall cases account for approximately 64 percent of all winter weather claims. Winter motor vehicle accidents account for 12 percent, and the other six types of cases range from three-to-five percent of the remaining 24 percent of all winter cases.

Slip-and-Fall Cases

Slip-and-fall cases can occur anywhere. That includes outside of a building or inside from tracked in, blown-in, or leaked-in winter precipitation, which is common for injuries in buildings, lobbies, and restaurants. Many slip-and-fall injuries occur in the winter on surfaces such as wood decks, cement or slate stairs, stone or brick walkways, and other different types of building materials. They also may occur in places such as playgrounds, rooftops, or gyms. In some cases, a weather analysis is used to prove that the cause was from winter weather; in other cases, it is used to prove that the cause was not a result of winter weather. Either way, a site-specific analysis for the exact time and place of the loss is the best way to properly analyze and document the conditions pertinent to the claim.

When managing a winter slip-and-fall case, adjusters should seek a site-specific analysis that covers the day of loss and a minimum of two days prior (two-to-six days prior to the loss is the average needed for most reports). For the period in question, any winter slip-and-fall analyses should include the following: all precipitation (type, amount, start and stop times) and temperatures. Other conditions to consider are pre-existing snow or ice prior to the event, new snow on top of ice, and freeze, melt, and re-freeze scenarios.

Motor Vehicle Accidents

Winter motor vehicle accidents are very similar to slip-and-fall cases, except for consideration of visibility factors. In this type of case, damage or injury is caused by a motor vehicle whose normal operation has been affected by winter weather. Sometimes the cause is an event in progress; other times, the cause is from conditions from a recent past event. In cases where fraud or credibility may need to be determined, a site-specific weather analysis is a good tool for this purpose.

Some of the more unique motor vehicle accident cases involve snow or ice crashing down onto a roadway from an overpass, tree, wires, or a bridge. “White-out” conditions also are something to consider. These conditions are found during a snowstorm when high winds are present. High winds also may blow snow across a roadway, causing low visibility conditions, debris on a roadway, or even unexpected lane shifts by motor vehicles. Still, the main conditions for most winter motor vehicle accidents remain snow, ice, and poor visibility.

Property Damage

Winter weather-related property damage is a very broad topic that covers damage to such items as dwellings, structures, roadways, cars, trucks, equipment, trees, wires, and pipes. Combinations of storm damage, wind damage, weight or load damage, and exposure damage all are very common situations that can affect and damage physical property during the winter. Wind damage is very common in situations of fallen trees or limbs, downed power lines, blowing debris, equipment damage, structural damage, and roof damage. Load damage from accumulated snow and ice also may cause similar failures. Damage from exposure or extreme winter temperatures can cause damage to underground pipes, underground cables, exposed pipes or wiring during construction, exposed structures during renovation or construction, or in situations where heating is inadequate or faulty. Blizzard conditions generally cause property damage due to the weight of the snow combined with the force of the high winds.

When dealing with a roof or building collapse due to winter weather, the weight of the accumulated winter precipitation is generally the factor that needs to be determined. In most of these cases, an engineer is needed to apply weather data to structural data in order to determine the actual cause of the loss. In new or recently serviced structures, construction defects also may be a factor to consider. In older structures, age may affect the ability to withstand severe or even normal winter conditions.

When managing a winter property damage claim, it is recommended that either a comprehensive storm study or a full winter-weather analysis be conducted for the exact point of loss, depending on the type of claim and whether the damage that occurred was from a single, identifiable event or from damage that occurred over time.

Personal Injury and Other Claims

Winter weather personal injury claims usually revolve around cases where a death has occurred. Liability cases generally need to determine whether death was from natural causes or from exposure to winter elements. Temperature is a big factor in these types of cases, as is wind chill. Wind chill only applies to people, though, not intangible objects. People can be injured in the winter from exposure while outside, or from the inside when heating is defective or insufficient.

Claims for frozen or burst pipes are very common in the winter. Compared to other types of winter claims, these are relatively straightforward to investigate and determine cause. One common mistake made when dealing with frozen or burst pipes is to consider the wind chill factor. As previously mentioned, wind chill only applies to people, not intangible items such as pipes.

Another winter weather claim involves pedestrians and motor vehicles. Pedestrians who don’t properly use a walkway or sidewalk as a result of snow or ice coverage, pedestrians walking in the street due to obstructed sidewalks, and pedestrians stepping in potholes or puddles are quite common scenarios. Many times, visibility is an element in these cases because low visibility conditions make it difficult or impossible for a driver to pedestrians who are not where they normally should be.

Water intrusion is an odd claim, but a fairly common situation in the winter. Water intrusion is a situation resulting from snow and ice accumulations on the roof of a building. Due to ice dams, faulty gutters, drainage, or shingles, melting water from the roof enters the building and causes damage to walls, ceilings, or floors. Generally, this is a result of either too much snow or ice collecting on a roof combined with temperatures that are too cold to allow normal melting and drainage. Many of these claims require an investigation to place blame. Many water intrusion claims are result of construction defects.

Winter weather claims need to be investigated and documented properly to avoid unnecessary payouts by insurance companies. Using site-specific weather reports will provide the best information available, which can result in cost savings on your winter weather-related claims. It is important to realize that a site-specific analysis and interpretation by a trained and experienced forensic meteorologist is required to pinpoint the exact conditions for the specific point of loss. There are no web sites or Internet resources that can do this for you. The only information available publicly on the web is airport weather data, and that is only useful for cases or claims taking place at an airport. Insurance professionals and attorneys can save tremendous time, money, and resources by properly investigating and documenting winter weather claims.

Jess Hurwitz is the director of sales and business development for CompuWeather, Inc. More information is available at www.compuweather.com.