NEW DAY MINISTRIES OF PITTSBURGH IN C/O HELEN ROBERTS v. AUTO-OWNERS INSURANCE COMPANY, 2:20-cv-00627

Background:

Plaintiff New Day Ministries (Helen Roberts) owns a church in East Pittsburgh and filed an insurance claim for roof and interior water damage allegedly caused by a February 24, 2019 windstorm under a policy issued by Auto-Owners.
Auto-Owners denied the claim, asserting the roof and interior damage pre-dated the 2019 storm and were caused by wear/tear, faulty maintenance, inadequate flashing, or prior tile displacement — matters excluded by the Policy.
Plaintiff had submitted a prior, related claim in 2016; the parties and their insurers relied on multiple expert inspections and reports from 2016–2021 that reached competing conclusions on timing and causation of damage.
Plaintiff contends the Policy is “all-risk” and that Defendant bears the burden to show an exclusion; Plaintiff’s expert (Gardner) opined wind likely caused increased displacement and interior damage after 2016/2019 inspections.
Defendant contends its experts (Donan/Wasson, Ellis) show the damage pre-dates 2019 and is excluded; Defendant moved for summary judgment arguing no covered loss as a matter of law.
The court denied summary judgment, finding genuine disputes of material fact about causation, the extent of pre-2019 damage, and the sufficiency of competing expert opinions — issues for a jury.

Issues:

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Defendant is entitled to summary judgment because Plaintiff cannot show a covered loss	Plaintiff: The Policy is all-risk; Plaintiff showed a loss and expert evidence supports wind causation, so insurer must prove any exclusion	Defendant: Evidence and experts show damage pre-dated 2019 and resulted from wear/tear/maintenance issues; no coverage	Denied — genuine factual disputes exist about causation and timing of damage, precluding summary judgment
Burden allocation under the Policy (all-risk vs named-perils)	Plaintiff: All-risk policy shifts initial burden to insurer to prove an exclusion once a covered loss is shown	Defendant: Disputes characterization but argues insured must still show claim falls within coverage; insurer has shown exclusions	Court: Characterization not dispositive here; factual disputes on coverage/exclusions prevent resolution at summary judgment
Adequacy of expert opinion to establish causation	Plaintiff: Gardner opined increased shingle displacement after 2016/2019 and that the 2019 windstorm reasonably could have caused the new/worsened damage	Defendant: Gardner failed to tie new damage specifically to the 2019 wind event; Donan/Wasson and Ellis say damage predates storm	Court: Reading Gardner generously, his opinions create triable issues; competing expert reports preclude summary judgment
Applicability of policy exclusions (wear & tear, maintenance, interior-entry limitation)	Plaintiff: Insurer has not proved exclusions apply; factual record does not establish excluded causes as the sole cause	Defendant: Exclusions apply because damage was from gradual deterioration and inadequate maintenance predating storm; interior damage not covered unless wind first breached roof/walls	Court: Whether exclusions apply depends on disputed facts about timing and causation — not resolvable on summary judgment

Key Cases Cited

Anderson v. Liberty Lobby, 477 U.S. 242 (1986) (summary judgment standard and genuine issue for trial)
Celotex Corp. v. Catrett, 477 U.S. 317 (1986) (movant's and non-movant's burdens on summary judgment)
Boyle v. County of Allegheny, Pa., 139 F.3d 386 (3d Cir. 1998) (summary judgment inference and materiality principles)
CoreStates Bank, N.A. v. Cutillo, 723 A.2d 1053 (Pa. Super. Ct. 1999) (elements of a breach of contract under Pennsylvania law)
Betz v. Erie Ins. Exch., 957 A.2d 1244 (Pa. Super. Ct. 2008) (burden-shifting principles in all-risk insurance coverage disputes)
Miller v. Boston Ins. Co., 218 A.2d 275 (Pa. 1966) (insured must show claim falls within policy coverage as prerequisite to recovery)