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Understanding Duty to Defend and Duty to Indemnify
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The letter arrived from the insurer 3 weeks after the property management company had tendered a claim for defence. It confirmed that the insurer would provide legal counsel to defend the lawsuit filed against the company, but it also stated that the insurer reserved all rights under the policy, specifically citing the pollution exclusion as a potential ground for denying indemnity. The property management company, a mid-sized commercial operator managing 14 multi-unit residential buildings across a metropolitan area, had never received such a letter before and was uncertain what it meant for the claim or for the company's exposure.

The underlying lawsuit had been filed by a former tenant of one of the managed properties. The tenant alleged that prolonged exposure to mould in their rental unit had caused respiratory illness and other health effects. The statement of claim asserted that the property management company had been negligent in failing to address moisture infiltration and visible mould growth despite repeated complaints over a period of approximately 8 months. The tenant sought damages for personal injury, medical expenses, and loss of income.

When the property management company notified its commercial general liability insurer, the insurer acknowledged that the claim potentially engaged the policy's coverage for bodily injury arising from an occurrence. The insurer assigned defence counsel and confirmed it would fund the defence. However, the reservation of rights letter noted that the policy contained a pollution exclusion and that mould might constitute a pollutant or contaminant within the meaning of that exclusion. If the facts as ultimately determined established that the tenant's injuries resulted from exposure to a pollutant, the insurer might have no obligation to pay any judgment or settlement, regardless of having provided the defence.

The property management company now faced parallel uncertainties. On one track, the liability question: whether the company was legally responsible for the tenant's alleged injuries and, if so, in what amount. On a second track, the coverage question: whether the policy would respond to pay that liability or whether the pollution exclusion would apply. The insurer's defence counsel would handle the first question. The second question remained open, and the company was advised to consider retaining independent counsel to monitor and protect its coverage interests. The defence would proceed for the next 16 months under this arrangement, with the property management company cooperating fully while awaiting resolution of both the claim and the coverage dispute.

How the Mould Claim Played Out

How the Mould Claim Played Out Under Reservation

The defence of the property management mould claim proceeded for approximately sixteen months. During that entire period, the insurer provided and paid for the defence while maintaining its reservation of rights on the pollution exclusion question. The property manager cooperated fully with the defence, retained independent coverage counsel at the company's expense, and waited to see how the two parallel tracks, the liability question and the coverage question, would resolve.

The Investigation

The defence counsel appointed by the insurer conducted a thorough investigation of the tenant's negligence allegations. The investigation included several components that are standard in property management liability claims.

A mould remediation specialist was retained to inspect the affected unit. The specialist found the source of the moisture: a failing window seal on the building's east-facing wall. The seal had degraded over time, allowing small amounts of water to penetrate the wall cavity during rain events. The moisture accumulated behind the drywall over approximately eighteen months, creating warm, damp conditions in the wall cavity that were ideal for mould growth. The mould colony had spread through significant portions of the bedroom and living room wall cavities. The growth was entirely behind the drywall and was not visible from inside the unit at any point before the drywall was opened for inspection.

The maintenance records were reviewed in detail. The property management company maintained work orders for every maintenance request. The records showed that the tenant had reported a persistent musty odour approximately twelve months before filing the claim. A maintenance worker was dispatched the same week. The work order documented the complaint, the worker's visit, the worker's assessment that the odour was caused by insufficient ventilation, and the corrective action taken, which was the installation of a bathroom exhaust fan. The work order was closed as resolved. There was no follow-up visit. There was no re-inspection of the unit after the fan was installed to verify that the odour had been addressed.

The property management company did not have a written protocol for investigating moisture complaints. There was no standard procedure that required maintenance workers to check behind drywall when a musty odour was reported, no requirement to use a moisture meter to test wall cavities, and no trigger for engaging a mould specialist or a remediation company. The company's approach to musty odour complaints was informal and based on the individual judgment of whatever maintenance worker happened to respond.

The tenant's medical records were obtained and reviewed by a medical expert retained by the defence. The expert's opinion was that the tenant's respiratory symptoms were consistent with mould exposure but could also be attributed to other causes, including seasonal allergies, upper respiratory infections, and environmental irritants unrelated to the mould. The expert could not definitively establish that the mould caused the symptoms, but acknowledged that the temporal relationship between the exposure and the symptoms was suggestive. The defence strategy was to argue that the causal link was not sufficiently established on the balance of probabilities.

The Settlement Dynamics

As the litigation progressed and the evidence developed, both sides began to assess the likely outcome of a trial. The tenant's case had strengths: a documented moisture complaint that was inadequately investigated, a twelve-month delay in discovering the mould, a physician's report linking the symptoms to the exposure, and the absence of a standard protocol for moisture investigations. The tenant's case also had weaknesses: the causal link between the mould and the symptoms was not definitive, the maintenance worker's response, while arguably inadequate, was not unreasonable on its face, and the mould was hidden behind intact drywall in a location that was not visible during a routine visit.

The defence case had strengths of its own: the maintenance response was prompt even if the assessment was arguably wrong, the mould was genuinely hidden and could not have been detected without opening the drywall, and the medical evidence did not conclusively establish causation. The defence case had weaknesses too: the absence of a moisture investigation protocol suggested a systemic gap in the company's maintenance practices, the company did not follow up to verify that the fan had resolved the odour, and the twelve-month delay between the complaint and the discovery of the mould was difficult to defend.

Neither side had a clear advantage. The case was the kind that could go either way at trial depending on which judge heard it, how the witnesses performed, and how the expert testimony was received. Both sides recognized this, and settlement discussions began.

The Coverage Question in the Background

While the liability case moved toward settlement, the coverage question sat in the background, unresolved. The insurer's coverage counsel had researched the application of the pollution exclusion to residential mould and found that Canadian courts had produced inconsistent results.

Some courts had applied the pollution exclusion broadly, interpreting the definition of pollutant to include any substance that irritates or contaminates, regardless of context. Under this interpretation, mould would qualify as a pollutant because it produces spores and volatile organic compounds that are irritants and contaminants in the ordinary meaning of those words. If the mould was a pollutant, the exclusion applied, and the insurer had no duty to indemnify.

Other courts had taken a more purposive approach, looking at the intent behind the pollution exclusion rather than applying its literal language to every possible substance. These courts held that the pollution exclusion was designed to address traditional environmental and industrial pollution, the kind of contamination that occurs when a factory releases chemicals into the groundwater or when a fuel tank leaks into the soil. The exclusion was not intended, these courts reasoned, to eliminate coverage for biological substances in a residential building. Mould in an apartment is not the same kind of risk as a toxic chemical spill, and applying the pollution exclusion to residential mould would expand the exclusion far beyond its original purpose.

The insurer's coverage counsel estimated the probability of the pollution exclusion being applied to the mould claim at roughly fifty percent. This was high enough to justify the reservation of rights but not high enough to justify a flat denial. If the insurer denied coverage and was wrong, the insurer would face liability for the defence costs, the settlement or judgment, and potential bad faith damages. If the insurer maintained the reservation and settled the claim within the policy limits, the coverage question became moot, the insurer paid the settlement, and the matter was closed without a precedent-setting coverage trial.

This calculation influenced the settlement dynamics. The insurer had an incentive to settle the claim at a reasonable amount rather than take it to trial and risk having to litigate the coverage question separately. A settlement within the policy limits would cost the insurer the settlement amount plus the defence costs, which was a known and manageable expense. A trial, followed by a coverage dispute, could cost significantly more, with the added risk of an adverse coverage ruling that would affect the insurer's position on mould claims across its entire portfolio.

The Settlement

The claim settled for approximately sixty-five thousand dollars. The settlement covered the tenant's medical expenses of approximately eight thousand, lost income of approximately fourteen thousand, general damages of approximately thirty thousand, and the accommodation costs of approximately six thousand, with modest reductions reflecting the uncertainty in the causation evidence and the contributory factors that the defence identified.

The insurer paid the full settlement within the CGL policy limits. The reservation of rights was not acted upon. The insurer chose not to deny coverage for several reasons. The settlement amount was modest relative to the policy limits. The cost of a coverage trial would have exceeded the settlement itself. The case law on the pollution exclusion and mould was uncertain, and a loss at the coverage trial could have established unfavourable precedent. And the insurer's relationship with the management company, which was a long-term client, was worth preserving.

The property manager's out-of-pocket costs from the entire claim were approximately twenty-two thousand dollars: eight thousand for the independent coverage counsel, and fourteen thousand for the mould remediation, which was a building maintenance expense paid by the building owner and charged back to the management company under the management agreement. The CGL policy covered the tenant's damages in full. The management company's financial exposure, while real during the sixteen months of uncertainty, was ultimately limited to the costs that the insurance system was not designed to cover.

What Would Have Happened If Coverage Had Been Denied

The outcome was favourable. But the outcome could have been different. If the insurer had acted on the reservation and denied coverage after the settlement was reached, the management company would have been responsible for the entire sixty-five thousand dollar settlement, the thirty-two thousand in defence costs the insurer had already paid and might seek to recover, and the cost of litigating the coverage dispute in a separate proceeding. The total exposure could have reached one hundred thousand dollars or more.

For a property management company operating on management fee margins of five to eight percent of collected rents, one hundred thousand dollars in unexpected legal costs would have been a severe financial blow. It would not necessarily have destroyed the business, but it would have required borrowing, deferring capital expenditures on the managed buildings, reducing staffing, and potentially losing management contracts if the company's financial stability came into question.

This is the reality that underlies every reservation of rights. The defence feels reassuring. The lawyer is working. The insurer is paying. But the reassurance is conditional. If the coverage question resolves against the insured, the reassurance evaporates, and the insured is left holding the full financial consequence of the claim. Understanding this reality before it happens, rather than during or after, is the purpose of this course.

Lessons From How the Claim Was Handled

The property management mould claim offers several practical observations that apply to any policyholder who finds themselves in a similar situation.

The first observation is that the reservation of rights did not prevent the claim from being paid. Many policyholders receive a reservation letter and assume the worst, that the insurer has decided to deny the claim and is just going through the motions of the defence until it can officially refuse payment. That is rarely the case. The reservation is a precautionary measure, not a predetermined outcome. In many cases, including this one, the insurer ultimately pays the claim in full, either because the coverage question resolves in the insured's favour, because the settlement amount makes coverage litigation uneconomical, or because the insurer makes a business decision that paying is better than fighting.

The second observation is that the insured's independent coverage counsel played a critical role in the management company's ability to navigate the situation with confidence. Without independent counsel, the property manager would have spent sixteen months in a state of uninformed anxiety, unsure whether the reservation was serious, unsure whether the exclusion was likely to apply, and unsure what steps to take to protect the company's position. The eight thousand dollars spent on coverage counsel bought clarity, informed decision-making, and the peace of mind that comes from understanding your actual exposure rather than guessing at it.

The third observation is that the defence counsel appointed by the insurer performed competently and professionally throughout the litigation. The defence was thorough, the investigation was comprehensive, and the settlement outcome was reasonable given the strengths and weaknesses of both sides. The reservation of rights did not compromise the quality of the defence. The insurer fulfilled its duty to defend fully and competently, even while reserving the right to contest the duty to indemnify. This is how the system is supposed to work, and in this case, it worked as designed.

The fourth observation is that the coverage question, the pollution exclusion's application to residential mould, remains unsettled in Canadian law. Different courts in different provinces have reached different conclusions, and the Alberta courts have not issued a definitive ruling on the question. This means that any future mould claim against a property management company or landlord in Alberta could face the same reservation of rights, the same uncertainty, and the same sixteen-month period of not knowing whether the insurer will pay. The policyholder who understands this dynamic in advance is better prepared to deal with it when it arrives.

The fifth observation is that the management company could have reduced its risk of facing this kind of claim in the first place by implementing a moisture investigation protocol. A written protocol that required maintenance workers to use a moisture meter when investigating odour complaints, to check behind drywall when elevated moisture was detected, and to engage a mould specialist when mould was suspected, would have increased the likelihood of catching the mould problem early, before it became a health issue for the tenant. The cost of implementing such a protocol would have been minimal compared to the cost of the claim, the independent counsel, the remediation, and the sixteen months of uncertainty. Prevention is always cheaper than defence, and in property management, a simple maintenance protocol can be the difference between a routine work order and a lawsuit.

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