In the early hours on Nov. 17, employees of the Manakai O Malama Integrative Healthcare Group & Rehabilitation Center heard what they believed was an explosion.

One worker thought that another had dropped something large, while others wondered what had caused the loud noise. The boom that they heard turned out to be a sewage pipe in a procedure room that ruptured, sending hundreds of gallons of untreated sewage into the office.

The sewage flowed for nearly 45 minutes, and by the time it was finally shut off, the entire Manakai O Malama sixth-floor office was sitting in about 4 inches of putrid water. No one was injured, and that was a major relief to Dr. Ira Zunin, medical director at the center.

Zunin was also relieved because he had taken out a business interruption insurance policy to cover any lost revenue caused by the temporary disruption at his clinic. The policy was required as part of his lease with the owner of the Honolulu Club building, and he had paid about $1,500 in premiums for the past seven years.

IT'S IN THE SMALL PRINT

But when Zunin filed a claim with his insurance carrier, Pyramid Insurance, he was told that the policy contained several exclusions and one of them was damage caused by sewage. In other words, he was told, the clinic wouldn't be reimbursed for any losses incurred as a result of the spill.

Zunin said he was shocked to hear that and wasn't aware of the numerous exclusions in his policy.

"Seven years ago they say get this, so I get that," he said. "I read the policy and I didn't look at the 4-point type."

He argued that the pipe that burst was not the clinic's responsibility and he had no way of preventing the spill.

But Zunin said the insurance company is standing its ground and will not reimburse the clinic for its losses. Zunin said it's too early to tell how much the clinic lost in revenue, patient volume and the inability of its staff to perform its duties.

He said he is considering his options, including another appeal to the insurance company. Zunin said he's also awaiting the results of an investigation to determine the cause and source of the spill to see if another party could be held liable.

AN 'UNFAIR' POLICY

Zunin said small businesses, particularly medical clinics, have to carry many types of insurance policies. He believes these many levels of coverage are unfair to the business owner.

He acknowledged that it's the policyholder's responsibility to thoroughly read the policy, but said sometimes that's just not possible.

"It's really so unfair that an insurance company would construct a policy and they know more than we know when they construct one," he said. "The small business owner innocently purchases that policy in good faith and pays the premiums in good faith and expects them to be there in a vulnerable moment."

State insurance commissioner J.P. Schmidt said the clinic's experience with its insurance company is not uncommon. He said it is important for businesses and individuals to understand what's covered and what's not in an insurance policy.

He said businesses affected by Thursday's heavy rain and wind may want to look at their various policies to see what will be covered.

"Oftentimes people will buy insurance and something will happen and they'll find that the insurance doesn't cover it," Schmidt said. "People will say, 'I thought it covered everything.' But insurance policies never cover everything. There are always limitations and exclusions and so it's important to know what those are."

He said business owners should carry some form of business interruption coverage because they could face financial disaster if forced to shut down for an extended length of time. But Schmidt repeated that owners must be clear on what their policies cover, and if they can't take the time to read a policy, they should find someone to do so.

"Most people don't like to read the policies themselves," Schmidt said. "They just say, 'Well, I have to buy it or I'm glad I bought it' and they throw it in a drawer."

WORKING THROUGH IT

While Zunin awaits the outcome of the investigation, he said the clinic will continue to operate. The landlord's insurance will pay for the repairs to his office and has allowed the clinic to move into vacant office spaces on the fourth floor while the repair work is done.

But Zunin said the business interruption is a "tough pill to swallow," particularly in the current economic climate.

"You have hospitals in bankruptcy, hospitals in the red, doctors leaving. It's tough enough to practice medicine and manage the clinic on a good day, so I don't think anybody has the fat to throw into a crisis like this with the down time," he said.

Zunin praised his staff and patients for banding together to help the clinic through this "crisis."

"Nothing is more important to me than being able to create the conditions that a suffering person can come, sit in that chair, and that we can help them," Zunin said. "Nothing can extinguish that passion. Not a flood, not a fire, not an insurance company."