Insurance Bulletins Can Help Consumers Looking for Full Recovery

Rarely do insurance commissioner bulletins warn insurance companies of paying too much or that consumers are not entitled to insurance benefits. Most departments of insurance only write bulletins because insurance company adjusters pay far too less to similarly situated consumers suffering from the same loss.  Of course, insurance company lobbyists now go into overdrive to argue against the bulletin and to influence those in power to change the bulletin to favor payment of less money. Insurance companies essentially use policyholder premiums to pay the expense of their lobbyists to reduce payments to those paying for the insurance benefits.  How ironic. Continue Reading

It Never Rains in Southern California (but it pours)

Mario Lopez was a guest host on the Today show the other day, and described his recent property loss where his backyard collapsed into the street. Photos of the loss are available on Mr. Lopez’ Instagram or the Los Angeles Times. What struck me as blogworthy, other than the horrific loss of his yard, was his statement: “Thank God for insurance.” Continue Reading

Assignment of Benefits and the 2017 Florida Legislative Session

The 2017 Florida Legislative Session does not start until March 7th but committee weeks have begun in both Chambers. As a member of the Florida House of Representatives, I have been assigned to the following committees:

  • Civil Justice & Claims Subcommittee
  • Commerce Committee
  • Energy & Utilities Subcommittee
  • Government Operations & Technology Appropriations Subcommittee
  • Insurance & Banking Subcommittee

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Claims Handling Requirements by State – North Carolina

Next up in our whirlwind 50-state tour of claims handling requirements is the Tar Heel State. Unlike our previous stops in New Jersey and Pennsylvania, North Carolina has relatively few explicit claims handling requirements. This may be why North Carolina ranked dead last in a 50-state ranking of insurance regulations as pointed out by my colleague, Nicole Vinson. Continue Reading

The Obligation to Comply with Proof of Loss Policy Conditions

Insurance policies containing conditions pertaining to an insured’s obligation to submit a notice and proof of loss are “meant to give the insurer the necessary facts to facilitate an investigation of a claim and to protect it against fraudulent and excessive claims.”1 Continue Reading

Allstate Voids Policy and is Awarded Damages Due to Policyholder Misrepresentations

On November 22, 2016, Judge Berle M. Schiller from the District Court for the Eastern District of Pennsylvania issued his Opinion and Order in Payne v. Allstate Insurance Company, granting summary judgment to Allstate and awarding them $25,000 in damages, after finding that the Plaintiff made material misrepresentations while securing the homeowners policy. Continue Reading

When Is a Backup/Overflow Not Excluded Under Your Policy?

The “water damage” exclusion, which applies to a loss caused by “water which backs up through sewers or drains” plagued New Yorkers for decades, until Pichel v. Dryden Mutual Insurance Company, 117 A.D.3d 1267 (3rd Dept. 2014). In Pichel, the insured was an owner of an apartment building and brought an action against its property insurer after a denial of coverage for a flood that occurred in the basement apartments from waste water entering the buildings through toilets, bathtubs, condensation drains, and laundry room drains. The insurer cited the water damage exclusion which excluded coverage for “water which backs up through sewers or drains.” Continue Reading