Property Insurance Coverage Law Blog : Florida Insurance Lawyer & Attorney : Merlin Law Group Law Firm : Tampa, Houston, Coral Gables, Gulfport

This spring, a hot topic for Florida public adjusters has been proposed changes to sections of the administrative code that govern public adjusters. Listen to the complete 25-minute audio recording from the recent DFS hearing here. Two of the proposed changes have the Florida Association of Public Adjusters taking action and explaining ramifications that may have been unknown to drafters of the code.

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Most insurance policies contain a subrogation condition. Subrogation is “[t]he principle under which an insurer that has paid a loss under an insurance policy is entitled to all the rights and remedies belonging to the insured against a third party with respect to any loss covered by the policy.”¹

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Insurance agents usually promise a bunch of service and sell their trust to policyholders at the point of sale. Most of the time, there is no loss or the loss is less than the deductible so even if the agent blundered and did not obtain the best coverage for the price, the agent's errors and ommissions are never raised. Insurance experts often realize most agents are taught that their duties to service policyholders are far greater than what agents will admit to if the policy coverages fail to provide indemnity after a loss.

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The Jet Star Rollercoaster that Hurricane Sandy washed off the Casino Pier in Seaside Heights has become a symbol of the storm recognized by almost anyone who has seen or heard news of the storm.

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Many insurance carriers attempt to force their insureds into subsurface repair contracts based on the carrier's recommendations. In fact, carriers will refuse to provide coverage for a valid sinkhole claim unless the property owner repairs the property exactly the way the carrier recommends. Interestingly, the carrier will not agree to be liable if the recommended repair fails. This lack of security leaves many of my clients insecure. Many insureds obtain additional professional engineers' opinions as to the appropriate repair to stabilize the affected property and if the opinions differ from the carriers’, litigation often follows.

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I am in Kansas City litigating an alleged vexatious refusal to pay case against American Family Insurance Company. Did you know Kansas City is known as the City of Fountains? I thought that title was reserved for a favorite city of mine, Rome.

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Most property policies contain an exclusion that voids coverage if a structure is vacant before the loss, commonly for 30 or 60 days. The thought behind the exclusion is that vacant or unoccupied buildings face an increased risk of vandalism and theft as well as property damage due to neglect or disrepair.¹

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Is USAA a bad faith insurer? Active duty and retired military people often ask me if USAA treats their policyholders fairly and whether it is a "good insurance company." My father, a former Admiral in the United States Coast Guard, is insured by USAA. My sister is awaiting promotion as a captain in the Coast Guard Reserve. Our law firm has had numerous claims and lawsuits with USAA.

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In my last post, I discussed the statute of limitations applicable to different claims in New Jersey. Under flood claims, a lawsuit must be filed within 1 year from the date of denial. For homeowner’s claims, the default statute of limitations is six years, but it can be shortened by policy language to as short as one year.

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Insurance is a highly regulated industry because insurance companies have a long history of failing to honor promises, going bankrupt or finding unethical novel methods to gain a competitive edge. State insurance commissioners and attorney generals are charged with enforcing laws and regulations protecting consumers. I posed a question about whether state insurance commissioners and attorney generals are doing enough to protect insurance consumers following a discussion about an insurance policy that specifically excluded any benefits for the cost of matching damaged portions of a residential structure with adjacent undamaged portions of the home. The homeowner had fire damage in the kitchen and the insurance adjuster refused to pay to match cabinets, paint and wallpaper.

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What’s good for the goose is good for the gander. If an insurance policy says ordinance and law is an incurred expense, then an appraisal panel cannot set the amount of loss for ordinance and law until it is incurred.

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(Note: This guest blog is by Ashley Smith, a third-year law student clerking in our Tampa, Florida, office)

A new opinion takes a step in the right direction for Florida policyholders seeking to hold insurance carriers accountable for their conduct in the adjustment of insurance claims. The Second District Court of Appeal’s opinion in Hunt v. State Farm Florida Insurance Company,¹ unambiguously states that policyholders can bring bad faith causes of action against their insurance carriers after a favorable appraisal award.

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The Florida Department of Financial Services proposed changes to very important sections of the administrative rules that govern public adjusters and, in part, other adjusters in Florida. I posted about the proposed changes in Take Action Florida Public Adjusters: The Florida Department Seeks to Change the Rules Again.

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I recently encountered something rather bizarre – an insurance company trying to conduct Examinations Under Oath (“EUO”) despite there being no pending claim. The carrier denied the claim several months ago. A few months after the first claim denial, and after supposedly entertaining more information from the insured, the insurer ratified the denial. A few months after the second denial, and seemingly for the heck of it, the carrier decided to send another letter to the insured ratifying its second denial. A few months after that, a carrier-retained attorney emerged from out of the blue demanding EUOs. EUOs? For what?

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