A number of policyholder attorneys have asked me why FIGA is being so difficult lately. At one time, it was not that way. There has obviously been a change of the guard because nobody should expect quick resolution of any claim from FIGA based on recent complaints and the developing case law helps demonstrate this point.
Continue Reading...The Florida Association of Public Insurance Adjusters (FAPIA) is holding its annual convention. I have put together a unique panel of attorneys and public adjusters who once worked for insurance companies in various capacities. This panel discussion, "Learning From Those on the Other Side of Claims Presentation: Persuasive, Professional and Ethical Techniques of Claims Adjustment for the Policyholder," is the type of practical discussion and analysis which should become much more common at public adjuster seminars and conventions rather than lawyers telling public adjusters what the law is on any given coverage topic.
Continue Reading...Continuing with our discussion regarding late notice and prejudice defenses asserted by insurers, when is a re-opened hurricane claim a “supplemental claim?” This issue often presents itself in the context of a demand for appraisal by the policyholder on a re-opened hurricane claim. Insurance carriers treat the re-opened claim as a “supplemental claim” because a certain amount of time has passed since its claim determination. What would the time criteria for a “supplemental claim” be: one month; one year; two years; three years; four years? The issue of time is not a factor in the test of whether a re-opened claim is in fact “supplemental.”
Continue Reading...A standard business interruption form reads:
We will pay for the actual loss of Business Income you sustain due to the necessary suspension of your “operations” during the “period of restoration”. The suspension must be caused by direct physical loss of or physical damage to property at the “scheduled premises”…caused by or resulting from a Covered Cause of Loss.
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The best way to ignore or cover up improper and incompetent claims practice activity would be to ask only the guilty party, right? That is exactly what Louisiana Insurance Commissioner James Donelon and Risk & Insurance appear to have done. It seems that Donelon is not only in bed with the insurance industry, but also with the BP oil spill claims adjusters. Everybody in the business knows that most BP oil spill adjusters need a great deal of accounting help, which they are not getting.
Continue Reading...This is the continuation of my Saturday guest blog series. I like to share the stories of public adjusters and try to focus the topic of my blogs to current topics and issues public adjusters are facing in the field.
As I write this, I am preparing for the Florida Association of Public Insurance Adjusters (FAPIA) Summer Conference in Fort Lauderdale. I always look forward to conferences like FAPIA because I get a chance to hear my colleagues and public adjusters speak on topics directly affecting the industry. I get to meet new people and see old friends. I always learn something new and gain new perspective on what is happening in the legislature, in various courts, and in the field.
Continue Reading...Jeff Masters' post, Act I, Scene I, Tropical Depression One of the Hurricane Season of 2010, indicated that a tropical depression was forming in the Western Caribbean. The National Hurricane Center has now confirmed this prediction and designated the storm Alex. In the discussion this morning was a note I did not like at all:
Continue Reading...THE GFDL...SHIPS...AND LGEM
MODELS FORECAST ALEX TO BE A HURRICANE OVER THE GULF OF MEXICO.
THE INTENSITY FORECAST WILL NOT YET DO THAT...BUT WILL CALL FOR
MORE STRENGTHENING OVER THE GULF THAN THE PREVIOUS FORECAST.
One of my TWIA slab case clients was very happy about the proposed resolution of her claim. Her tone changed when she mentioned that TWIA raising rates five percent. I have often felt that our elected leaders are in a no-win situation when the people electing them to office hold a noose over their neck when it comes to government sponsored insurance. Voters want lower rates, even if that means the government charges absurdly low rates and unfairly competes with private enterprise.
Continue Reading...Almost every attorney has filed a Motion to Compel regarding discovery. Sure, we’ve won some. Of course, we’ve lost some. And we’ve all gotten the “granted in part and denied in part.” But how many times has your motion to compel been granted in a bad faith case? When has the court ordered your insurer to produce both its “work product” and “attorney-client” privileged material about how your insured’s claim was handled? I know what you’re thinking - “it’ll never happen.” But it does…
Continue Reading...The United States House of Representatives has unanimously passed a bill reinstating and extending the National Flood Insurance Program until September 30, 2010, according to an article in the National Underwriter, New NFIP Extension Bill Passes House; Senate Action Uncertain. The bill (H.R. 5569) will be sent to the Senate for further action. My suggestion in Flood Insurance is Harder to Find and Politics is One Reason was to call all Congressmen. Now we are down to just the Senators that need to get their act together.
Continue Reading...A paper, "Understanding Valuation Issues of Gulf Oil Spill Claims," will be delivered by me in Atlanta on Thursday. For those interested in the business interruption and lost income coverage disputes that Michelle Claverol writes about on this blog every Sunday morning, you'll love the paper. For those of you that simply want to know how to properly present the vast majority of all claims so they will get paid quickly by BP, you will enjoy the PowerPoint presentation I will cover in 12 minutes. I should probably advertise this speech as "how any attorney can make a lot of money by following these simple directions" and fill the room with my colleagues.
Continue Reading...The Blanchards owned a trailer and an apartment, located at 7529 Ling Road in Lake Charles. They lived in the trailer and rented the apartment. On April 11, 2006, Wesley Blanchard applied for a Standard Flood Insurance Policy (SFIP) on the buildings with Fidelity, listing the mailing address for the trailer as 7529A Ling Road and the mailing address for the apartment as 7529B Ling Road. Even though the two structures had separate mailing addresses, there was only one mailbox at the property. Fidelity issued two separate SFIPs for the properties.
Continue Reading...In a local television news report in New Orleans and one yesterday in Tampa, I explained the need for policyholders in coastal areas to purchase flood insurance. The problem is that flood insurance is getting harder to find and more expensive to purchase.
Continue Reading...Last week, Shaun Marker started us on the topic of late notice for hurricane claims. He ended his post with a few questions for later discussion, such as “what is timely notice, and how has the insurer been deprived of the opportunity to investigate the facts?” Corey Harris gave an excellent explanation of “what is timely notice” in his blog entries on January 23 and January 30 of this year.
Continue Reading...The “Period of Restoration” in a business interruption claim is a concept of time. The period, as defined in most ISO forms, begins at the time of “direct physical loss or damage” and ends on the earlier of “the date when the property should be repaired, rebuilt, or replaced with reasonable speed and similar quality.” […] or “the date when the business is resumed at a new permanent location.”
Continue Reading...This is a continuation of my guest blog, which shares the stories of public insurance adjusters. Today, I am writing about the role of the public adjuster and contents inventory forms. I would like this to be a discussion about best practices shared by those who assist policyholders with their personal property losses.
Continue Reading...(Note: This guest blog is by Vivian Persand, an attorney with Merlin Law Group in the Coral Gables office).
Last week, I wrote about some of the things you can expect to see, and not see, when Insurers like Safeco and Liberty Mutual respond to discovery requests. This week, I want to explain one of the steps you can take to combat these evasive discovery tactics. Some of the most effective and successful methods have been used across the country by large and small firms alike. What makes these plaintiffs’ law firms stand out is not the type of claim they pursue, the amount of the claim or the kind of insured they represent, but their commitment to not letting insurers get away with stonewalling discovery tactics. These attorneys go the extra mile, invest wisely, and do their homework. Sure, it might take some time; it’s going to take extra effort, and, naturally, nothing is free. But in the end, plaintiffs’ attorneys who obtain adjuster’s diaries, employee training manuals, and documents showing incentives for employees to put money into their own pockets instead of the insureds’ pockets, are going to go a long way in proving how their insured’s claim was improperly handled by the insurer from day one. This type of evidence can show your judge how the insurer never really intended to pay anything near a fair amount on your insured’s perfectly legitimate claim, if anything at all.
Continue Reading...Merlin Law Group has two great reasons for Florida public adjusters to come to West Palm Beach, Florida, on Wednesday, July 14th.
The oil spill attorneys advertising for a mass of clients and recent advertisements in Texas regarding Hurricane Ike claims, seem to indicate that all my colleagues always win, and win big. Nothing could be further from the truth. The truth is that if you are going to trial or push for what should fully be paid, at least one party to the litigation will lose and, sometimes, lose after a lot of money is offered to settle. Everybody loves to talk about their wins. Losses happen, and I am reminded of that bitterness and horrible feeling of injustice every now and then.
Continue Reading...The Preservation Hall Jazz Band, Lenny Kravitz, Mos Def, Trombone Shorty, and Tim Robbins recorded a version of The New Orleans Mardi Gras classic, It Ain’t My Fault, by Joseph Smokey Johnson and Wardell Joseph Quezergue, updating some of the lyrics for the Gulf Aid concert:
Continue Reading...Could there be a worse time to have a hurricane or tropical storm than the summer and fall of 2010? Given the extraordinary warmth of water this early in the hurricane season and the ongoing BP oil spill catastrophe, policyholders and public officials need to start taking immediate steps to prepare for two catastrophes which are greater than their sum. Jeff Masters, of WunderBlog, is discussing the possibility that a tropical depression is currently forming in the Atlantic. Those in the Gulf Coast have one eye out for the increasing probability of a hurricane while also watching for the spread of oil.
Continue Reading...A frequent issue that lawyers, adjusters and other insurance industry experts address in Florida involves policyholders’ failure to timely report their Hurricane Wilma claims to the insurance carriers. Often times, a policyholder is unaware of his or her rights and obligations under the policy and Florida law, and is unfamiliar with finding and determining damages to property. Also, policyholders have often heard horror stories of insurers canceling policies after one claim. Some policyholders try to make repairs themselves to avoid the headache of presenting a claim and going through the claim process. When the problem re-presents itself and the policyholder decides to file an insurance claim, a significant amount of time has passed since the date of loss.
Continue Reading...The proper determination of more significant oil spill commercial lost profit and earning capacity claims must be approached very similarly to business interruption catastrophe claims. The best approach for larger or more complex claims is through a team of specialists. A business client can only be properly represented and fully indemnified through a collegial debate and analysis developing the proper assessment of the business, the circumstances resulting from the catastrophe, the amount of the loss, and legal considerations of what the law will allow and require as proof, if challenged.
Continue Reading...(Note: This Guest Blog is by Michelle Claverol, an attorney with Merlin Law Group in the Coral Gables, Florida, office. This is the part of a series she is writing on business interruption claims).
The Standard ISO Extra Expense provision reads as follows:
Continue Reading...When considering the selection of an insurance commissioner, why not vote for somebody that knows about insurance laws and regulations rather than a politician? The race for California's Insurance Commissioner had a stunning result demonstrating that the Republican electorate might make such a selection. Brian FitzGerald, an insurance enforcement attorney in the California Department of Insurance with virtually no political campaign other than a Facebook website holds a small lead for the Republican nomination for California's insurance commissioner.
Continue Reading...My last work Friday night, other than checking the eleven o’clock news -- hoping BP had found a miracle to contain the oil spill, was to read emails from Texas attorney Steve Mostyn and Javier Delgado, of our firm about coinsurance coverage issues. I woke up this morning thinking about yesterday. My wife, Kim, noticed that my cell phone's power was depleted, and she asked whether I wanted it recharged. I thought some more about yesterday. "No" was the answer.
Continue Reading...Do I have your attention now?
Welcome to my guest blog series devoted to the stories and cases of public insurance adjusters. I have been happily working on this blog, and I am encouraged at how many responses I received from public adjusters all over the country who are interested in sharing information. Thank you. It means a lot to me to have interested readers and contributors. So, I began thinking about the topics for the blog and I thought it was most fitting to begin the series by discussing the hot topic of getting paid.
Continue Reading...(Note: This guest blog is by Vivian Persand, an attorney with Merlin Law Group in the Coral Gables office).
How many times have you reviewed documents produced by Safeco, Liberty Mutual or other insurers, only to receive virtually nothing significant other than a large privilege log? While the purpose of discovery is to exchange relevant documents or information which helps parties prove their cases, the clever and difficult attorneys hired by insurers have developed a knack for hiding and preventing the disclosure of crucial evidence pertaining to what really motivates and determines claims actions and decisions. In many cases, policyholders and their counsel can expect well-calculated discovery tactics which lead many to simply give up or think that the effort will delay the case for too long a time.
Continue Reading...Dimechimes ClaimSmentor had an interesting post on its blog which partially supports my opinion that the BP claims process has an insufficient number of qualified people attempting to figure out and pay the full amount owed to those damaged by BP. An Open Letter to Admiral Thad Allen, President Obama, White House News Correspondents, ESIS Insurance, and All involved in the BP Oil Response- We Can Help Address Your Claims Concerns- Lead, Follow, or Get the Heck out of our Way!!!! stated this:
Continue Reading...Safeco Insurance Company cancelled depositions in a Texas insurance litigation matter yesterday. So, we spent the day working on Safeco and Liberty Mutual Insurance Company discovery and networking with other consumer attorneys who are helping clients with Safeco and Liberty Mutual claims problems. The collegiality of policyholder attorneys helping each other is refreshing. The Texas plaintiff's bar is very good at this.
Continue Reading...The last thing public adjusters need is another class on the unauthorized practice of law as a substitute discussion for professional behavior. On Thursday, I will present a speech regarding professionalism at the National Association of Public Adjusters Annual Meeting. The title, "Fantastic Adjustment Results through Professionalism and Ethical Conduct: Tips from the Masters and Lessons from the School of Hard Knocks" fairly explains what I think is the most important issue facing the public adjusting industry in the long term.
Continue Reading..."Maybe if we think and wish and hope and pray it might come true"
--The Beach Boys
A recent Florida case that involves examinations under oath demonstrates that insurers should cooperate with policyholders and not try to use technicalities to prevent payment. In First Home Ins. Co. v. Fleurimond, 3D09-2034, 2010 WL 2178839 (Fla. 3rd DCA June 2, 2010), policyholders were allegedly yelled at and badgered during an examination under oath. They left, obtained counsel, and the insurer then refused to reconvene the examination under oath. The policyholders filed suit, demanded an appraisal, and the insurer refused. The trial court ruled that the matter should proceed to appraisal, and the insurer appealed.
Continue Reading...Evaluating a business interruption claim is not as simple as it sounds. After reading Chip's blog, How to Value an Oil Spill Claim--Not an Easy Task, I sincerely hope that everyone involved in this oil mess is properly trained in business valuation losses. Sometimes, as a result of inadequate or improper training, insurance companies can put their policyholders in an untenable position.
Continue Reading...The lost profit and earning capacity commercial claims arising from the BP oil spill are not easy calculations. BP should not hire liability and casualty adjusters to determine these claims, as they are now doing. In my experience, the vast majority of these adjusters do not know what they are doing when it comes to determining lost profits following business interruption. Many of my attorney colleagues advertising for these cases in a "sign them up and we'll figure it out later mentality" have quite a bit of learning to do as well. Merely asking clients and claimants to send in financial documents and then analyzing them will not determine the amount of the lost profits and earning capacity caused by the BP oil spill.
Continue Reading...This is a new series devoted to public adjusters. The purpose is to share your stories and to tell others about your cases and clients. I want to make this a place where information can be shared and the industry examined for the benefit of field advocates fighting for policyholders.
Continue Reading...Colorful and strong willed people make the world more interesting. Every meeting and phone call I had with Pat Catania was filled with colorful debate. He was a fighter and always made me rethink issues, methods of adjustment and coverage because he never accepted conventional thinking. When he learned he had liver cancer, he fought the conventional grim prognosis to the bitter end. I would have expected nothing less from him.
Continue Reading...(Note: This guest blog is by Nicole Vinson, an attorney with Merlin Law Group in the Tampa, Florida, office. This is part of a series she is writing on Examinations Under Oath and Public Adjusters).
Everyday, I talk with various people about insurance claims. I meet with public adjusters, consult with clients, discuss cases with my colleagues, talk with defense counsel, and, often, take testimony of witnesses or experts concerning insurance claims. My focus in all of these communications is to find a way to help the client and solve the problem. Many times this is easier said than done.
Continue Reading...In Texas, courts have long held that the qualifications required of appraisers are that they be competent and independent. Similarly, the appraisal provision of most insurance policies typically contains language requiring an appraiser to be competent, knowledgeable, impartial, disinterested, etc. Although both Texas courts and most insurance policies require that appraisers be – in some form or fashion – competent and independent, it is not always clear how someone should interpret such language. Fortunately, Texas courts have shed some light on this topic.
Continue Reading...Politicians who keep their campaign promises should be applauded. They are a special breed, particularly when knowing that such integrity will be criticized. Charlie Crist kept his word to Floridians when he vetoed a property insurance bill that would have allowed insurance companies to raise rates by ten percent each year. His veto is a huge victory for every Floridian who is outraged over the highest property insurance premiums in the country. The insurance industry offered the most illogical of all arguments as to why the proposed law was "consumer friendly:" by allowing rates to go up, insurance premiums would go down. This point was made in Do Florida Legislators Think We Are Stupid?
Continue Reading...Today is the day Governor Crist decides the fate of the pending property insurance bill by choosing whether to exercise his veto. Yesterday, investigative journalist Paige St. John's article, Lobby Had a Hand in Insurance Bill, was on the front page of the Sarasota Herald-Tribune. While I was unsuccessfully advocating for policyholders this past legislative session, I observed the insurance lobby, with an army of insurance lawyer lobbyists, seemingly writing most of the proposed laws that eventually passed. Indeed, I have not found one quote from a Florida representative claiming to have stopped any insurance industry sponsored law.
Continue Reading...1-877-449-4700
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