Following massive hail damage losses, the Arizona Department of Insurance issued a statement which reiterates a warning I have given time and again:
Continue Reading...[C]ontractors cannot “negotiate” the settlement of the insurance claim with the insurance company representatives on behalf of the property owner...
Last week, I began a brief history of the all-risk policy. I left off at the point where insurance companies were beginning to add more perils to their policies. Originally, these perils were added by underwriters, many times at the consumer’s request. In an effort to simplify the underwriting process and increase profits insurance companies began packaging perils together.
Continue Reading...Last week I discussed Colorado case law which requires an insurer to replace a hail damaged roof to its pre-loss function, even if such replacement places the insured in a better position than before the loss. See Dupre v. Allstate Ins. Co., 62 P.3d 1024, 1031-32 (Colo. App. 2002). Policyholders may be entitled to payments for substrate or roof deck not directly affected by hail if replacement of substrate or roof deck is required to support the new top layer.
Below are tips to help policyholders obtain sufficient payments from the insurer. The key is to provide sufficient evidence to the adjuster, so that denial of coverage for a portion of or all of the roof system becomes less likely.
Continue Reading...The California landscape has changed dramatically from when I was a child growing up in Southern California. The population boom that California experienced with the dot.com companies (in Northern California) and the extensive building of homes in Southern California have changed the landscape forever. Despite all these changes, I love living in California and have the privilege of practicing law here.
Continue Reading...Do you have to be named on a property insurance policy to enforce it? The answer in Florida is "no," so long as you have an insurable interest in the policy.
Continue Reading...In Late Notice Of The Claim Part 1 -- Contrary to The Popular Belief of Insurance Carriers in Florida, Late Notice Is Not Necessarily An Absolute Coverage Defense, I wrote that the late notice defense is not an absolute coverage defense. In that post, I discussed the test the Florida Supreme Court has applied to late reported claims. When an insured fails to give timely notice of a loss, prejudice to the insurer is presumed. Bankers Ins. Co. v. Macias, 475 So.2d 1216 (Fla. 1985). A court should presume that the insurance company’s investigation into the cause and damages associated with the loss was prejudiced, however, policyholders can rebut that presumption by showing that the insurer was not, in fact, prejudiced by the late notice. Macias, 475 So.2d at 1218.
Continue Reading...In the book Business Interruption: Coverage, Claims and Recovery, the authors devote a section to discuss relevant issues surrounding the presentation of reports and data in support of a business income claim. We live in a world where information is being stored in “clouds;” knowing exactly how to gather, collect and present business data after a loss or catastrophe is likely the best practice to avoid unnecessary delays and obstacles during the claims process.
Continue Reading...Today, high-speed computer networks and Internet access are considered to be as essential as indoor plumbing. We have access to what seems like limitless data and information. Company computer systems house terabytes of financial information that is sliced into countless management and financial reports that executives use to efficiently run and guide their business
Easy access to all of this information can be good or bad for business interruption claims as it can 1) assist in speeding the insurance claims process to an agreeable settlement, or 2) mire the process in unnecessary data that slows progress, contributes to countless questions and requests from insurer representatives, and increases scrutiny regarding the amounts being claimed.
Yesterday, Emmett Pierce of Insure.com reported on a topic that affects policyholders and public adjusters nationwide. In Vanishing Act: Your Home Insurance Coverage Is Disappearing, Amy Bach, the executive director United Policyholders, discussed the nationwide trend of insurance companies offering less and charging more. Steven Venook, the president of Florida’s Advocate Claims Services, provided a perspective of what is happening in the field when claims are adjusted and investigated. Venook explained how higher deductibles and policies rampant with exclusions are affecting claims in Florida.
Continue Reading...Last week, in 'Bama Bad Faith - An Alabama Case Evaluates a Number of Bad Faith Issues, Part 3, I began an evaluation of whether there was a genuine issue of material fact as to the basis for the insureds' bad-faith claims in Jones v. Alfa Mutual Ins. Co., 1 So.3d 23 (2008). The lower court granted summary judgment in favor of Alfa, concluding that there was no genuine issue of material fact, and the insureds appealed. The Alabama Supreme Court explained that the allegations against Alfa included both a “normal” bad-faith claim and an “abnormal” bad-faith claim. This week, I am writing about the “normal” bad faith claim.
Continue Reading...Throughout my career, I have spent a great deal of time in Tallahassee, working on a broad range of insurance issues. Even with that experience, Tallahassee is a strange place to me. It is also a distant place to most Floridians – both in location and in familiarity. Some of us know the legislators in our own districts sent to represent home interests, but few know anything about the other 158 members who together create the laws which govern us. For most of us, Tallahassee is something we like to passively complain about – the punch line in an all-to-familiar joke.
Continue Reading...The United States and Florida Constitutions give everybody the rights to due process under law and a jury trial. These fundamental rights were important to the founders of this country. Yet, some Florida legislators fail to respect and observe these rights when it comes to making special laws which protect the insurance companies who fill their campaign coffers.
Continue Reading...My post last week touched on an ambiguity that arose out of an all-risk policy, and I realized that the all-risk policy is an interesting and important topic that has not yet been discussed in detail on this blog. Insurance has evolved over time, and the all-risk policy is, perhaps, the evolution that has most benefitted consumers.
Continue Reading...(Note: This Guest Blog is by Erin Kristofco, an attorney with Merlin Law Group in the Denver, Colorado, office).
Home and business property owners who suffered hail damage during Colorado’s hail storms must determine whether their property insurance policy requires the insurer to replace not only the hail damaged surface, but also any substrate, insulation or the structural deck.
Continue Reading...Aside from protecting policyholders’ rights against their insurance companies, Merlin Law Group also monitors bills that may affect your rights as a policyholder.
Continue Reading...Citizens Property Insurance Corporation was created by the Florida legislature. Generally, Citizens’ goal is to pay claims from funds acquired through insurance premiums and other investments, but sometimes this is not possible. According to Fla. Stat. § 627.351(6), if Citizens’ funds for paying claims are depleted by a hurricane or other catastrophic loss, Citizens may impose surcharges and other assessments on Citizens’ policyholders, as well as other Florida insurance companies and policyholders to make up for deficits in Citizens’ reserves. To help explain its surcharge and assessment powers, Citizens has provided a brief summary of these powers on its website.
Continue Reading...Civil Authority provisions normally provide coverage for business income losses when access to an insured premises is prohibited by a governmental action. This coverage, however, is not easily triggered, and it will also be subject to time restrictions.
Continue Reading...Restaurant proprietor and fellow blogger, Bruce Buschel, wanted to open a fantastic restaurant. Inspired by charming European restaurants, Buschel opened a Hamptons restaurant that served locally grown or raised food -- wine from New York and seafood from Peconic Bay. Just last fall, Southfork Kitchen opened its doors to rave reviews. With a fresh menu that featured the local ingredients expertly prepared by a talented and recognized chef, Southfork Kitchen was getting a lot of great press. But the restaurant was in the news most recently because of a fire loss. Southfork Kitchen is temporary closed and Buschel has described the damage and his claim experience on his blog.
Continue Reading...In my post three weeks ago, I addressed the factual background in the Supreme Court of Alabama’s opinion on the bad faith case Jones v. Alfa Mutual Ins. Co., 1 So.3d 23 (2008). Last week I wrote about the issue of whether the Insureds timely filed their Complaint. This week, I am writing about whether there was a genuine issue of material fact regarding the basis for the Insureds' bad-faith claims.
Continue Reading...The lodging and resort industry faces a significant exposure to hurricanes. In an article, Preparation for the Hurricane Season Includes Insurance and Risk Reviews, which I wrote for Lodging Hospitality, I noted the following:
Continue Reading...This morning, I spoke to the Destin, Florida, chapter of the Condominium Association Institute about properly reviewing and purchasing insurance coverage. Before speaking, I saw the prettiest white sugar sand beaches on the planet. Destin also has the clearest crystal blue water you can find along the northern Gulf of Mexico.
Continue Reading...Ambiguities in policies often prompt litigation. In Certain Interested Underwriters at Lloyd’s London v. Chabad Lubavitch, No. 4D10-762, (Fla. 4th DCA June 8, 2011) litigation arose over a potential ambiguity in a windstorm exclusion.
Continue Reading...Texas courts have ruled that insurance policies which provide coverage for vandalism, but exclude coverage for theft, also exclude any damage that is “in furtherance of theft.” Practically speaking, if a thief breaks through your interior sheetrock walls to steal the copper wires behind them, a typical insurance policy will exclude coverage completely, even for the damage to your sheetrock walls. Now, if they had been vandals instead, and had just smashed holes in your walls without stealing copper wire, your policy would likely provide coverage. As you can see, the difference is subtle, but very important.
Continue Reading...Time flies. It seems like yesterday when Ray Altieri excitedly met me outside the entrance to the December 1992 National Association of Public Adjusters Mid-Year Meeting. Ray is Italian and very passionate about things that matter to him--usually his family, work and the New York Yankees.
Continue Reading...The Southern District Court of Florida recently addressed the issue of whether a condominium association fraudulently sought to join parties in a lawsuit to destroy diversity jurisdiction in the federal Court. If there was no diversity jurisdiction, the case would have been remanded to the Florida state court, where it was originally filed.
Continue Reading...Businesses develop and thrive on symbiotic relationships, in which the entities rely on the continued operational viability of each other,(or even exclusively beneficial relationships. Few businesses, however, consider the risk and exposure of losing that relationship due to an unexpected calamity.
Continue Reading...Early this week, I was sent the following letter from a Florida public adjuster. He contacted me because he reads this blog and knows I am always interested in hearing about trends in the adjustment of claims.
Continue Reading...In my last post titled 'Bama Bad Faith - An Alabama Case Evaluates a Number of Bad Faith Issues, I addressed the factual background of the bad faith case Jones v. Alfa Mutual Ins. Co., 1 So.3d 23 (2008), which analyzes several legal issues. This week, I will write about the first legal issue: whether the Insureds, Harold and Pam Jones, timely filed their complaint.
Continue Reading...Last Friday, the Houston Chronicle reported that Texas Governor Rick Perry has added the Texas Windstorm Insurance Association (TWIA) to the agenda of concerns to be addressed at the special legislative session.
Continue Reading...Plaintiffs in agent negligence cases usually seek to recover what they would have received from the insurer had the proper insurance been procured. However, damages in agent negligence cases aren’t always limited to just that.
Continue Reading...The ability to anticipate future events is important. How about this August 2009 prediction I made in More News on the Michael Jackson Event Cancellation Insurance Policy and Claim:
Continue Reading...One of the trends in insurance claims is that some insurance carriers are a lot more willing to litigate potential defenses regardless of the wealth or size of the policyholder. Two decades ago, corporate clients and those of public reputation infrequently needed to resolve insurance matters in courtrooms. That is no longer the case. With $17.5 million at issue, I would not be surprised if the underwriters were considering application defenses as well.
The Florida Commission on Hurricane Loss Projection Methodology (FCHLPM) recently approved catastrophe modeling firm Risk Management Solutions’ new hurricane model. The FCHLPM, an independent body of experts, was created by the Legislature in 1995 to develop standards and review hurricane loss models used in the development of residential property insurance rates and the calculation of probable maximum loss levels. The “experts” include engineers, meteorologists, actuaries, insurance academicians and the insurance consumer advocate. They review hurricane loss models submitted by various modelers.
Continue Reading...Let’s say you’re a bank and you loan a customer money to develop a commercial property. As part of your normal business practices, you require the developer to purchase insurance and list you as a “loss mortgagee,” which means you have a right to the insurance proceeds as an additional insured. Last, assume that the borrower/developer committed some act that would invalidate his rights and benefits under the insurance policy. Does that also affect your rights as the “loss mortgagee?” Well, if the underlying insurance contract was a fire or marine insurance policy, Texas law states that your rights are unaffected by the acts of the borrower/developer.
Continue Reading...“Any fool can criticize, condemn and complain, and most fools do.”
--Benjamin Franklin
I thought of Benjamin Franklin this morning while responding to a comment raised by a public adjuster to recent Florida legislation. A number of comments were posed to Florida Legislative Update for Public Adjusters, and the last was:
Continue Reading...Chip,
One last question.
What is to prevent every insurer in the state bellying up to the Legislature and asking for the same rights and privileges as Citizens?
Is there any talk from other companies?
Also, you say this will be fought in court. Is there a time-frame and who is lining up to challenge the legislation?
When a dispute as to the amount of loss in an insurance claim arises, some insurance policies allow for the dispute to be resolved through appraisal. Appraisal however, is not appropriate when an insurance claim has been outright denied. Sometimes, when an insurance company finds coverage below the policy deductible, it will wrongfully characterize this coverage as a denial in order to avoid appraisal. This is what appears to have happened in Oceania I Condo Ass'n, Inc. v. QBE Ins. Corp., No. 11-20578, 2011 WL 1984483 (S.D. Fla. May 20, 2011), and the insurance company avoided a compelled appraisal by alleging that the policy was void due to fraud.
Continue Reading...Learn from the mistakes of others. You can’t live long enough to make them all yourself.
-- Eleanor Roosevelt
One of the main reasons I research and write about business income claims every week is to share real life situations that should help all of us learn to avoid making the same mistakes.
Continue Reading...Hurricane Season is here, and with the devastating weather that has already ravaged the United States this spring, Florida policyholders are urged to be prepared. The Florida Association of Public Insurance Adjusters’ most recent article reminds policyholders that true preparation requires homeowners and business owners to not only prepare their property and their families, but to also have an action plan in place for after the storm.
Continue Reading...The failure to provide a policyholder with statutory notice of mediation prevents an insurer from enforcing appraisal in Florida. In Universal Property and Casualty Insurance Company v. Colosimo, 2011 WL 2031332 (Fla. 3rd DCA May 25, 2011), the Court noted that insurers have statutory and administrative duties to inform policyholders of the alternative mediation process.
Continue Reading...Insurance agents play an important role in the insurance marketplace. Insurance policies do not provide "peace of mind" if they have gaps in coverage that leave policyholders without benefits following a loss. Accordingly, insurance agents who promise to work and advise insurance customers should be selected over those that promise to obtain "cheap insurance."
Continue Reading...The answer to the title question should be:
"Nobody should trust the government to conclusively determine anything."
The property insurance law news is that a Mississippi Senator has proposed federal legislation that would allow FEMA to determine the amount of wind damage versus flood damage an insured structure sustained when the issue arises. Anita Lee, of the Sun-Herald, reported on how this proposed system would work in Wicker Charts New Course for NFIP Changes:
Continue Reading...The National Oceanographic and Atmospheric Administration would gather hurricane data from public and private sources. FEMA would use the data to apportion losses between wind and flood.
Elevation and construction materials for each property would be included in the assessment.
Any disputes that arose over a wind/water allocation would be resolved by a FEMA-appointed arbitration panel.
Lawsuits are prohibited. However, an insurance company and policyholder could, by agreement, opt out of an assessment.
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