Richard Schwartz, a former fire cause and origin investigator, recently shared some of his insight into how insurance carriers evaluate fire losses and the evolution special investigative units have had in the claim process. Richard has vast experience, with more than nineteen years as an insurance company consultant and expert witness.
Continue Reading...Insurers and their policyholders are more frequently clashing over sinkhole claims, and the Florida Legislature seems to be weighing in on the insurers’ side. In this case, the policyholder won; his insurer paid the policy limits after a Civil Remedy Notice, and his claim for damages caused by the insurer’s lack of good faith in handling the total loss claim has survived the first gauntlet: the insurer’s motion to dismiss.
Continue Reading...Last week my colleague, Denise Sze, wrote about delayed notice in California and did a great job explaining California’s “notice-prejudice rule.” In several states, including California, an insurer cannot deny a claim unless it can demonstrate actual prejudice resulted from delayed notice of a loss.
Continue Reading...One of my favorite Winston Churchill quotes is, “If you are going through hell, keep going.” This continuing review of recent Colorado insurance coverage law is another reminder to policyholders, public adjusters, and plaintiff’s insurance coverage lawyers of the light at the end of the tunnel. (Also, the Broncos’ two losses forced me to change my blog post focus from NFL adrenaline last week, to holiday gifts this week.)
Continue Reading...As we enter the New Year, it is a good time to review what constitutes "Bad Faith" in California. The case law has evolved over time and so have the statutes. I’ve heard people claim that bad faith doesn’t truly exist in California, but that assertion is simply untrue. The Courts have taken a very conservative approach to bad faith damages in the last ten years, however, there are times a truly exceptional case may sway both judge and jury when damages calculations are before them.
Continue Reading...Merry Christmas, Happy Holidays, and Season’s Greetings! I hope all of you are enjoying some well-deserved time off. And since many of you are on holiday, I’d like to pass along some light insurance reading that may interest you.
Continue Reading...It has been said that genius is the ability to reduce the complicated to the simple. The title of this article is an actual quote from Magistrate Judge Jonathan Goodman in a recent Florida Southern District Court Federal Order. It is not everyday that Judges disclose to us where they find their inspiration, and given the Judge’s musical reference in this order, I could not pass up the opportunity to share it. It is also not everyday that Federal Judges look to Meat Loaf to inspire the creative analogy.
Continue Reading...On January 1, 2012, Florida Statute §626.854 imposes many important changes that all public adjuster in Florida need to be familiar with and implementing into their businesses. Many of the changes relate to the requirements that must be contained in a contract between a public adjuster and policyholder. In the holiday theme, below you will find a summary of some of contract requirements for public adjusters, just sing it to the tune of the 12 days of Christmas:
Continue Reading...Insurance policies are contracts in which insurance companies agree to indemnify policyholders for sudden and accidental covered losses, and insureds agree to pay a premium and comply with the policy’s enumerated post-loss obligations. Examinations under oath are typically one of those post-loss obligations. When a claim is made by a policyholder, the insurer can request that the insured sit for an EUO. The insured must appear at a designated time and place, take an oath to tell the truth, and answer the questions posed by the carrier’s representative while a court reporter writes down every word that is said for the record.
Continue Reading...Florida law is not settled regarding noncompliance with conditions precedent to filing suit under an insurance policy, including whether a policyholder’s failure to submit a proof of loss bars the claim.
Continue Reading...Everyone knows that insurance coverage law us just as exciting, hard-hitting, and adrenaline infused as the NFL. Colorado’s more recent insurance coverage case law is no exception. The insurance industry’s power lineup pitted some of its hardest hitting power houses, including Allstate, State Farm, and American Family, against some of the hardest working grandmas, small business owners, and families that America has to offer. The gut wrenching, mind blowing battles that ensued made Tebow and the Broncos’ win over the Chicago Bears look like child’s play.
Continue Reading...Recently, I had a discussion regarding "inception of the loss" versus "discovery of a loss" to real property and how this may affect or trigger an insured’s timely notice to an insurance carrier. The issue was if a landlord rents a property out to a tenant and does not know there is damage to the building but reports the damage to the carrier and mitigates the damage as soon as he is aware of the problem, will the landlord’s delayed notice to the carrier negatively impact the conditions of insurance coverage under the policy?
Continue Reading...In my experience, an insurer oftentimes acts differently than its lawyers. What I mean is that the way in which an insurance claim is handled changes dramatically once it is handed off to a defense lawyer. Insurance defense lawyers oftentimes argue different reasons for the denial of a claim than its client wrote in its denial letters to my client. This sometimes leads to insurance defense lawyers arguing that a policy provides much less coverage than the insured believed it provided. But in zealously advocating for their client, sometimes insurance defense lawyers go too far, as was the case in RLI Insurance Company v. Willbros Construction (U.S.) L.L.C., et al.
Continue Reading...Two weeks ago, I addressed the notice provision in a property insurance policy, specifically timeliness of notice and what happens if the policyholder is accused of delayed notice. Generally, under Florida law, there is a two step process to determine if delayed notice of a claim precludes payment under an insurance policy: (1) the trier of fact must determine that the notice of loss was too late, and (2) the insurance company must be prejudiced from the delay. If the court answers the first question in the affirmative, the insurance company is entitled to a rebuttable presumption of prejudice. If this presumption is not rebutted, the policyholder may be denied benefits under the policy.
Continue Reading...Last week’s blog entry, Fact: 40 % of Businesses Shut Down After a Disaster. Will Yours Survive?, profiled a New York Times case study on a business that provides holistic services to women undergoing medical fertility. The yoga studio is conveniently located a few doors down from one of the country’s largest fertility clinics, and 60% of their clientele stream down the hall to their studio after their medical treatments.
Continue Reading...It’s no secret that insurance companies are in business to make money, but the lengths some insurance companies go to in order to increase profits is alarming. In fact, dozens of posts on this blog have alerted our readers to the improper actions some insurance companies may take to put profit above their policyholders’ interests.
Continue Reading...Two weeks ago, Southern California experienced unusually strong Santa Ana winds which brought gusts up to 140 mph in some places. Southern Californians, particularly in the Pasadena area, were forced to clean up debris left by the storm. A staggering 18,000 tons of debris was cleaned up in Pasadena, which is the city’s normal total for one year. Parts of Pasadena were left without power for seven days; approximately 419,000 customers effected by the outages at one time. The State estimates that the hurricane force winds caused at least $40 million in damage.
Continue Reading...Homeowners policies usually require policyholders to provide information supporting their claims and the amount of the loss, upon the insurer’s request. This document, referred to as a “proof of loss,” may require the policyholder, to set forth under oath the time and cause of the loss, identification of all who have an interest in the property, all the potential insurance that might be implicated from the loss, changes in title or occupancy during the policy’s term, specifications of damaged buildings and detailed repair estimates, an inventory of damaged personal property, and receipts for expenses incurred as a result of the loss. The information required will depend on the type of loss, damage sustained as a result of the loss, and the particular requirements of the policy.
Continue Reading...On December 1, 2011, Steamboat Springs experienced wind speeds equivalent to an F2 tornado or a level three hurricane. Gusts of 123 mph were recorded at ski area peaks. Captured in this video on NBC’s channel 9 local news is the severe roof and window damage the winds caused to the condos in the village.
Continue Reading...Often in insurance cases, a plaintiff may bring a lawsuit against both the insurance company and the insurance agent in the same action. Such was the case in Braziel v. Becton Insurance Agency, Inc., No. 07-11-0134-CV, 2011 WL 5061162 (Texas App. - Amarillo October 25, 2011). The insureds suffered a fire loss to their home. The trial court ruled that the contents of the home were covered under the policy, leading the insurance company to settle the case with the insureds. Of course, the insureds were pleasantly surprised with this turn of events, entered into the settlement, and signed a customary release regarding their claims against the insurance company.
Continue Reading...Appraisal in first party property insurance claims is an alternative dispute resolution process designed to help policyholders and insurers resolve their disagreements over the amount of loss for claims. It has been utilized quite often in past years for hurricane claims in Florida. As it is an alternative dispute resolution process, an appraisal proceeding and outcome should not be disturbed by lawyers and courts after the fact, unless there is some unusual circumstance such as fraud or collusion on behalf of the appraisal panel. A Florida appellate court recently rejected an insurer’s request to reduce the amount of an appraisal award in the case First Protective Ins. Co. v. Hess, No. 1D10-6577 (Fla. 1st DCA December 9, 2011).
Continue Reading...The US Department of Labor estimates that forty percent (40%) of businesses never reopen after experiencing a disaster. Twenty five percent (25%) of surviving businesses will lose their market and shut down within two (2) years of a calamity. Savvy entrepreneurs understand that insurance policies are not meant to hedge these serious odds. Do you?
Continue Reading...Last year, I wrote several posts in a series on Examinations Under Oaths. Last week, I was contacted by a policyholder who had read my posts after he received a letter from an attorney to schedule an examination under oath on his claim for fire damage. This insured, like many others, wanted to understand why the insurance company was demanding his examination.
Continue Reading...When evaluating the various bad faith allegations that can be asserted against a carrier, a number of things come to mind. Some of my prior posts addressed programs that are implemented to reward insurance company adjusters for paying less on claims. Some of my posts addressed how policyholders are subtly, if not overtly, discouraged from retaining a public adjuster or an attorney despite their right to do so. Other posts talked about legally strategic maneuvers taken by insurance companies, possibly Safeco, to play hard ball or not to play fair at all when it comes to litigating a bad faith case.
Continue Reading...The 2012 Legislative session is right around the corner. It’s hard to believe December has already arrived, leaving only one more committee week before session begins on Tuesday, January 10, 2012.
Many bills favored by leadership have already cleared their first major hurdle by navigating through at least one committee.
Continue Reading...Last week, I discussed the gale-force wind gusts that plagued Southern California and how these unusually strong Santa Ana winds brought widespread destruction to property. Unlike Hurricane Alley, Southern California is usually immune to hurricane force winds, and the roofs of most structures in this region are rarely forced to endure this kind of storm.
Continue Reading...Many businesses have commercial liability insurance policies which provide coverage if they ever lose a lawsuit for damages caused by their goods or services. Here’s an overview of how such coverage generally works: (1) the insured is sued for damages stemming from its business operations; (2) the insured loses in court and is ordered to pay a certain amount; (3) the insured makes an insurance claim with its carrier for those parts of the court award for which the policy provides coverage; and (4) the carrier pays those portions of the award covered under the policy. However, in the case of National Union Fire Insurance Company of Pittsburgh, Pennsylvania v. Puget Plastics Corp., the carrier’s denial of coverage rested on the definition of “accident.”
Continue Reading...Is there a specific period of time in which insurance claims must be made before they are barred as a matter of law? In What Has Happened to the Rebuttable Presumption of Prejudice in a Recent Late Notice Case?, Shaun Marker focused on one sentence fragment from the recent Florida case of Kroener v. Florida Ins. Guar. Ass’n, 63 So. 3d 914 (Fla. 4th DCA 2011), which appears to have turned the issue of notice of Florida insurance claims on its ear. That sentence says:
Continue Reading...[A]s a matter of law, notice to the insurer of a claim of loss more than two years and two months after the loss occurred was not prompt notice; the untimely reporting of the loss violated the insurance policy and was sufficient to bar the claim.
Zurich Financial Services Group and the Business Continuity Institute conducted a survey among 559 organizations in more than 62 countries, covering 14 different industries, to look at the impact of this year’s natural and manmade occurrences that have caused supply chain disruptions worldwide. Overall, 85% of the companies reported at least one supply chain disruption. Twenty percent of the occurrences were attributed to the earthquakes or tsunamis in Japan and New Zealand; fifty-one percent were attributed to adverse weather; and forty-one percent were attributed to IT or telecommunications outages.
Continue Reading...The Sheldon family suffered a fire loss to their home in St. Petersburg, Florida, in January, 2011. While their homeowner’s insurance company, Citizens Property Insurance Corporation, has admitted this the loss is covered under the policy, Citizens has failed to properly pay the claim. As a result, this Bay area family will be displaced from their home this holiday season.
Continue Reading...Yesterday, Los Angeles residents awoke to massive power outages, downed trees and extensive roof damage. Beginning on late Wednesday afternoon, a powerful windstorm with gale-force gusts began ripping through the region, with some gusts over 70 mph. The wind blew power lines down and more than 350,000 customers were without power.
Continue Reading...Hardworking, dedicated employees are important to any business. While most of us are still stumbling out of our Thanksgiving turkey comas or gearing up for the remainder of the holiday season, I had the privilege of traveling to the greater Phoenix area, where I visited a client’s commercial properties. One of those properties suffered severe fire damage, forcing the company to move its production approximately 70 miles away.
Continue Reading...Property insurance claims litigation often requires hiring several experts. Policyholders may need to retain a construction cost expert and engineer to give opinions on property damage, a bad faith expert regarding claims handling practices, and an accountant regarding business income losses. Depending on the case, the list can quickly grow to include an architect, a hygienist, and many more.
Continue Reading...1-877-449-4700
Enter keywords:
