New Appraisal Clauses Change Appraisal

State Farm and Farmers have created new property insurance policy forms which significantly change the rules of appraisal. One of the trends of insurance coverage is that new policies are not being written with standard language, where years of case law have interpreted meanings of phrases used by all insurers. These two forms are perfect examples of this trend.

As noted in Insurance Appraisal Called "Almost Perfect Method" of Alternative Dispute Resolution, here is language which many policies have used as a standard appraisal clause:


If we and you disagree on the value of the property or the amount of the "loss," either may make written demand for an appraisal of the "loss." In this event, each party will select a competent and impartial appraiser. You and we must notify the other of the appraiser selected within twenty days of the written demand for appraisal. The two appraisers will select an umpire.

If the appraisers do not agree on the selection of an umpire within 15 days, they must request selection of an umpire by a judge of a court having jurisdiction. The appraisers will state separately the value of the property and the amount of the "loss." If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be the appraised value of the property or amount of "loss." If you make a written demand for an appraisal of the "loss," each party will:

a. Pay its chosen appraiser; and
b. Bear the other expenses of the appraisal and umpire equally.

Compare this simple clause with the two appraisal provisions authored by State Farm and Farmers. The Farmers appraisal endorsement is written over four pages and even has the American Arbitrations Association appointing the Umpire. The new State Farm endorsement is two pages and has the following language:

You and we do not waive any rights by demanding or submitting to an appraisal, and retain all contractual rights to determine if coverage applies to each item in dispute.

My prediction is that other insurance companies will follow this trend. My other prediction is these more detailed clauses will lead to more litigation, even after an appraisal award is made.

Departments of insurance should question the need and impact of the proposed language before approving such clauses. I can guarantee you that the insurers are not writing the new language to help policyholders get full benefits paid quicker and sooner.

I thank Cynthia Montgomery and Steve Hadhazi for the policy samples.

Positive Thought for The Day

“Your mind is a tool you can choose to use any way you wish.”
       —Louise Lynn Hay

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Comments (6) Read through and enter the discussion with the form at the end
Linda Heinrich - January 27, 2016 7:24 AM

My insurance company uses the same appraisers all over town for other companies. Someone said it takes two weeks to become an appraiser. That's all?

Michael C. Bayer - January 27, 2016 8:17 AM

I do not see how Farmers & State Farm can arbitrarily change the policy language regarding appraisal in states that have statutorily outline the appraisal procedures such as in Connecticut (CT Standard Fire Policy)? They can not have a more restrictive process without getting a statutory change. Certainly they could "liberalize" the process, but it does not sound like that is what your article is describing.

Stephen R. Figlin - January 27, 2016 8:55 AM

Based on a recent conversation with the Penna DOI, they don't routinely review or approve policy language for commercial policies and only exercise limited review on forms for personal lines. They seem to have a threshold based on certain amount of premium dollars affected by polices before they will examine and comment on the introduction of new forms. From the conversation their interest and time is not directed toward property insurance forms.

Cynthia Colvin-Montgomery - January 27, 2016 12:42 PM

Farmers TX186A follow up.

Homeowners roof hail claim wherein appraisal was driven and there remains a difference of approximately 8 to 10k that is in dispute between the appraisers.

Umpire was invoked as mandated on the TX186A form through AAA in Voorhees, New Jersey on January 26, 2015 through the email address on the TX186A form.

Received this morning January 27,2015 the 57 page "Commercial Arbitration Rules Demand for Arbitration" package.

Three copies of application required along with a credit card authorization form for pre-payments and it appears as though by signing these forms I will be agreeing as a third party to represent my insured client in Arbitration .. It appears as though I must also file a "Demand" as set forth in Rule R-6. Under Rule R-11 it appears as though AAA may determine the local or place where the arbitration is held. Apparently after execution of the triplicate arbitration forms AAA will send me an identical list of 10 names of persons off the National Roster for selection of the arbitrator. The chosen arbitrator must meet the standards of Section R-18 Pursuant to Section R-18 (b). Under section R-14 it appears as though there must also be an appointment of a Chairperson if it's Pursuant to Section R-13 .. Then it goes on with additional alpha numerical RULES including R-21 Preliminary Hearing, R-22 Pre-Hearing Exchange and Production ... It does state under Rule R-26 that any party may participate without representation ...or by counsel .. Needless to say this goes on with more Rules of procedure which I'm sure you are familiar with as a LAWYER .. My big question of the day is: As the insureds Appraiser I am forced by the policy endorsement to be subjected to this "Arbitration", however, I believe this may be dangerously close to practicing law without a license in that I would be representing a first party as a third party appraiser in an arbitration ???

Does my client need a lawyer? Can a lawyer be brought in to Appraisal in Texas?

My formal letter of concern will be forwarded to TDI today along with copies of the "Arbitration" package I received

Thank you for any advice you may have on this "Matter".

Cynthia Colvin-Montgomery

Roger Poe - January 29, 2016 10:55 PM

Positive Thought for The Day

“Your mind is a tool you can choose to use any way you wish.”
—Louise Lynn Hay

Conversely - Corrupt Insurers, Agents, and Adjusters can choose to unfairly influence naive insureds minds any way they wish.

James Westervelt - February 4, 2016 9:31 PM

Wow! It is basically a waste of time to invoke the appraisal process if the carrier is allowed to disregard the ruling. Apparently any carrier that plays by these rules enjoy being in court. Policy holders may as well just "lawyer up" as soon as they file a claim.

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