Kelly Kubiak burst into my office jubilant in her recent victory over Great American Insurance Company. She received an Order granting her Motion for Summary Judgment in a case where the central dispute involved the interpretation of the valuation clause of an insurance policy. We so often talk about the problems of causation that we fail to spend enough time talking about how many benefits insurance policies are supposed to provide. It has been our experience that many policyholders think they have obtained a fantastic settlement from their insurance company until we explain how much money was left on the table through lack of knowledge and experience.
The insurance company adjuster is ethically required to help the policyholder maximize benefits. A properly trained and motivated adjuster teaches the policyholder how the policy can be used to soften the financial blow caused by insured peril. One can imagine how much money is innocently not claimed or recovered when an adjuster does not understand the policy.
In Kelly’s case, the small business she represented had an adjuster fight with the owner over “new” merchandise versus “used” merchandise. I wonder how many other insureds have been cheated as a result of Great American's obviously wrong interpretation of the valuation clause. Many policyholders do not realize the issue or simply fail to fight the issue by retaining an attorney. Unfortunately, this scenario is repeated far too often as many insurance company adjusters do not help the policyholder find ways to encourage payment of full policy benefits.
Have you ever heard of an insurance adjuster saying, “I think the policy can help you and pay you more if you would just….?”
