Kevin Pollack

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Is Unauthorized Construction/Demolition Performed by a Tenant Covered Damage Under a First-Party Property Policy?

If a homeowner agrees to sell a home, and as part of the sale agreement allows the prospective buyer to: (1) lease the property before escrow is closed, and (2) make certain improvements to the property with the owner’s permission, but then, after taking possession during the lease, the prospective buyer tears the property down … Continue Reading

Cell Phone Records Support Insurer’s Denial Based on Fraud

When insurers investigate insurance claims and suspect that something about the claim is not quite right, they often assign special investigation units evaluate whether the claim lacks merit or is otherwise fraudulent. In Young v. Progressive Casualty Insurance Company,1 a federal district court in California recently upheld an insurer’s denial of its insured’s claim for … Continue Reading

Insurance Dispute Stemming from Denial of Coverage for Stolen Baseball Card Collection Highlights Bad Faith Claims Handling

The Arizona Court of Appeals recently overturned a trial court’s dismissal of an insured’s bad faith case stemming from a disagreement with an insurance company over coverage for a stolen baseball card collection.1 As a kid who grew up collecting baseball cards, I took particular interest in this case.… Continue Reading

Undefined Term in Business Insurance Policy Must be Interpreted with Reference to Industry Specific Meaning to Satisfy Insured’s Reasonable Expectations

In an unpublished decision, the Ninth Circuit Court of Appeals recently used extrinsic evidence to interpret the meaning of “direct supplier” in the context of a commercial property loss.1 I previously blogged about this case in 9th Circuit to Interpret Meaning of “Direct Supplier” In Context of a Commercial Property Loss Claim.… Continue Reading

Is Evidence of a Liability Insurer’s Investigative Findings Admissible in a Third-Party Property Damage Claim?

Assume a homeowner suffers damage as a result of a construction professional’s negligence. After the homeowner notifies the construction professional of the damage, the construction professional puts his liability carrier on notice and advises the homeowner that the liability insurer will investigate the damage and work with the homeowner to resolve the claim. Further assume … Continue Reading

The Importance of Having a Professional Review Your Insurance Policy

A recent federal district court decision in New Jersey once again highlights why policyholders need to review their insurance policies with professional insurance brokers to ensure the insurance obtained satisfies their needs. Often, insurance policies contain “additional” or “optional” coverages that, for a small amount of money, can extend insurance coverage to circumstances that would … Continue Reading

Insurers Cannot Rely on Rescission if They Fail to Inquire and Investigate Insureds Before Claims

After a claim is made, and despite the obligation to objectively, fairly, and reasonably investigate a claim with an eye toward providing coverage and without putting the insurance company’s interests ahead of their insured’s, some insurers actively look for ways to deny coverage. One of the ways some insurers do this is by using the … Continue Reading

Does Actual Cash Value Mean Fair Market Value or Replacement Cost minus Depreciation?

What is an insured, who has an “actual cash value” property insurance policy, entitled to recover when their property is damaged, but not a total loss? Is the insured entitled to the cost to repair/replace the property minus depreciation? Or is the insured’s recovery limited to the property’s fair market value? What if the property’s … Continue Reading

Collapse Claim Highlights the Importance of Retaining Experts Early in the Claim Process

A recent case filed in the Western District of Texas highlights the importance of retaining experts to assist in evaluating the cause of loss early in the claim process. In White Lodging Services Corporation et al v. Liberty Mutual Fire Insurance Company,1 a hotel development and management company filed suit against Liberty Mutual over a … Continue Reading

Business Interruption Claims – Calculating The Period of Restoration

Business interruption coverage provides protection against loss of income when a business suffers property damage from an insured peril (e.g., fire, water loss) that interrupts the operation of the business.1 A typical business interruption policy form provides that the insurer will pay the actual loss of business income the insured sustains during the necessary suspension … Continue Reading

Proof of Loss: Can an Insurer Deny Coverage and Later Argue the Claim is Barred Because the Insured Did Not Comply with the Proof of Loss Condition?

Insurers on occasion deny coverage or make claim decisions based on one ground, and then later, during litigation, seek to avoid liability based upon an entirely new defense theory. Although coverage decision letters regularly throw in boilerplate language seeking to avoid waiving coverage defenses, I was recently asked whether an insurer can deny coverage or … Continue Reading

Business Income and Extra Expense – Understanding the Differences

In addition to covering property damage, most first-party commercial insurance policies offer business interruption coverage. Business interruption coverage typically has two different built in coverages: business income and extra expense. Both are intended to assist businesses in the event a covered peril damages business property and impacts business operations.… Continue Reading

The Genuine Dispute Defense and Bad Faith

Insurers often seek to avoid liability for bad faith by asserting the “Genuine Dispute Doctrine.” Under the genuine dispute rule, an insurer’s coverage or claim decision may not be in bad faith when it mistakenly withholds policy benefits, if the mistake is reasonable and is based on a legitimate dispute as to the insurer’s liability.1… Continue Reading

Insurers Must Provide Complete Replacement Cost Estimates

The California Supreme Court issued a unanimous ruling yesterday requiring insurers to communicate “complete” replacement cost estimates to insureds.1 The ruling not only found the regulation requiring this action to be well within the Insurance commissioner’s authority, but found the basis for the regulation to be well founded. It is a wonderful victory for policyholders … Continue Reading

Exclusions in States That Have a Statutory Standard Form Fire Insurance Policy

Insurers often issue property insurance policies intended cover multiple perils (e.g. water damage and fire). While insurers often include a number of exclusions in their policies, in states with statutory standard form fire policies (such as California), insurers cannot apply exclusions that substantially vary from the terms and conditions in the standard form fire policy … Continue Reading
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