Loss reserves are discussed and published in the media, and data freely exchanged until an insurance company is asked for it in a lawsuit. Once the lawsuit is filed, insurers pretend as if this information is something extraordinarily private and only told to a priest in a confessional. I suggest that insurers and their counsel are like Pinocchio, with long noses getting longer when making such absurd arguments preventing disclosure. Continue Reading Loss Reserve Information For Property Insurers Should Be Disclosed In Litigation—Reserve Information In a First Party Case Is Relevant and Not a Secret

Practicing solely in the field of first-party claims and studying, debating, and analyzing with others within Merlin Law Group raises the bar and makes our law firm members better at what we do. We also study other cases to learn winning techniques and what to avoid. Bad faith cases are never easy. But I was somewhat surprised while studying a recent Pennsylvania court’s decision to go out of its way to find delay and underestimating “reasonable.”1 I wonder if the court would have ruled the same way if an insurer stopped his paycheck and prevented him from making rulings for 17 months? Continue Reading Pennsylvania Bad Faith Law and Learning From Others Cases

Property insurance coverage cases provide lessons for others to follow. A recent Oklahoma federal court decision1 following a fire loss reflects why my book, PayUP!, suggests that public adjusters should be considered for retention shortly after any significant loss. The language from the opinion that caught my attention was the following: Continue Reading Court Implies That Policyholders Are Better Off With Professional Claims Help

The property insurance claims industry is increasingly turning to independent adjusters rather than company adjusters. The number of independent adjusters calling, texting, and literally confessing to me about unethical conduct has exploded over the last few years. My thought is that insurance companies are hiring independent adjustment firms and then placing financial pressure on those entities to reduce claims severity. Insurers trying to make their financial claims goals will simply hire a competitor of the independent adjusting firm if those numbers are not met. Those independent adjustment companies, in turn, have their claims managers place more emphasis upon closing claims for less than what is owed—damn regulatory ethics requirements and good faith treatment. Continue Reading Do Independent Property Claims Adjusters Need More Legal Protection From Unethical Managers

Today’s blog is not going to endear me to HAAG, Rimkus, JS Held, and other regularly retained forensic engineers working for insurance companies. These engineering and consulting firms are big business. So much so that Sedgwick, a large independent adjusting firm, has acquired a number of these engineering firms. I can imagine many of you wondering how an adjusting firm representing the insurance company’s interest can obtain an independent and honest opinion under such circumstances. Continue Reading The Plague of Wrong and Insurer Worded Engineering Reports by Insurance Company Retained Engineers

Florida does not recognize a first-party bad faith cause of action at common law. Instead, it has a statutory scheme where a formal notice (CRN) must be sent that provides the specific statutory provisions which are violated, the relevant policy language relevant to violations, and the facts giving rise to the violations. Then, the insurance company gets 60 days to cure the defects of its actions. Continue Reading Florida’s Bad Faith Scheme Requires a 60 Day Notice Including Facts

Why aren’t the federal flood insurance limits at least equal to the amount which the Federal government backs Fannie Mae mortgages? Why haven’t federal flood limits on residential policies kept up with inflation? Why do they stay the same for over a decade? And why isn’t the increased costs of compliance coverage up to $100,000, so people can rebuild to the new flood standard? Continue Reading FEMA 50% Rule Hits Hurricane Ian Victims—Why Don’t We Double Federal Flood Limits and Triple ICC Coverage?

An article in the Insurance Journal, New Hampshire Body Shop Owner ‘Winging’ Own Case Beats State Farm in High Court, about an assignment of benefits (AOB) case caught my attention. State Farm’s attorneys lost to a non-lawyer in New Hampshire’s Supreme Court.1 The dollar dispute was overwhelmed by the practical implications of the case. The article noted in part: Continue Reading Assignment of Benefits Post Loss—New Hampshire Looks To Policy Language

If you own a condo in California, it’s a safe bet you are not covered against damage caused by an earthquake (“EQ”). EQ damage is typically an excluded peril under HO-6 and similar condo policies. EQ coverage is required to be offered, but only about 15% of condo owners choose to pay an additional premium to cover this peril despite reports1 that within the next 30 years, there is (1) over a 99% chance that one or more M6.7 or greater EQs will strike somewhere in California; (2) a 75% chance one or more M7.0 or greater EQs will strike Southern California; and (3) a 76% chance one or more M7.0 or greater EQs will strike Northern California. Continue Reading Make Sure Your California Condominium Is Covered Against Earthquake Damage