A recent Florida appellate opinion addresses common issues regarding the death blow or failure to comply with policy conditions. It should be well-known that a material breach of a policy condition may be fatal to a claim and grounds for voiding the policy. Continue Reading
Hurricane Michael Flood Proof of Loss Extension
Last month the Assistant Administrator for Insurance, Paul Huang, extended the deadline for submitting a Proof of Loss for flood insurance claims. The Standard Flood Insurance Policy (SFIP) provides that a proof of loss must be submitted within 60 days of the loss. However, FEMA Bulletin W-18026 waived the 60-day proof of loss deadline, extending the deadline to submit a proof of loss to 365 days (one year) from the date of loss: Continue Reading
Can My Insurance Company Deny My Claim Because It Didn’t Find a Wind-Created Opening in My Roof?
Possibly. Many policies exclude or limit coverage for interior water damage unless there is evidence of a wind-created opening in the roof, outside wall, door or window where rain entered the home or business. I often see carriers deny coverage in a manner similar to the below scenario: Continue Reading
Inflatables—Don’t Get Bounced!
Parents of young children know the birthday party appeal of inflatables like bounce houses, slides, trampolines, and moonwalks. But it’s no picnic to learn that your homeowner’s insurance won’t be of any help if someone gets hurt on an inflatable dragon slide in your front yard at your child’s birthday party. A few tips may help insure your child’s next birthday party with inflatables won’t be a bust and that you don’t get bounced into state court with a lawsuit on your hands. Continue Reading
Claim Handling Requirements by State: Ohio
In states like Ohio where catastrophic disasters are not as common as in other states, policyholders should still understand how important it is to have a claim handled properly. Ohio’s most common disasters are tornadoes, snow, and floods. Although not common, Ohio has been affected by hurricane winds and rain that have reached some areas. Other risks are forest fires and earthquakes.1 Continue Reading
Do I Really Have To Provide My Insurance Company With My Financial Records After A Loss?
Most policyholders usually do not know what to expect when they submit a claim to their insurance company. Some simply expect to fill out a claim form, maybe answer a few questions, and then receive a claim check from the insurer compensating them for the loss. Most policyholders are usually taken back when the insurance company asks for copies of their income tax returns, bank statements, bills, and other financial records. Continue Reading
Beware a Jurisdictional Pitfall: Federal Diversity Jurisdiction and Limited Liability Companies
Our Constitution vests federal district courts with limited subject matter jurisdiction to adjudicate cases and controversies.1 Unless the Constitution or federal statute authorizes the district court to proceed, the district court must dismiss the action or—in the case of removal— remand the matter to state court.2 In addition to other grants, federal statute provides district courts original jurisdiction over civil actions between citizens of different states where the amount in controversy exceeds $75,000, exclusive of interest and costs.3 Eleventh Circuit precedent holds that a limited liability company is a citizen of any state in which a member of the company is a citizen.4 Continue Reading
How Can the Schedule of Locations Affect Your Claim?
A ‘schedule of location’ lists property locations where insured assets are located. A homeowner’s policy will list the house, possibly an additional structure. A business policy, when drafted properly, will list all locations insured under the policy where a business loss can occur. Failing to include all such locations can result in denial of what would otherwise be a covered loss. Continue Reading
Chocolatier Gets Sweet Revenge on Chubb
In a Second Circuit decision, the court of appeals revived Madelaine Chocolate Novelties Inc.’s Superstorm Sandy claim against Chubb for property damage and business interruption for an additional $49 million in coverage. In overruling the lower court, the appellate court found that the lower federal court failed to properly evaluate all the relevant policy provisions.1 Continue Reading
An Injunction Forcing Homeowners to Comply with An Elect to Repair Provision Won’t Fly, Florida’s Third District Confirms
In October 2016, Guillermo Acosta and Laura Pirela (the “Insureds”) suffered a water loss at their home and filed an insurance claim.1 The insurer inspected the property and then invoked the ‘elect to repair provision’ under the policy that stated as follows:
If a peril causing a loss and related damage are covered (other than sinkhole loss) and repairs are necessary to protect covered property from further damage, [the Insureds] must notify [the Insurer] before authorizing or commencing repairs so [the Insurer], at [its] option, may select Rapid Response Team, LLC™ to make the covered Reasonable Repairs.
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If [the Insureds] and [the Insurer] fail to agree on the amount of loss, which includes the scope of repairs, either may demand an appraisal as to the amount of loss and the scope of repairs.
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The scope of repairs shall establish the work to be performed and completed by Rapid Response Team, LLC™. Such repair is in lieu of issuing any loss payment to [the Insureds] that otherwise would be due under the policy.
