Closed Claim File Statistics Following Hurricanes

By Chip Merlin on Posted in Insurance

Facts are stubborn, but statistics are more pliable.
—Mark Twain

Closed claim file statistics reported by various departments of insurance following hurricanes seem absurd to those in the impacted areas and those working in the insurance claim business. The root of the problem is that most departments of insurance put pressure on insurance companies to close claims fast and provide high percentages of closed claims. So, insurance companies “administratively close” files to meet regulatory requirements and the politicians look good in the press reporting what everybody knows are fabricated numbers. The files then are reopened to make more payments and then closed again. Continue Reading

California Regulations Require That an Insurer’s Preferred Vendor Return Property to Its Pre-Loss Condition – A Quick Guide to What You Need to Know

By Victor Jacobellis on Posted in Insurance, Regulation

It is becoming more and more common that insurance companies are recommending and suggesting that their “preferred vendors” perform loss repairs. California offers insureds protection if they opt to use a preferred vendor. Under the Fairs Claims Settlement Practices Regulations, if an insurer recommends a vendor, the insurer is essentially required to guaranty that vendor’s work. Continue Reading

Yee-Haw!! Meet Your Tapia Cowpoke Friends in the Cowtown Capital of Texas—Fort Worth—For the Fall Conference October 15-17, 2019

By Kay Morgan on Posted in Insurance

The Round-up: The Texas Association of Public Insurance Adjusters (“TAPIA”) has lassoed and corralled a great group of speakers and events that you absolutely will not want to miss this fall in Fort Worth. If you register by August 31st, members will only have to “pony-up” $149 and non-member, first timers $195. If you don’t have a bed roll or pup-tent to pitch, early registration is already open at Embassy Suites Downtown Fort Worth at 600 Commerce Street. You can save a nickel at Embassy Suites if you register by September 16th and mention “TAPIA” to get a TAPIA rate. Register either on line or call (817) 332-6900. Continue Reading

Reflections on Superstorm Sandy Along the Jersey Shore Almost Seven Years After the Catastrophe

By Chip Merlin on Posted in Insurance

Larry Bathgate was my co-counsel on 23 municipal insurance claims Following Superstorm Sandy and countless commercial and residential claims as well. We spoke on Friday evening and Saturday morning about our former clients, the rebuilding of the Jersey Shore and our law practices. From my view, there has been an amazing transformation and it was gratifying to see the American patriotism in Bay Head, New Jersey, with hundreds of American flags everywhere.

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Insurance Claim Payment Delay Following Expected Disasters is Epidemic

By Chip Merlin on Posted in Insurance

Crawford has acknowledged that the insurance industry it serves is not living up to its good faith claims obligation in a recent publication. Here is the confession about the 2017 Hurricane season which it reported in Today’s Large & Complex Claims Landscape: Preparing for the Perfect Storm:

To adequately respond to today’s evolving catastrophe landscape, insurers need to be prepared with contingency plans for their contingency plans to make sure the “perfect storm” of 2017 doesn’t happen again. Through streamlined, coordinated team response, expert scenario planning and the vast knowledgebase of worldwide claims expertise, insurers can rest easy knowing they’re getting the best possible resources working on the frontlines of catastrophe.

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Reasonable Expectations – North Carolina

By Beaujeaux de Lapouyade on Posted in Insurance

The reasonable expectations doctrine could be outcome determinative in coverage disputes in the Tar Heel State. Two doctrines courts often consider when analyzing policy interpretation are the doctrines of (1) contra proferentem and (2) the insured’s “reasonable expectations.” North Carolina state courts embrace the doctrine of contra proferentem while its adoption of the reasonable expectations doctrine is more limited. The doctrine of contra proferentem is one of contract interpretation and construes any ambiguity in the contract against the party who drafted the contract. North Carolina state courts apply this principle in policy interpretation. Courts look to the plain meaning of the contract. Strict construction applies unless there is an ambiguity. In the property insurance context, North Carolina state courts use this rule to interpret policy terms liberally in favor of the policyholder and strictly against the insurance company since the insurance company chose the language in the policy. Continue Reading

All Acquisition Costs Should Be Included For Replacement Cost Values

By Chip Merlin on Posted in Insurance

Insurance company adjusters often leave off the reasonably expected acquisition costs when determining replacement cost. While the actual pricing can become theoretical, the bottom line is that these acquisition costs can be a material cost and every adjuster should include them when determining the top line replacement cost value. Continue Reading

Hurricane Michael Policyholders, Public Adjusters, Contractors, and Agents Warning About Some Policies With One Year Limitations To File Arbitration

By Chip Merlin on Posted in Insurance

Lloyd’s of London

Hurricane Michael policyholders, public adjusters, contractors and agents must check their policies to make certain that there is not a one-year deadline to start arbitration. The above photo is Lloyds at London. Lloyds is a place where surplus lines insurers do business and it is not an insurance company. Many of the Lloyds Underwriters have placed obscure arbitration provisions into their policies which mandate that New York law with a one-year limitation to start the arbitration. Continue Reading

The Joy of Being a Policyholder Attorney

By Daniel Ballard on Posted in Insurance

I recently had my second child. So, when my paralegal, Regina, came in my office the other day with a large box I assumed that it was more gifts over and above the abundance of gifts that Chip, the Tampa office, and the Red Bank office had already showered my growing family with. Although I was correct as to the contents, the box was from a client whose case I had recently settled. Continue Reading

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