The answer to the first question in the title is “yes”—insureds have a duty to read their insurance policy.1 The use of the term “duty” implies a legal responsibility imposed by law but from where does this duty derive? It’s certainly not in any insurance policy I have ever read. The closest answer to that question may be that in Texas, the duty for an insured to read the insurance policy has developed as a presumption. Continue Reading In Texas, Do Insureds Have A Duty To Read Their Policy And, If So, Is That Duty Absolute?

Property insurance policies have long-contained appraisal and arbitration provisions.1 Although both avenues offer insureds the ability to resolve their claims through extrajudicial means, each has clear distinctions and similarities. In certain circumstances, some issues may only be resolved through a trial court. Continue Reading What May and May Not Be Resolved Through Appraisal or Arbitration in Florida?

In unique situations, actual cash value (“ACV”) or replacement cost (“RC”) coverage may not be the best match to meet a property owner’s needs, or even be available. Policies that provide functional replacement cost (“FRC”) valuation, or endorsements that do so, offer an alternative. This valuation method is most commonly used to insure older structures built with obsolete materials and by outdated or custom methods; structures where the RC often exceeds the market value. One ISO endorsement defines FRC as:

‘Functional replacement cost’ means the amount which it would cost to repair or replace the damaged building with less costly common construction materials and methods which are functionally equivalent to obsolete, antique or custom construction materials and methods used in the original construction of the building.1 Continue Reading Functional Replacement Cost – When Will You Encounter It and What To Be On the Lookout For

Communications between Insurance Companies and their insureds are always important, and copies of these are requested to understand insurance claims when filing a complaint. Recently, the Puerto Rico Court of Appeals ruled on an Accord and Satisfaction case in which Plaintiff presented a memo received from the insurer that contradicted its allegations against the Plaintiff’s Hurricane claim. Continue Reading Accord & Satisfaction: Will My Insurance Claim Be Dismissed If I Deposit A Payment? – Part 2

In a recent case, Sullivan v. Nationwide Affinity Insurance Company,1 the 10th Circuit Court of Appeals upheld a trial court’s decision finding a policy’s earth movement exclusion barred coverage for damage caused by rockfalls. On Monday, the three-judge panel found the policy’s earth movement exclusion is not limited to damage caused by soil movement, but also included rocks, concluding a “rockfall” is a type of “landslide.” Continue Reading Rockfall Damage Not a Landslide Victory

April Hall with Storm Consultants, LLC, & the Storm Restoration Contractor Summit (SRC Summit) joined Chip Merlin on Tuesday to discuss the upcoming SRC Summit event she is hosting in Frisco, Texas, on January 23rd – 25th. As many of you that follow our blog know, it is common this time of year for industry seminars and events to take place around the country. However, due to COVID, this year is quite different and the SRC Summit is the only in-person industry conference happening in the first quarter of 2021 that I am aware of. April Hall advises there are attendees coming from 29 states to attend the Summit, so there is going to be a great turnout. Continue Reading Storm Restoration Leaders Gather at SRC Summit on January 23rd-25th

A hybrid witness is a fact witness who also happens to have the requisite knowledge, skill, or expertise to provide opinion testimony and whose opinion is formed as a result of the witness’ involvement in the subject events.1 Continue Reading The Best of Both Worlds! Join me on Friday at 2 for a Brief Presentation on Hybrid Expert Witnesses

The battle regarding insurance surrogates is being waged in Washington state. Many insurance companies want the Department of Insurance to allow unlicensed non-adjusters determine how much policyholders deserve to be paid. Here is the what the Washington Department of Insurance states is a legislative priority: Continue Reading Insurance Surrogates and Insurers Delegating Those Duties Do Not Want Surrogates To Be held Accountable For Failing To Provide Honest and Good Faith Treatment In Washington

Governmental insurance pools or quasi-governmental entities offering insurance are often treated differently than typical private insurance companies. Since many of these insurance entities are set up to provide insurance to other governmental entities, especially municipalities and local school districts, it is important to recognize that state laws often treat these entities different than private insurers. Continue Reading Municipal and Local Government Insurance Claims With Governmental Insurance Pools Are Different

Lesser & Company have been pioneers and leaders in Florida public adjusting since 1944. It is Florida’s oldest public adjusting firm. I was stunned to learn from Mark Boardman that Steve Lesser passed yesterday morning. I felt a lump in my throat and wished that this horrible news was simply not true. Steve is my age. It is hard to accept that my friends and I are getting so much older that the things that cause older people to die are happening to us. My visual memories of him are always with a sly and happy smile, knowing he had a significant, quiet thought that he might only share if asked for. He was wise and thoughtful. True to the private person he was, his illness was kept secret except to a few. Continue Reading Steven Lesser- A Leader of Public Adjusters—Passes