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.

Continue Reading

What Is A Fire?

Last month, I spoke at the First Party Claims Conference in Rhode Island on the topic of the Standard Fire Insurance Policy, which 165-line form provides coverage for direct loss by fire and lightning.1 My presentation presumed that everyone knows what a fire is, myself included. I changed my mind though after reading the Connecticut federal district court’s recent opinion in National Liability & Fire Insurance Company v. Jablonowski.2 Continue Reading

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