It’s a Brand-New Ballgame

The phrase, it’s a brand-new ballgame, was popularized by Hall of Fame Dodgers’ Broadcaster, Vin Scully; when a team scores a run that brings the score up to a tie, announcers say: “It’s a brand-new ballgame.”

Texas Insurance Code Section 542A.006, effective December 1, 2017, allows insurers to accept liability for the acts of their adjusters either before suit is filed or after suit is filed. If the election of liability is made before suit is filed, the in-state defendant adjuster never becomes a party if suit is filed eventually. If the election is made after suit is filed, the court must dismiss the adjusters from the suit. Continue Reading

Restoration Contractors Providing Great Quality Workmanship Are Policyholder Friends But Many Insurance Companies Refuse To Pay For Quality

Contractors often tell me and other Merlin Law Group attorneys of the crazy excuses and refusals insurance adjusters give to avoid paying for required construction materials, processes, and practices which constitute quality workmanship. Cheap and non-quality construction is easy to do and often overlooked by policyholders completely unfamiliar with the detailed specifications demanded by manufacturers of materials, building codes and OSHA requirements which must be followed for legal and quality construction to take place. Insurance company claims mangers know that doing construction right is a lot more expensive and demanding than paying for cheap construction. Continue Reading

Protective Safeguards Endorsements: Does Your Policy Have One?

We see many commercial insurance claims denied because the insured did not maintain a particular “protective safeguard” required by the policy. For example, a policy may require burglar alarms, and exclude coverage for theft if alarms are not working at the time of a loss. Or, a policy may require fire sprinklers, and exclude coverage for fire loss if the property does not have any. Some provisions may even allow the insurer to deny coverage if the insured failed to have a contract in place for regular service of the protective safeguard, something often seen for Ansul systems in restaurants. Courts across the country have almost uniformly upheld the validity of these endorsements.1 Continue Reading

For The Policyholder! Merlin Law Group’s Kelly Kubiak Testifies Before The Florida Legislature

Insurance company lawyers and lobbyists are a crafty crew. Kelly Kubiak got word from me after I learned late Tuesday afternoon that Florida legislators needed to hear from her early Wednesday morning regarding a proposed law that would let delaying, denying and wrongful acting insurance companies obtain a “get out of free jail card” so long as a claim was paid 20-60 days after appraisal. Kelly changed her schedule and travelled up to Tallahassee to do work For the PolicyholderTM. Continue Reading

Court Rules Sewer Backup Clause Does Not Include Internal Plumbing

Back in January 2017, I blogged about the landmark case of Pichel v. Dryden Mutual Insurance Company,1 where New York’s Third Department ruled that the insurance policy contained an ambiguity when differentiating between loss caused by backup to a sewer or drain and a loss caused by backup to an internal plumbing system. Continue Reading

Freezing Exclusions: One Size Does Not Fit All

“One size fits all” is a phrase used to describe pieces of clothing or accessories designed to fit all people. Over time, it has been used to refer to anything meant to apply in all circumstances.

Obviously, one size cannot fit all people. The same holds true when it comes to “freezing” exclusions in homeowner’s insurance policies. Not every freezing exclusion is the same. Compare the following two freezing exclusions. Continue Reading

Assignment of Benefits Contracts are the Hot Topic of Discussion and Legislation in Florida, North Dakota and Elsewhere

Merlin Law Group knowledge manager Ruck DeMinico sent me recent North Dakota legislation pertaining to Assignment of Benefit contacts. This topic was also hotly debated two weeks ago at the Windstorm Insurance Conference in Orlando. Insurance restoration contractors, their lobbyists and attorneys are desperately trying to prevent any changes that would make such contracts more difficult to enter into or enforce. The insurance lobbyists and their public relation firms are doing everything they can to show contractors and their lawyers as evil and greedily taking advantage of the public trust. Continue Reading

Ice Dammed If You Do, Ice Dammed If You Don’t

This time of year, the northeast of the United States starts to feel insufferably cold, followed up by winter storms which can dump anywhere from an inch to three feet of snow at a time. The snow can be a welcomed arrival in winter as it brings snow days, sleigh riding and joy. It can also signal the beginning of a damming experience; ice damming that is. Continue Reading

Two Year Anniversary Approaching for Colorado’s May 8, 2017 Hailstorm

Colorado policyholders should be mindful to review their insurance policies for time limit considerations that may bar them from pursuing insurance benefits beyond two years after the May 8, 2017, hailstorm. While Colorado requires that any action against an insurance company for failure to pay covered benefits must be brought within three years of the date of loss, Colorado allows insurance companies to contractually reduce this time period to as little as six months in commercial and business owner policies of insurance. Failing to bring an action within this prescribed period can ultimately lead to the inability to seek legal recourse where an insurance company is failing to pay covered benefits. Continue Reading

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