NFIP’S Horseshoe Option

By Deborah Trotter on Posted in Insurance

When a National Flood Insurance Program (“NFIP”) insured is not satisfied with the payment for flood-related losses, the NFIP insured is directed to three options:1

  1. The NFIP insured may file an appeal with the Federal Emergency Management Agency (“FEMA”) within 60 days of the NFIP insurer’s written denial or partial denial of the requested claim amount.2
  2. The NFIP insured can invoke the Appraisal Provision of her policy. NOTE: The NFIP insured may not file option one above, the appeal with FEMA, if the Appraisal Provision is invoked.
  3. The NFIP insured may file a lawsuit within one year of the date of the written denial of all or part of the NFIP insured’s claim. NOTE: The filing of a lawsuit precludes option one, the appeal, and option two, the appraisal process, as those are considered pre-litigation administrative remedies. Continue Reading

North Carolina Insurance Commissioner Requires More Thorough Investigation of Hidden Water Damage and Hurricane Florence Claims

By Chip Merlin on Posted in Insurance

The North Carolina Insurance Commissioner, Mike Causey, gets an A+ grade for his recent bulletin requiring greater investigation of otherwise hidden areas behind walls to ensure losses are being adjusted properly. This bulletin will certainly help victims of Hurricane Florence. Continue Reading

Should Insurance Agents Get Sued for Selling Insurance Which Requires Arbitration in a Far Away Location and Deprives Their Customers of Consumer Protection Laws?

By Chip Merlin on Posted in Insurance

Why would any insurance agent sell a customer an insurance policy that allows the insurance company to low-ball, delay payment, and otherwise not pay, and then force the insurance customer to obtain justice through an arbitration in a far-away jurisdiction applying foreign law? That is exactly what many commercial policyholders are being sold in Texas and Florida. Insurance agents are supposed to sell insurance that protects policyholders, and these types of policies sold by the surplus lines insurance industry should be banned and not sold. The above image of Timbuktu is appropriate because that is where policyholders could be forced to arbitrate. Continue Reading

Move Out and Lose Coverage—Common Property Insurance Minefields Caused By Changes of Residency

By Chip Merlin on Posted in Insurance

Insurance agents, divorce attorneys, elder law attorneys, wills, trusts and estate attorneys, and real estate attorneys need to read this post. They also need to read “Where You Reside” – The “Where’s Waldo®?” Catastrophic Homeowners Policy ‘Exclusion’ That Could Bankrupt Your Insureds, by insurance coverage expert Bill Wilson. Wilson’s article shows how often coverage can be lost just by common changes of where people are living. Continue Reading

Hurricane Michael Claims Data Update

By J. Ryan Fowler on Posted in Insurance

The Florida Office of Insurance Regulation recently released updated data from Hurricane Michael.1 A review of the available data shows the damage for the Florida panhandle. While we all know that Michael did substantial damage in the Florida panhandle the numbers have continued to grow. Over one hundred and twenty-five thousand claims have been filed (125,356) totaling estimated insured losses at over three billion dollars ($3,430,014,424). Continue Reading

Federal District Court Weighs in on Whether Labor Can Be Depreciated in Arriving at an Actual Cash Value Loss Settlement

By Edward Eshoo on Posted in Allstate, State Farm

Whether labor can be depreciated in arriving at an actual cash value property loss settlement has been a hot topic of debate over these past five years. A federal district court in Ohio recently weighed in on the issue in ruling on motions to dismiss two putative class action lawsuits, one against State Farm Fire & Casualty Company1 and one against Allstate Indemnity Company.2 Continue Reading

The Trouble with Releases of Claims in Exchange for Policy Benefits

By Christopher Mammel and Tamara Chen-See on Posted in Insurance Claim

As policyholder attorneys, we frequently hear concerns from public adjusters that at the conclusion of a difficult adjusting process with an insurance carrier, a release was demanded in exchange for some agreed payment for the loss.1 Public adjusters cannot advise their clients whether the release is appropriate since that advice would constitute the practice of law, and the policyholder is then presented with a dilemma: sign the release to receive the insurance check – and give up the right to seek supplemental benefits under the policy – or refuse and challenge the insurance company’s release requirement. Continue Reading

Puerto Rico Aprueba Enmiendas Al Código de Seguros Para Proteger A Los Asegurados Y Mejorar Los Procedimientos Para Solucionar Reclamaciones

By Julitza Perez on Posted in Consumer Protection, State Legislation

A raíz de la catástrofe causada por los huracanes Irma y María, surgió la necesidad de revisar el proceso de reclamaciones ante las aseguradoras en aras de hacer este uno más eficiente. Es por esto que, el gobierno ha trabajado en métodos que ayudarán a mejorar los procedimientos de manejo de reclamaciones ante las aseguradoras. Siguiendo múltiples modelos de varias jurisdicciones de los Estados Unidos, los asegurados en Puerto Rico ahora tendrán herramientas adicionales de protección y que facilitarán la resolución de sus reclamaciones, tanto de propiedades residenciales como aquellas que sean comerciales. Recientemente, el Gobernador aprobó enmiendas al Código de Seguros de Puerto Rico para su inmediata aplicación. Dichas enmiendas pretenden solucionar el atraso y aclarar las ambigüedades que han afectado el proceso de recuperación y resolución de reclamaciones de forma justa y adecuada para el consumidor. A continuación, un breve resumen de las enmiendas realizadas al Código de Seguros ahora disponibles para el beneficio de los asegurados en Puerto Rico: Continue Reading

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