While researching Nevada insurance agency law and duties, I came across a course entitled, Ethical Issues in Insurance. Two points of the course, which seem very relevant to most claims situations, involved the trust that policyholders place with agents and then the trust they place with the companies hoping they will be fully paid when a claim is presented. Continue Reading The Insurance Industry Teaches Ethics But Does It Follow What It Teaches?

Public adjusters serve a critical ally to policyholders throughout the claim adjustment process. In Nevada, public adjusters are regulated under the provisions of chapter 684A of the Nevada Revised Statutes (NRS) and chapter 684A of the Nevada Administrative Code (NAC).1 The Nevada Division of Insurance outlines what is required of public adjusters in the Silver State. Continue Reading Nevada Public Adjuster Requirements and Regulations

While Florida’s political leaders have taken away policyholders’ traditional rights and protections by passing recent anti-policyholder laws, as discussed in Florida’s New Anti-Policyholder SB 76 Signed Into Law By Governor DeSantis, Louisiana has doubled down on traditional policyholder rights which are standard throughout the country by passing Louisiana Act 345 (fka HB 591). Continue Reading “No” to Managed Repair, “Yes” to Overhead and Profit And “Yes” to Appraisal—Louisiana Takes Steps to Maintain Traditional Rights Afforded To Policyholders

Virtually every property insurance policy has a specific section regarding the post-loss obligations of the insured. Whether it be expressly stated in its own policy provision or implied from the wording of other post-loss obligation provisions, it is almost universally agreed that an insured has a duty to mitigate their damages after a loss. Continue Reading Conflicting Policy Provisions Regarding the Duty to Mitigate in Business Interruption Claims

A number of Florida insurance companies removed appraisal from their policies over the past several years. Since litigation was the only method of resolution, this lead in part to a sharp increase in lawsuits filed. This “Wag The Dog” scenario then allowed the Florida insurance industry to claim a spike increase in the number of lawsuits filed and seek a need for alleged reform which harms Florida policyholders. Continue Reading Does SB 76 Require An Insurer and Policyholder to Go To Appraisal If The Policy Does Not Reference Appraisal?

Tuesday @2 is going to be a quick 30-minutes by yours truly discussing the bottom line of this crazy new law. This law has significant ramifications for policyholders, public adjusters, and contractors. Some of my feelings regarding this law were posted this weekend in, Florida’s New Anti-Policyholder SB 76 Signed Into Law By Governor DeSantis. Continue Reading Public Adjusters and Contractors—The Readers Digest Version of What You Need to Know About SB 76 in 30 Minutes By Chip Merlin on Facebook Live @ 2pm Today

Greene v. USAA1 is probably the most cited case by first-party insurance carrier attorneys in Pennsylvania. It is an appellate level case that centered on whether an insurance carrier is required to replace a roof when the existing shingle is no longer in production, but shingles of “similar color, texture, function, and shape” are available. In Greene, the Superior Court of Pennsylvania (appellate) held that using shingles similar to the damaged shingles in function, color, and shape satisfied the insurer’s obligation to pay for repair or replacement with like construction. Continue Reading Repair vs. Replacement in Pennsylvania

We still field questions from adjusters about what gets paid if there is a total loss in Florida. I am certain that most adjusters remember something about a Florida total loss case where law and ordinance benefits were automatically paid without showing proof of loss. That case is known as Mierzwa1 and that part of Mierzwa was overruled by Ceballo.2 Continue Reading Total Loss Does Not Mean Supplemental Coverages Get Paid—Ceballo Overruled Mierzwa So That Law and Ordinance Does Not Get Automatically Paid Following a Total Loss

A recent Florida case1 has a lengthy discussion about cases where changing valuations by the insured are then used by clever insurance company attorneys to argue that a post-loss fraud has occurred. This is now a common practice in litigation throughout the country as policyholders, public adjusters, and contractors make differing estimates of loss and have different opinions about what the measure of the loss should be. Continue Reading Insurance Company Attorneys Often Wrongfully Argue That a Fraud Occurs When Parties Only Have a Difference of Opinion

Florida’s new anti-policyholder laws found in SB 76 were not vetoed and instead were signed into law effective July 1, 2021. This is a big win for insurance companies which delay and underpay claims. The effect of these laws make it more difficult to hold those insurance companies accountable, further delay claims payments when those insurance companies do delay payment, provide new technical defenses to insurance companies when they are sued, reduce the time to submit all claims to insurers, and make it much less probable that policyholder attorneys fees will be fully paid by delaying and underpaying insurance companies. To top it off, nobody in the insurance industry promises that these new laws will reduce insurance rates. Continue Reading Florida’s New Anti-Policyholder SB 76 Signed Into Law By Governor DeSantis