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Much Needed Clarification of Appraiser Qualifications in Florida

The appraisal alternative dispute resolution procedure in most first-party property insurance policies in Florida is a valuable process for insureds. In our experience at Merlin Law Group, few states in the country have a greater need for an understandable, enforceable appraisal process than Florida. Since at least Hurricane Andrew in 1992, policyholders and insurers have … Continue Reading

Follow-Up: My Insurance Claim Was Denied Because My Water Leak Lasted Over a Period of 14 Days or More – Was the Denial Proper?

In March, I posted a blog on the Hicks v. American Integrity Insurance Company opinion,1 in which a Florida court ruled that policy language stating: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days,” did not preclude coverage for damage caused during the first … Continue Reading

Colorado Supreme Court Clarifies Unreasonable Delay or Denial Statute

The Colorado Supreme Court issued two opinions favorable to Colorado policyholders earlier this week: American Family Mutual Insurance Company v. Barriga; and Rooftop Restoration, Inc. v. American Family Mutual Insurance Company. Both cases address the unreasonable delay or denial of insurance benefits statute in Colorado. This post addresses the Barriga opinion, and the Rooftop Restoration, … Continue Reading

The Independent Injury Rule Is Dead!

May 11, 2018, is a day that shall live in infamy for insurance law plaintiff attorneys. On that day, the Fifth Circuit declared the independent injury rule as dead in Aldous, PC v. Darwin National Assurance Company,1 citing the substituted April 13, 2018, Menchaca II opinion.2… Continue Reading

Policy Exclusions Must Be Narrowly Applied to Assure Policyholders Receive All Benefits Available

In a recent post, Policyholders May Benefit From All Their Coverages, I discussed the importance of carefully evaluating all the insurance benefits potentially available to policyholders if a catastrophic loss occurs. That blog examined the decision in Citizens Property Insurance Corp. v. Hamilton,1 which allowed recovery of benefits for a total loss due to flood … Continue Reading

An Unlucky Day? Friday, April 13, 2018, the Texas Supreme Court Issued a New Opinion in USAA Texas Lloyds v. Menchaca

On Friday, April 13, 2018, by avoiding black cats, ladders, and breaking mirrors, seven members of the Texas Supreme Court1 managed to issue a new, sixty-six page opinion in USAA Texas Lloyds Company v. Menchaca (“Menchaca II”).2 Withdrawing its April 7, 2017, opinion3 —”Menchaca I”—the court unanimously reaffirmed the five legal principles and rules announced … Continue Reading

Better Late Than Never? Don’t Think So – Voluntary, Untimely Payment of Benefits Does Not Absolve Carrier from Liability for Bad Faith in Florida

It has been over 30 years since Florida lawmakers enacted section 624.155, which was designed to provide a civil remedy when an insurer fails to settle their policyholder’s claim in good faith or commits any one of the unfair claims handling practices identified in section 626.9541(1)(i). Yet, to this day, questions still arise on one … Continue Reading

Nearly Ten Years Later, Hurricane Ike’s Stormy Winds Are Still Churning in the Texas Supreme Court — USAA Tex. Lloyds V. Menchaca

On April 7, 2017, the Texas Supreme Court in USAA Tex. Lloyds Co. v. Menchaca,1 answered several issues that had continually swirled around litigation arising out of Hurricane Ike policy disputes. Unresolved issues included among others: Whether an insured is required to obtain a breach of contract finding as a prerequisite to a recovery for … Continue Reading

My Insurance Claim Was Denied Because My Water Leak Lasted Over a Period of 14 Days or More – Was the Denial Proper?

Many property insurance policies have a provision that states something similar to the following: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days.” Insureds may find their claims for water loss under their homeowners’ policy denied on the grounds that the leak was present … Continue Reading

Policyholder Attorneys Beware: Make Sure Your Contingency Fee Multiplier Awards Are Airtight and “Anderson” Proof

Back on November 7 of last year (2017), I wrote about an important opinion in the world of property insurance litigation, Joyce v. Federated National Insurance Company,1 where the Florida Supreme Court reaffirmed that you could still obtain a contingency-fee multiplier where justified under Quanstrom and in so doing reversed the Fifth District Court of … Continue Reading

The Importance of Promptly Providing Notice of Loss

Most property insurance policies require that the insured must provide “prompt” notice of a loss as soon as possible after a covered loss. While many states throughout the country have adopted the Notice-Prejudice Rule which prevents an insurer from denying a claim unless it can demonstrate actual prejudice resulting from the delayed notice of loss, … Continue Reading

Court Rejects Jury Instruction Inconsistent with Concurrent Causation Doctrine; Remands for New Trial

In December of 2016, I wrote about Sebo v. American Home Assurance Company,1 where the Florida Supreme Court reversed the appellate court’s adoption of the “Proximate Efficient Cause” doctrine and found that instead, the lower court should have applied the “Concurrent Causation Doctrine,” as laid out in Wallach v. Rosenberg,2 in a situation where both … Continue Reading

Court Reaffirms on Contingency Fee Multipliers in Joyce v. Federated National

William and Judith Joyce filed a claim with their insurer, Federated National, after suffering water damage to their home. Instead of agreeing to cover the loss, Federated National denied the Joyces’ claim alleging they made material misrepresentations on their insurance application by failing to disclose prior losses they had with their previous carrier.… Continue Reading

An Insurer’s Obligation to Match: Comparable Materials and Quality

Policyholders purchase property insurance and pay lofty premiums with the intention of their insured property being restored to where it was prior to a loss. But what happens when the loss affects only a portion of the siding or has destroyed only a handful of discontinued roofing tiles? Is the policyholder forced to accept mismatching … Continue Reading

Can an Insured Recover from Their Insurance Broker If the Broker Fails to Obtain the Coverage Requested, or Misrepresents Coverage?

If an insurance broker fails to obtain the insurance coverage requested or misrepresents the scope or extent of coverage, does an insured have a claim against the broker when the insurance they expected to cover their loss does not as a result of the broker’s negligence?… Continue Reading

California Supreme Court Affirms California Fair Plan Ass’n v. Garnes, and Preserves Homeowners’ Interests

The California Department of Insurance recently issued a press release announcing that the California Supreme Court affirmed the homeowner reimbursement protections recently decided in California Fair Plan Association v. Garnes.1 Back in June, my colleague Kevin Pollack wrote about the recent decision and whether actual cash value means fair market value or replacement cost minus … Continue Reading

Eighth Circuit Agrees: Pre-Award Interest on Appraisal Award is Appropriate

I recently wrote about the case of Poehler v. Cincinnait Insurance Company,1 in which the Minnesota Supreme Court recently held that Minnesota Statute section 549.09 provides for pre-interest on insurance appraisal awards. Following this decision, the Eighth Circuit Court of Appeals in Housing and Redevelopment Authority of Redwood Falls v. Housing Authority Property Insurance,2 similarly … Continue Reading

Appraisers Agreeing Not To Include Issues of Loss May Render Policyholders with No Later Recovery

Appraisals can result in losing propositions for policyholders. I often teach that policyholders need to make certain that they do their best during appraisal and not expect a bad award to get overturned. Policyholders need very hardworking, honest, and knowledgeable persons selected as their appraisers.… Continue Reading

Standard Fire Insurance Policies Still Provide Basic Protections—A Major Victory for Policyholders and Merlin Law Group

The Seventh Circuit Court of Appeal’s opinion this week in Streit v. Metropolitan Casualty Insurance Company,1 is a major victory for policyholders in Illinois. There, the Seventh Circuit affirmed the lower court judgment entered in favor of my clients, Wesley and Barbara Streit, arising out of Metropolitan’s failure to cover a fire loss to their … Continue Reading

Insurers Cannot Rely on Rescission if They Fail to Inquire and Investigate Insureds Before Claims

After a claim is made, and despite the obligation to objectively, fairly, and reasonably investigate a claim with an eye toward providing coverage and without putting the insurance company’s interests ahead of their insured’s, some insurers actively look for ways to deny coverage. One of the ways some insurers do this is by using the … Continue Reading
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