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 resorted to appraisal as a quicker, more cost-effective, binding means to determine a critical issue under the policy – the amount of a loss.
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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 13 days of a water leak.
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Ashley Harris

The Iowa Supreme Court determined that “appraisers may determine the factual cause of damage to insured property to ascertain the amount of loss,” in Walnut Creek Townhome Association vs Depositors Insurance Company.1 I am proud that Ashley Smith (nka Ashley Harris) was cited by the court for her analysis of the issue.
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The Colorado Supreme Court issued two opinions favorable to Colorado policyholders earlier this week:

  1. American Family Mutual Insurance Company v. Barriga; and
  2. 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, Inc. will be discussed in the coming days.
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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 and due to wind damage under both a flood and a separate specified-peril wind insurance policy.
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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 in that opinion which addressed the relationship between contract claims under an insurance policy and tort claims under the Texas Insurance Code.4 The court issued the same disposition in Menchaca II —reversal and remand for a new trial—as it had in Menchaca I. So, one asks: “What is the difference in the two opinions? Which party suffered an unlucky day?” This article will attempt to answer those questions.
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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 basic question: When is an insured legally entitled to bring a civil action against their property insurance carrier for failing to meet its statutory obligations?
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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:

  1. Whether an insured is required to obtain a breach of contract finding as a prerequisite to a recovery for an insured’s extra-contractual claims such as an insurer’s violations under the Texas Insurance Code; and
  2. if an insured can show entitlement or a right to policy benefits, whether those policy benefits can serve as actual damages for extra-contractual claims even if the insured cannot establish a breach of contract claim.


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