On September 30, 2020, the Puerto Rico Court of Appeals revoked the rulings held on two (2) Accord and Satisfaction cases. The first case, Victor Cruz Perez v. Universal Insurance Company,1 was reversed due to the insurer’s failure to prove that all elements of Accord Satisfaction had been fulfilled.
Continue Reading Puerto Rico Court of Appeals Revokes Two Accord & Satisfaction Rulings on Hurricane Maria Claims

Florida law distinguishes between insurance agents and insurance brokers.1 In Essex Ins. Co. v. Zota, the Florida Supreme Court defined an insurance broker as an individual who “represents the insured by acting as a middleman between the insured and the insurer, soliciting insurance from the public under no employment from any special company…[and] places it with a company selected by the insured.”2 If the insured has no preference as to the company, the broker can select the company.3 An insurance agent, on the other hand, is someone who “represents an insurer under an exclusive employment agreement by the insurance company.”4
Continue Reading When Can an Insurance Carrier be Liable for the Actions of its Agents?

Wildfires have erupted across Colorado, forcing thousands of Coloradans to evacuate to safety from the Cameron Peak, CalWood, Lefthand Canyon, and East Troublesome Fires. Accordingly, the Colorado Division of Insurance (DOI) issued a news release to give insurance advice to those effected on evacuation, filing insurance claims, and financial preparedness. The consumer advisory provides practical insurance tips, insurance evacuation and claims advice, and guidance on returning home after the fire.
Continue Reading Colorado Wildfires – Colorado Division of Insurance Advisory to Impacted Coloradans

Civil Authority and Ingress/Egress Coverage Bibliography

Robert M. Horkovich, et al., Insurance Coverage for Businesses Affected by Civil Unrest. Risk Management (June 15, 2020).

Shannon O’Malley. Commercial Property Insurance Coverage and Coronavirus. Zelle LLP (Mar. 11, 2020).

Jonathan McBride. Civil Authority Coverage For Coronavirus Claims. Zelle LLP (Mar. 20, 2020).

Douglas Berry.

Jon Held is one of the best advocates I have ever seen and heard argue about keeping the amount owed to policyholders down. He is a brilliant businessperson and has built an exceptional insurance consulting company regarding virtually every aspect of the insurance claims valuation process. I called his company a “surrogate” for claims adjusters

Deductibles are an issue in all property insurance claims. Policyholders hate to pay them but love the discount in policy price when a higher deductible is part of the policy. I wrote about a new deductible financing product in High Deductible? Try FundMyDeductible.com. Some questioned whether this was proper and what the insurance industry response would be.
Continue Reading Insurance Industry Adopting Deductible Financing and Deductible Payments Over Time

Auto-Owners has begun a sad trend of suing its insureds and alleging that the insured’s contractors and/or public adjusters are fraudulently inflating prices. Auto-Owners is levying these accusations even though its insureds’ contractors and/or public adjusters are also using Xactimate to estimate the costs of repair to reach a lump sum agreement. In taking this drastic step, Auto-Owners and its attorneys confusingly assert Xactimate results is fair and reasonable pricing for them, but results in fraud when its insureds’ contractors and/or public adjusters produce an estimate utilizing the same software. This trend is both shocking and concerning for Auto-Owners’ insureds.
Continue Reading Auto-Owners Utilizes Xactimate to Draft Claims Estimates, But Argues Fraud When its Insureds Do the Same

As wildfires continue to devastate California yet again, countless homes and businesses have been destroyed. The destruction of buildings and other property, however, does not even begin to reflect the actual extent of wildfire damages. Thousands more homes and business have been affected by smoke damage. Unfortunately, some insurance companies will refuse to recognize smoke damage alone if a property was not actually touched by a fire. If you can demonstrate that smoke has indeed affected a building and personal property, then you can also demonstrate damages and the insurer should be held accountable to pay to return the smoke affected property to its pre-loss condition.
Continue Reading The Importance of Demonstrating that Damages Exist in Smoke Damage Insurance Claims