Archives: Insurance

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It’s a Brand-New Ballgame. . .In Texas When it Comes to Filing Suit Against Your Property Adjuster

Texas Insurance Code Section 542A.006, effective December 1, 2017, allows insurers to accept liability for the acts of their adjusters either before suit is filed or after suit is filed. If the election of liability is made before suit is filed, the in-state defendant adjuster never becomes a party if suit is filed eventually. If … Continue Reading

Restoration Contractors Providing Great Quality Workmanship Are Policyholder Friends But Many Insurance Companies Refuse To Pay For Quality

Contractors often tell me and other Merlin Law Group attorneys of the crazy excuses and refusals insurance adjusters give to avoid paying for required construction materials, processes, and practices which constitute quality workmanship. Cheap and non-quality construction is easy to do and often overlooked by policyholders completely unfamiliar with the detailed specifications demanded by manufacturers … Continue Reading

Freezing Exclusions: One Size Does Not Fit All

“One size fits all” is a phrase used to describe pieces of clothing or accessories designed to fit all people. Over time, it has been used to refer to anything meant to apply in all circumstances. Obviously, one size cannot fit all people. The same holds true when it comes to “freezing” exclusions in homeowner’s … Continue Reading

Ice Dammed If You Do, Ice Dammed If You Don’t

This time of year, the northeast of the United States starts to feel insufferably cold, followed up by winter storms which can dump anywhere from an inch to three feet of snow at a time. The snow can be a welcomed arrival in winter as it brings snow days, sleigh riding and joy. It can … Continue Reading

Two Year Anniversary Approaching for Colorado’s May 8, 2017 Hailstorm

Colorado policyholders should be mindful to review their insurance policies for time limit considerations that may bar them from pursuing insurance benefits beyond two years after the May 8, 2017, hailstorm. While Colorado requires that any action against an insurance company for failure to pay covered benefits must be brought within three years of the … Continue Reading

Bill Berk and John Pappas Provide a Unique Perspective About Insurance Bad Faith Claims Handling and Claims Ethics Found Only at the Windstorm Insurance Conference

John Pappas is a tough litigator and very bright. I’ve known him since I helped him get his position at the 100 plus insurance coverage defense firm eventually known as Butler Pappas way back in 1982 when only a handful of attorneys worked there. Bill Berk was a tough prosecutor before he became a principal … Continue Reading

Partial Flood Proofs of Loss Requesting Only Items In Dispute Are Losers In Flood Claims

Flood insurance claims governed by the National Flood Insurance Program are different. The requirements to get paid are strict and must be complied with. Many inexperienced attorneys and public adjusters prepare these claims improperly and the result is that policyholders do not get paid or paid as much as they otherwise deserve. Federal proofs of … Continue Reading

Broken Pipe During Polar Vortex: Don’t Let Your Policy’s “Freezing Exclusion” Leave You Uncovered for Losses From Arctic Cold

Most property insurance policies exclude coverage for damages caused by the freezing of household systems or appliances unless the insured used reasonable care to maintain heat in the building or shut off the water supply and drained all systems and appliances of water. Courts interpreting the “freezing exclusion” have generally found that the language within … Continue Reading

Consequences of a Well-Pled Complaint

The New York Supreme Court, Appellate Division, First Department “unanimously reversed, on the law, with costs, the motion denied and the claims reinstated,” the New York County Supreme Court trial judge’s order dated April 2, 2018, to the extent appealed from, which granted dismissal of Plaintiff D.K. Property, Inc.’s (“D.K.”) consequential damages (other than attorney’s … Continue Reading

Panama City Attorney Jeff Carter Joins Merlin Law Group to Help Hurricane Michael Policyholders

Panama City attorney Jeff Carter has joined Merlin Law Group in its Panama City office. While I lived in Panama City and attended Mosley High School, I have always found that it helps to have local attorneys with fine reputations in our firm who team up and use Merlin Law Group’s longstanding experience and dedication only … Continue Reading

Puerto Rico Update: Real Legacy Confirms Rumors of Insolvency – What’s Next?

For some time now, people have been keeping a close eye on several of Puerto Rico’s major insurance carriers due to rumors of insolvency. One of those insurance carriers, Real Legacy Assurance, has unfortunately confirmed these rumors and recently filed for liquidation. According to reports, the carrier has paid nearly $40 million dollars to settle … Continue Reading

Case Highlights How Writing and Interpreting Policies Can Be Challenging in Today’s Technological World

In the recent case of Rainforest Chocolate, LLC v. Sentinel Insurance Company, Ltd.,1 the Supreme Court of Vermont found coverage for Rainforest where Sentinel’s “false pretense” exclusion turned out to be ambiguous as there were at least two reasonable interpretations of what constituted “physical loss or physical damages.”2… Continue Reading

Appraisal: Competent, Disinterested and Impartial. Are appraisers and Umpires Ever Actually Any of the Three?

Recently, I presented at the Professional Public Adjusters Association of New Jersey educational conference on the area of insurance appraisal to roughly 30 public adjusters. During my preparation, I reviewed current and past appraisal provisions contained within standard insurance policies. In my research, I found some very interesting differences contained within insurance policy appraisal provisions … Continue Reading

Insurance Agent Versus Experienced Policyholder Attorney Viewpoints About Insurance Coverage Denials

Ed Eshoo works out of Merlin Law Group’s Chicago office and is one of the best property insurance policyholder coverage attorneys you could find. I do not think there is anybody with a national reputation as being “the expert” on the 165-line Standard Fire Insurance Policy on a national, rather than state, basis. Ed is an … Continue Reading
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