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Texas Insurance Appraisal: Who is Grading Insurance Company Papers and the Policies They Sell?

It is no secret that there are problems with the appraisal process. The ever-growing issues with appraisal include, but certainly are not limited to, exorbitant expenses pushed onto policyholders and insurance companies, gamesmanship, and the never-ending questions of: When is appraisal appropriate What can be addressed and assessed within appraisal, and Whether a policyholder’s claims … Continue Reading

Matching in Ohio

There must be a lot of matching disputes out there because I have received two questions this week alone on matching issues in various jurisdictions. So, for today’s blog I will discuss matching in Ohio—The Buckeye State.… Continue Reading

Can Post-Loss Benefits be Assigned to a Mitigation/Restoration Vendor if the Policy Contains an Anti-Assignment Provision? Can the Vendor then Sue the Insurance Company?

The Arizona Court of Appeals in a recent opinion said, Yes to both. In Farmers Insurance Exchange v. Udall,1 four homeowners insured by Farmers Insurance Exchange (“Farmers”) sustained separate losses, which required water damage mitigation and restoration services. The homeowners hired a vendor to perform the mitigation and restoration services. In each case, the insureds … Continue Reading

FEMA Implements Enhancements to NFIP Claims Process

In a June 7, 2018, FEMA bulletin, W-18013, FEMA discusses several claims process enhancements and claims handling reminders that apply to all claims with a date of loss of June 7, 2018 through December 31, 2018. The enhancements to the NFIP’s claim process are in response to the widespread flooding that occurred in 2017.… Continue Reading

California Department of Insurance Has Approved the State’s First Cannabis Business Owners Policy

More states across the country are implementing legislation allowing for the legal use of cannabis. Currently 23 States and the District of Columbia allow for medical use with four of the states and D.C. also allowing recreational use. The conflicts between state and federal law have left businesses uninsured and often without access to bank … Continue Reading

What is a Collapse? Crumbling Concrete Case is Catalyst for Coverage Query Certified to State Supreme Court

Recognizing the public policy implications of an unsettled, recurring coverage issue involving crumbling concrete foundations in thousands of Connecticut homes, U.S. District Court Judge Stefan Underhill recently certified the following insurance coverage question to the Supreme Court of Connecticut: What constitutes a “substantial impairment of structural integrity” for purposes of applying the “collapse” provision of … Continue Reading

Roads to Exhaustion

Since Superstorm Sandy, many of our New Jersey condominium associations clients and others are working closely with their brokers these days to review the terms of attachment for their excess insurance coverage policies. The current trend we see in the trigger language for excess insurance policies is designed to circumvent the established majority rule1 first … Continue Reading

To Plea or Not to Plea? Insurer’s Denial of Coverage for Residential Fire Loss Upheld

I recently came across an interesting opinion, Fuller v. Mercury Insurance Company of Georgia,1 where the Eleventh Circuit Court of Appeals discussed the effect of a guilty plea on a policyholder’s civil action against their insurance carrier. The opinion stemmed from a residential fire loss and the insured’s subsequent claim for benefits under her homeowner’s … Continue Reading

Are TWIA Appraisals Ever Fair or Impartial?

TWIA (short for Texas Windstorm Insurance Association), frequently referred to as the Texas windstorm insurance carrier of last resort, just can’t seem to get this insurance claims handling thing right. A conclusion quite alarming considering that insurance claims handling is one of the primary functions of its business. At this point many are left wondering … Continue Reading

Policyholder Deposits Check and Loses Rights!

Accord and satisfaction are legal terms frequently used in insurance contract dispute and often included in any insurance carrier’s Answer and Affirmative Defenses to any complaint filed. An agreement (accord) between two contracting parties to accept alternate performance to discharge a preexisting duty between them and the subsequent performance (satisfaction) of that agreement.… Continue Reading
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