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It took my carrier almost a year to make their coverage determination, and now I am being told that the one-year limitations period under the policy ends in a few days. Is that right?

Most insurance policies contain a contractual provision that sets forth the time frame in which the insured must commence suit should a dispute arise concerning the policy. In many instances, these limitation provisions provide that the insured must file suit no later than one year after the date of the loss.… Continue Reading

Free Flood Insurance Webinar

David Stearnett, who is the Flood Insurance Advocate for the National Flood Insurance Program, and Sha Ron James, Florida’s Insurance Consumer Advocate, should be congratulated for hosting a free webinar on July 25: Guiding and Educating Insurance Professionals and Consumers about Flood Insurance Needs During a Catastrophe.… Continue Reading

Does An Insurer Waive Privilege for Attorney-Client Communications in the Claims File By Denying Bad Faith?

Merlin Law Group is closely monitoring a case pending before the South Carolina Supreme Court to see how it answers the question: “Does South Carolina law support application of the ‘at issue’ exception to the attorney-client privilege such that a party may waive the privilege by denying liability in its answer?”… Continue Reading

AmTrust Buys Tower Insurance But Finds a Way to Not Pay Tower’s Pending Claims

Most people think insurance companies are flush with billions in cash as they continually underpay and deny claims. For most of the big insurance companies, this is true, but for some smaller companies spread across the country and localized in certain states, solvency can become an issue. Often, insurance companies such as Tower Insurance get … Continue Reading

When Is “Too Late” for an Insurance Company to Invoke Appraisal?

I often take calls from potential clients and public adjusters frustrated with an insurance company that has denied, delayed and then underpaid a claim and then ultimately invoked appraisal. Often the insured or public adjuster states that multiple inspections have taken place with substantial correspondence between the parties and the question is, “can the insurance … Continue Reading

Policyholders Beware: When You Hear “Drip…Drop” Think “Tic Tock”

When homeowners discover a plumbing issue in their home, there are usually several things running through their minds: investigating the source of the leak, stopping and fixing the problem, and drying as much of the water as possible. One thing that can be easily overlooked, especially by insureds who have never experienced a plumbing leak … Continue Reading

Social Engineering Schemes – Is There Coverage for Computer Fraud Involving the Company’s Email System?

Various courts across the country have reached mixed decisions for insurance coverage disputes involving insureds who fell victims of social engineering crimes. The court’s ruling in Medidata Solutions Inc. v. Federal Insurance Company,1 finding coverage for the insured who was spoofed by e-mail fraudsters was previously discussed by my colleague, Verne Pedro. As Verne pointed … 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

National Flood Administrator Says “Hell No, No More Extensions” To Harvey, Irma and Maria Flood Victims

One certain way FEMA and National Flood Administrators get out of paying otherwise valid flood insurance claims is to require strict and timely requirements. Citing an internally generated and fraudulent 99% closure statistic, the National Flood Program denied a request to extend the timeline for filing Proofs of Loss for Hurricane Harvey, Irma, and Maria … Continue Reading

Policy Conditions “Conformity to State Law” May Extend the Period Time to File Suit.

Some insurance policies will contain a clause within the conditions section entitled “Conformity to State Law.” This provision contains language similar to: “Conformity to State Law. When a policy provision is in conflict with the applicable state law of the State in which this policy is issued, the law of the state will apply.”… Continue Reading

Top Seven Things Public Adjusters Should Know About Cyber Risks and Cyber Insurance

Cyber-risks are not just about corporate data breaches anymore. I recently spoke to a public adjuster who said he was a victim of a ransomware attack. Ransomware is malicious software (malware) installed on a computer, smart phone, or other mobile device, without the owner’s consent. Once malware is installed, cybercriminals can monitor and control online … Continue Reading

When the Insurance Company Labels Your Loss a Collapse, Can It Still Deny Your Collapse Claim?

At least one Michigan court has ruled that even when the execute general adjuster calls a building’s damage a collapse and labels it as a “cave in,” the denial will stand where the policy language supports an exclusion.1 This case arises out damages that occurred to a large commercial shop that repairs commercial trucks. There … Continue Reading

Condominium Associations Must Purchase Flood Insurance

Many state statutes and condominium bylaws require the purchase of reasonably available property insurance which covers all direct physical risks of loss on an extended and replacement cost basis. One issue I have heard associations and their insurance agents ask: “Is flood insurance reasonably available” so that it has to be insured.… Continue Reading

Insurance Department Guidance on Application of Named Storm / Hurricane Deductibles

Louisiana’s Department of Insurance, through its Commissioner, James J. Donelon, issued an Advisory Letter No. 2018-01 on June 18, 2018, to inform all property and casualty insurers how the separate named storm deductibles or hurricane deductibles are to be interpreted and applied to claims resulting from a subtropical storm named by the National Hurricane Center … Continue Reading

Attorney Richard Kent Livesay Pleads Guilty to Charges of Insurance Fraud Involving Roof Claims

“We hope this sentence sends a message that this conduct will not be tolerated in our county.” —Matt Smid, Tarrant County Assistant Criminal District Attorney According to the Tarrant County district attorney’s office, a Tarrant County judge sentenced Richard Livesay to five years in prison after he pled guilty to various charges including fraud and … Continue Reading
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