I have been receiving several inquiries about whether it is legal or ethical for public adjusters to sell a portion of their contingent fee to a funding company. For example, I received the following solicitation from a public adjuster who was solicited by a “funding company” that is associated with a law firm:
Continue Reading Can and Should Public Adjusters Be Allowed to Sell Their Fees to Funding Companies Affiliated With Lawyers Who Want to Represent the Public Adjuster’s Clients?

AmGuard has been having trouble with delayed claims where it is not promptly responding to inquiries from its customers or making claims payments. A recent jury verdict in Missouri found AmGuard guilty of vexatious refusal to pay a fire, vandalism, and resulting freeze claim. I previously noted similar AmGuard conduct from a Washington case in Claim Delay Leads to Bad Faith Judgement.
Continue Reading AmGuard Guilty of Bad Faith—Do Not Ghost The Claimant!

A recent topic of this blog has been the made-up insurance fraud statistics by the insurance industry, which has been discussed in Is the Insurance Industry’s Fraud Statistic Fraudulent? and Insurance Professor Jay Feinman Comments About Insurance Fraud Statistics. I have always wondered why we encounter such few allegations of policyholder fraud from insurers such as Amica, Chubb, and Lexington Preferred who charge higher premiums and compete on service rather than price. These companies do not nitpick their customers to death, and the focus is on fully paying the loss right away.
Continue Reading Does Nitpicking On Claims Have An Adverse Effect on Policyholder Morals?

This weekend’s post, Is the Insurance Industry’s Fraud Statistic Fraudulent? resulted in several great comments. One was from Rutger’s insurance law professor, Jay Feinman, who wrote the book, Delay Deny Defend–Why Insurance Companies Don’t Pay Claims and What You Can Do About It. His book should be in everybody’s personal library.
Continue Reading Insurance Professor Jay Feinman Comments About Insurance Fraud Statistics

The federal judge’s remark in a denied summary judgment opinion from a fire loss currently in litigation caught my attention.1 I often wonder about the reasons why some cases resolve without litigation or appraisal, and some do not. Accordingly, I propose that readers of this post read the full opinion and think—what would I have done differently regarding the handling of the adjustment of this loss?
Continue Reading “Trouble Began Soon After” — A Weekend Case Study for Those Involved with Property Insurance Adjustments

A lawsuit filed by Church Mutual seems to be part of a trend of insurers analyzing high-value appraisal awards and not paying them. I recently mentioned the nationwide non-payment of appraisal awards by State Farm in
Why Has State Farm Stopped Paying Appraisal Awards? The instant lawsuit1 argues that the award inherently is subject to coverage determinations of unowned amounts because the appraisal panel said they never applied any of the policy conditions:
Continue Reading Are More Appraisals Being Challenged By Insurers—Why Go to Appraisal If Insurers Will Not Pay the Appraisal Award?

The insurance landscape in California has become more precarious as a result of the severe and incessant wildfires. The great urban fires of the 19th century caused many insurers to become insolvent. These great wildfires, not even in urban areas, are having similar property insurance market impacts—especially in California.
Continue Reading California Thoughts and United Policyholders

Ed Eshoo obtained a favorable ruling this week with a finding that held a collapse caused by hidden decay was covered.1 The opinion has a full analysis of the coverage because the insurer raised the normal set of objections to each element pertaining to collapse coverage—it did not happen during the policy period, the dropping floor does not constitute a collapse, the collapse was not total, and the collapse was not hidden.
Continue Reading Collapse By Hidden Decay Covered