While researching Nevada insurance agency law and duties, I came across a course entitled, Ethical Issues in Insurance. Two points of the course, which seem very relevant to most claims situations, involved the trust that policyholders place with agents and then the trust they place with the companies hoping they will be fully paid when a claim is presented.
Continue Reading The Insurance Industry Teaches Ethics But Does It Follow What It Teaches?

Public adjusters serve a critical ally to policyholders throughout the claim adjustment process. In Nevada, public adjusters are regulated under the provisions of chapter 684A of the Nevada Revised Statutes (NRS) and chapter 684A of the Nevada Administrative Code (NAC).1 The Nevada Division of Insurance outlines what is required of public adjusters in the Silver State.
Continue Reading Nevada Public Adjuster Requirements and Regulations

A number of Florida insurance companies removed appraisal from their policies over the past several years. Since litigation was the only method of resolution, this lead in part to a sharp increase in lawsuits filed. This “Wag The Dog” scenario then allowed the Florida insurance industry to claim a spike increase in the number of lawsuits filed and seek a need for alleged reform which harms Florida policyholders.
Continue Reading Does SB 76 Require An Insurer and Policyholder to Go To Appraisal If The Policy Does Not Reference Appraisal?

Tuesday @2 is going to be a quick 30-minutes by yours truly discussing the bottom line of this crazy new law. This law has significant ramifications for policyholders, public adjusters, and contractors. Some of my feelings regarding this law were posted this weekend in, Florida’s New Anti-Policyholder SB 76 Signed Into Law By Governor DeSantis.
Continue Reading Public Adjusters and Contractors—The Readers Digest Version of What You Need to Know About SB 76 in 30 Minutes By Chip Merlin on Facebook Live @ 2pm Today

Greene v. USAA1 is probably the most cited case by first-party insurance carrier attorneys in Pennsylvania. It is an appellate level case that centered on whether an insurance carrier is required to replace a roof when the existing shingle is no longer in production, but shingles of “similar color, texture, function, and shape” are available. In Greene, the Superior Court of Pennsylvania (appellate) held that using shingles similar to the damaged shingles in function, color, and shape satisfied the insurer’s obligation to pay for repair or replacement with like construction.
Continue Reading Repair vs. Replacement in Pennsylvania

We still field questions from adjusters about what gets paid if there is a total loss in Florida. I am certain that most adjusters remember something about a Florida total loss case where law and ordinance benefits were automatically paid without showing proof of loss. That case is known as Mierzwa1 and that part of Mierzwa was overruled by Ceballo.2
Continue Reading Total Loss Does Not Mean Supplemental Coverages Get Paid—Ceballo Overruled Mierzwa So That Law and Ordinance Does Not Get Automatically Paid Following a Total Loss

A recent Florida case1 has a lengthy discussion about cases where changing valuations by the insured are then used by clever insurance company attorneys to argue that a post-loss fraud has occurred. This is now a common practice in litigation throughout the country as policyholders, public adjusters, and contractors make differing estimates of loss and have different opinions about what the measure of the loss should be.
Continue Reading Insurance Company Attorneys Often Wrongfully Argue That a Fraud Occurs When Parties Only Have a Difference of Opinion

If an insured suffers a loss caused by a third-party and an insurer compensates the insured, either wholly or partially, the insurer typically may subrogate the claim in an attempt to recover its payment. However, when an insured does not receive enough funds from its insurer to be made whole, typically due to underinsurance or limiting policy provisions, does the insurer or the insured have priority of funds from the responsible third-party? This is an important distinction when the third-party has limited funds available.
Continue Reading The Made Whole Doctrine in California

On September 20, 2017, Hurricane Maria caused catastrophes through its passing by Puerto Rico. As mentioned in past blogs,1 many policyholders filed their insurance claims and as soon as they received their response from the carrier along with a check, they proceeded to deposit the check unaware that even if they did not agree with the amounts, these were considered “total and final” payments and therefore, a waiver to their right to claim. Since then, as I have discussed on other blog posts, many policyholders have battled in court as to the application of accord & satisfaction doctrine to their claims.2
Continue Reading Accord & Satisfaction: Puerto Rico Supreme Court Rules for Policyholder in Hurricane Maria Claim