Insurance policies impose a duty on insureds to cooperate with the insurer’s investigation of a claim. An insured’s duty to cooperate encompasses the insured’s obligation to appear for an examination under oath (“EUO”), if requested, and to provide documentation verifying the loss. “Cooperation clauses” generally have been held to be material provisions of insurance policies with compliance therewith a condition precedent to coverage.
Continue Reading Can My Insurance Company Deny My Claim For Failure to Cooperate With Its Investigation?

Insurance companies in Florida can cause foreseeable harm to their policyholders and not be held accountable pursuant to a recent opinion by the Florida Supreme Court.1
Continue Reading Florida Supreme Court Issues Anti-Consumer Opinion and Holds Insurance Companies Are Immune From Foreseeable and Consequential Damages When They Breach Contracts

The answer to the first question in the title is “yes”—insureds have a duty to read their insurance policy.1 The use of the term “duty” implies a legal responsibility imposed by law but from where does this duty derive? It’s certainly not in any insurance policy I have ever read. The closest answer to that question may be that in Texas, the duty for an insured to read the insurance policy has developed as a presumption.
Continue Reading In Texas, Do Insureds Have A Duty To Read Their Policy And, If So, Is That Duty Absolute?

Property insurance policies have long-contained appraisal and arbitration provisions.1 Although both avenues offer insureds the ability to resolve their claims through extrajudicial means, each has clear distinctions and similarities. In certain circumstances, some issues may only be resolved through a trial court.
Continue Reading What May and May Not Be Resolved Through Appraisal or Arbitration in Florida?

In unique situations, actual cash value (“ACV”) or replacement cost (“RC”) coverage may not be the best match to meet a property owner’s needs, or even be available. Policies that provide functional replacement cost (“FRC”) valuation, or endorsements that do so, offer an alternative. This valuation method is most commonly used to insure older structures built with obsolete materials and by outdated or custom methods; structures where the RC often exceeds the market value. One ISO endorsement defines FRC as:

‘Functional replacement cost’ means the amount which it would cost to repair or replace the damaged building with less costly common construction materials and methods which are functionally equivalent to obsolete, antique or custom construction materials and methods used in the original construction of the building.1
Continue Reading Functional Replacement Cost – When Will You Encounter It and What To Be On the Lookout For

Communications between Insurance Companies and their insureds are always important, and copies of these are requested to understand insurance claims when filing a complaint. Recently, the Puerto Rico Court of Appeals ruled on an Accord and Satisfaction case in which Plaintiff presented a memo received from the insurer that contradicted its allegations against the Plaintiff’s Hurricane claim.
Continue Reading Accord & Satisfaction: Will My Insurance Claim Be Dismissed If I Deposit A Payment? – Part 2

In a recent case, Sullivan v. Nationwide Affinity Insurance Company,1 the 10th Circuit Court of Appeals upheld a trial court’s decision finding a policy’s earth movement exclusion barred coverage for damage caused by rockfalls. On Monday, the three-judge panel found the policy’s earth movement exclusion is not limited to damage caused by soil movement, but also included rocks, concluding a “rockfall” is a type of “landslide.”
Continue Reading Rockfall Damage Not a Landslide Victory

April Hall with Storm Consultants, LLC, & the Storm Restoration Contractor Summit (SRC Summit) joined Chip Merlin on Tuesday to discuss the upcoming SRC Summit event she is hosting in Frisco, Texas, on January 23rd – 25th. As many of you that follow our blog know, it is common this time of year for industry seminars and events to take place around the country. However, due to COVID, this year is quite different and the SRC Summit is the only in-person industry conference happening in the first quarter of 2021 that I am aware of. April Hall advises there are attendees coming from 29 states to attend the Summit, so there is going to be a great turnout.
Continue Reading Storm Restoration Leaders Gather at SRC Summit on January 23rd-25th