Possibly. Many policies exclude or limit coverage for interior water damage unless there is evidence of a wind-created opening in the roof, outside wall, door or window where rain entered the home or business. I often see carriers deny coverage in a manner similar to the below scenario:… Continue Reading
Parents of young children know the birthday party appeal of inflatables like bounce houses, slides, trampolines, and moonwalks. But it’s no picnic to learn that your homeowner’s insurance won’t be of any help if someone gets hurt on an inflatable dragon slide in your front yard at your child’s birthday party. A few tips may … Continue Reading
In states like Ohio where catastrophic disasters are not as common as in other states, policyholders should still understand how important it is to have a claim handled properly. Ohio’s most common disasters are tornadoes, snow, and floods. Although not common, Ohio has been affected by hurricane winds and rain that have reached some areas. … Continue Reading
Most policyholders usually do not know what to expect when they submit a claim to their insurance company. Some simply expect to fill out a claim form, maybe answer a few questions, and then receive a claim check from the insurer compensating them for the loss. Most policyholders are usually taken back when the insurance … Continue Reading
Our Constitution vests federal district courts with limited subject matter jurisdiction to adjudicate cases and controversies.1 Unless the Constitution or federal statute authorizes the district court to proceed, the district court must dismiss the action or—in the case of removal— remand the matter to state court.2 In addition to other grants, federal statute provides district … Continue Reading
A ‘schedule of location’ lists property locations where insured assets are located. A homeowner’s policy will list the house, possibly an additional structure. A business policy, when drafted properly, will list all locations insured under the policy where a business loss can occur. Failing to include all such locations can result in denial of what … Continue Reading
In a Second Circuit decision, the court of appeals revived Madelaine Chocolate Novelties Inc.’s Superstorm Sandy claim against Chubb for property damage and business interruption for an additional $49 million in coverage. In overruling the lower court, the appellate court found that the lower federal court failed to properly evaluate all the relevant policy provisions.1… Continue Reading
In October 2016, Guillermo Acosta and Laura Pirela (the “Insureds”) suffered a water loss at their home and filed an insurance claim.1 The insurer inspected the property and then invoked the ‘elect to repair provision’ under the policy that stated as follows: If a peril causing a loss and related damage are covered (other than … Continue Reading
Cal Thur was one of the nicest and helpful senior attorneys I have ever met. I was shocked to get a message from insurance claims expert Gary Fye indicating that he died while walking his dog last weekend. Whenever I hear the words “Arizona bad faith law,” I always think of Stanley Feldman and Cal … Continue Reading
A recent Colorado Supreme Court opinion in Schultz v. GEICO Casualty Company, clarifies the standard for bad faith in Colorado. In the opinion, the court discusses both claims for common law bad faith and statutory unreasonable delay or denial of benefits.… Continue Reading
Last month, I spoke at the First Party Claims Conference in Rhode Island on the topic of the Standard Fire Insurance Policy, which 165-line form provides coverage for direct loss by fire and lightning.1 My presentation presumed that everyone knows what a fire is, myself included. I changed my mind though after reading the Connecticut … Continue Reading
You purchased a condo, closed on the mortgage loan, and are now ready to move in to your new home. But what happens if a pipe bursts and floods your unit or an electrical short causes fire damage to your unit? Should you call the insurance company or your Condo Association? Are you covered by … Continue Reading
In the case Biasatti v. GuideOne National Ins. Co., No. 07-17-00044-CV (Tex. Ct.App. Aug. 16, 2018), Steven Biasatti and Paul Gross, d/b/a TopDog Properties, brought suit against its insurance company, GuideOne National Insurance Company for breach of contract.… Continue Reading
The Texas Windstorm Insurance Association (TWIA) Board of Directors voted to increase rates for 2019 by 10% at the July 31st Board Meeting.1 TWIA then reported the proposed rate increase to the Texas Department of Insurance and the Commissioner of Insurance must approve the rate. The rate increase would go into effect for all policies … Continue Reading
These days cyber risks and cyber insurance are hot topics in almost every industry. In a recent post I wrote about the Top Seven Things Public Adjusters Should Know About Cyber Risks and Cyber Insurance.… Continue Reading
As the Category 4 Hurricane Michael approached Florida, many areas evacuated in preparation for the storm. During a catastrophic event, such as Hurricane Michael, governmental authorities often order evacuation and prohibit access to certain areas due to public safety. The evacuation orders in Florida forced many businesses to shut down their operations until further notice. … Continue Reading
At Merlin Law Group, we want policyholders to have the tools necessary to maximize recovery following a loss. Understanding when policyholders are entitled to statutory interest and knowing how to calculate it is a small trick of the trade in the property insurance industry.… Continue Reading
The Florida Advisory Commission on Arson Prevention was one of the first organizations I prepared a public presentation for while I worked with Paul Butler in the early 1980’s. Paul gave a speech about wrongful steps insurance adjusters should not make during a fire loss investigation and those where arson was suspected. One of those … Continue Reading
A federal court in the Northern District of Georgia recently found that State Farm’s contamination clause was ambiguous regarding its application to a meth lab claim.… Continue Reading
The Illinois Supreme Court recently overturned the Court of Appeals’ decision in American Family Mut. Ins. Co. v. Krop, 82 N.E. 3d 533, 2017 IL App (1st) 161071 (Ill. App. 2017). As discussed in my post on June 14, 2017, the Illinois Appellate Court had concluded that the insured’s claim against their agent for negligent … Continue Reading
Managed repair is the rage of many insurance companies. To reduce claims costs and better compete on low price, some insurance company adjusters use various techniques to steer or pressure policyholders into using contractors the insurance company wants the policyholder to hire. Independent restoration contractors and public adjusters have legions of stories about how adjusters … Continue Reading
United Policyholders is the largest and oldest charitable organization serving the interests of policyholders. The photo above shows us with Amy Bach at Monday night’s Tee UP 2018 fundraising event for United Policyholders in San Francisco.… Continue Reading
The appraisal alternative dispute resolution procedure in most first-party property insurance policies in Florida is a valuable process for insureds. In our experience at Merlin Law Group, few states in the country have a greater need for an understandable, enforceable appraisal process than Florida. Since at least Hurricane Andrew in 1992, policyholders and insurers have … Continue Reading
The interests and needs of policyholders is why public adjusters get to make a living adjusting claims. The financial interests of the public adjuster are not paramount to the policyholder. The public interest is paramount over the public adjuster trade. So long as public adjusters properly serve policyholders, serve the public interest, and strive to … Continue Reading
