Regulation

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In 2019, Merlin Law Group’s California offices received calls almost daily from insureds who were “dropped” by their homeowners insurance company (i.e., non-renewed). The reason insurers are providing? Unsurprisingly: increasing risks of wildfires. In November 2019, Ricardo Lara, the California Insurance Commissioner, exercised his powers to place a one-year moratorium on cancelling insurance policies related to wildfire risk. Earlier in the month, Lara ordered the FAIR Plan—a quasi-governmental insurer-of-last-resort for people who can’t get insurance elsewhere—to sell the same kind of policies for which Californians once had no problem qualifying.1…
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A judge agreed with my view posted in, Did Florida Mistakenly Place an Insurer Into Insolvency, Try to Disqualify the Law Firm That Pointed Out the Mistake and Harm 91,000 Policyholders By Quick and Unnecessary Non-Renewals?

The Florida Department of Financial Services and the Office of Insurance simply made a mess of Florida Specialty Insurance Company’s financial problems and cancellation of policies.…
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In California, the moment an insured obtains a repair estimate that exceeds the insurer’s estimate, the insurer must either pay the difference or adjust its original estimate. This rule is set forth in the Fair Claims Settlement Practices Act, 10 Cal. Code Regs. § 2695.9(d). Generally, whenever anyone makes an insurance claim, the insurance company will create a scope of work to repair the damaged property and an estimate of what that cost to repair is. The insurer’s estimate does not atomically mean that is the amount of the claim. An insured has the right to get his or her own estimate and the insurer is required to consider that estimate.…
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It is becoming more and more common that insurance companies are recommending and suggesting that their “preferred vendors” perform loss repairs. California offers insureds protection if they opt to use a preferred vendor. Under the Fairs Claims Settlement Practices Regulations, if an insurer recommends a vendor, the insurer is essentially required to guaranty that vendor’s work.…
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Many policyholders do not have enough insurance to replace their buildings or homes after a total loss. Often these policyholders were assured by their agents or insurance companies at the point of sale that their limits were sufficient. And many times these assurances were based on estimates that fell below the minimum standards set by law.…
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From left to right, JL Evans, Donice Krueger, Chip Merlin, Ron Delo, James and Rene Howard

Hurricane Michael insurance claims continue to take up a lot of time with Merlin Law Group attorneys. The photograph above is from dinner last night in Panama City, Florida, where the issues and problems of getting insurance claims resolved fully were the hot topic of discussion. Hurricane Michael has a lot of slow and low paying claims where insurers are wrongfully reporting to the Office of Insurance Regulation that the claim is administratively “closed” when it is anything other than being over from the policyholder’s view.…
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Florida Insurance Commissioner David Altmaier

Assignment of benefits contracts for property damage claims may be going the way of the dinosaur in Florida. A recent Florida Insurance Bulletin notes that the new statute allows insurance companies to issue policies preventing an assignment of benefits if insurers offer a premium discount.…
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One of the strongest tools in an insured’s arsenal is a good public adjuster. If lucky, most insureds will only suffer a property loss once or twice in a lifetime. Not dealing with claims handling on a day to day basis, navigating the claims process can be not only confusing and tedious, but costly as well if the insured does not know when they are being treated unfairly.…
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The Colorado Department of Insurance has proposed eliminating one of its long-standing bulletins requiring insurance companies to pay contractor overhead and profit rather than deduct the amount until incurred. Such an elimination is obviously against policyholder interests and is the result of insurance industry lobbyists making inroads with Colorado insurance regulators who are supposed to be guardians of the public interest.…
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An overwhelming number of claims are settled on a mutual understanding with respect to the covered loss and the amount necessary to indemnify the policyholder. The question is then: What can a policyholder do if the insurance company is taking an unreasonable amount of time to tender settlement payment. Florida law remains focused on strong public policy encouraging settlement of claims. To accomplish that goal Florida legislature has implemented statutes to protect the policyholders even when an amicable resolution has been reached between the policyholder and the insurance company. …
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