Exclusion provisions in a policy work to limit the range of coverage by restricting certain events or losses; often serving as a basis to deny a claim. Nevada case law has long held the burden is on the insured to prove a claim falls within the scope of coverage, and the insurer bears the burden to prove the applicability of an exclusion. However, for the first time the Supreme Court for the State of Nevada was faced with the question of who bears the burden to prove an exception to a policy’s exclusion provision, essentially restoring coverage.1
Continue Reading Nevada Insureds Bear Burden of Proving Exceptions to Exclusion Provisions

Last week I had the pleasure of meeting Scott and Amy Newcomer, the founders and power-couple behind ATI Training. For over 30 years, the Newcomers have been helping home inspectors learn the industry and become qualified, not just certified. Realizing the cross-over potential between the home inspection and public adjusting worlds, the Newcomers expanded the ATI Training program to include the training of public adjusters.
Continue Reading Forging a New Path: ATI Training Expands to Support Public Adjusters

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

Throughout my years at Merlin Law Group, I have noticed a troubling pattern with insurance carriers: denying claims based on confusing and ambiguous policy language. Perhaps you are challenging a continuous seepage or leakage exclusion or a protective safeguard requirement on your collectibles. It is unlikely the policy defines “seepage” “leakage” or what qualifies as a protective safeguard. However, the Arizona courts and Legislature have brought some clarity to interpreting these unclear provisions.
Continue Reading Clearing Things Up: Interpreting Ambiguities in Arizona Policies

Last week the Supreme Court of Texas weighed in on a longstanding dispute regarding the decision by Farmers Group Inc. (“Farmers”) to replace their HO-B homeowner policies with less comprehensive HO-A policies, back in 2001.1 Following an influx of mold claims in Texas, Farmers and other insurers decided to replace their HO-B policies, a broad “all-risk” policy, with narrower HO-A policies, or “named peril” policies.
Continue Reading The Insurance Coverage Gap Worsens—Farmers Policy Changes Approved

In a press release Monday, Oklahoma Attorney General Mike Hunter and Insurance Commissioner Glen Mulready announced Farmers Insurance agreed to pay Oklahoma policyholders $25 Million they denied or improperly failed to pay policyholders out of coverage for earthquake damage.1
Continue Reading Hot off the Press: Farmers to Pay Oklahoma Policyholders $25 Million for Earthquake Claims

Insuring your home or business can be a daunting task. Policy language is often confusing, leaving policyholders wondering if they are adequately covered. While the questions below are not intended to be an exhaustive list, they will serve as a great starting point to better understanding your policy and knowing its limitations.
Continue Reading Eight Essential Questions Every Policyholder Should be Asking

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