It can be difficult after a fire for an insured to remember with 100% certainty what personal property they had in their home. Most likely, receipts and other purchase records have also been destroyed. As such, public adjusters in preparing estimates and/or proofs of loss are typically left to rely upon the insured’s memory. After all, who knows better than the insured what property was there before the fire? But what if there are inaccuracies in the proof or estimate….is that enough to cause the claim to be denied based on the concealment and misrepresentation clause?
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Dewey Hill owned eight townhome buildings in Minnesota insured by Auto-Owners.1 On August 16, 2013, a hail and windstorm damaged the buildings. Three days later, Dewey Hill notified Auto-Owners of the loss and submitted written property loss notices ten days later. Auto-Owners investigated the claim and approximately nine months later issued its first payment to Dewey Hill. A second payment was made by Auto-Owners approximately four months after that.
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Policy language varies when it comes to how and when an insured is required to give notice of a claim. Some policies have a definitive time frame setting forth when notice must be given, but others use terms such as “prompt,” “immediate” or “as soon as practicable.” When the policy does not provide a definitive timeframe, the question of whether an insured’s notice complied with the policy’s notice requirement can be questioned. In such situations, courts will look to various factors to determine whether the insured’s notice was “reasonable.”
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The Eight Circuit Court of Appeals in Noonan v. American Family Mutual Insurance,1 recently upheld that the Minnesota Amendatory Homeowners Endorsement (“Endorsement”) excludes “matching.” The Endorsement provides that an insurer does “not pay to repair or replace undamaged property due to mismatch between damaged material and new material used to repair or replace damaged material.”
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As any contributor on this blog will tell you, the first step in assessing any claim is to read the Policy. Policy language is ever evolving and changing, especially when it comes to notice requirements. The purpose of a notice requirement in an insurance policy is to enable the insurer to make a timely and thorough investigation.1 Many policies however contain language which provides that notice is to be provided “as soon as practicable,” “promptly,” “immediately” or “within a reasonable time.”
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Minnesota Statute section 604.18, commonly known as Minnesota’s Bad Faith Law, permits an insured to add a claim to recover taxable costs based on an insurance company’s bad faith denial of policy benefits. The procedure for bringing a claim under section 604.18 differs from most states. Generally, an insured is strictly prohibited from including a claim for bad faith in its initial pleading. Rather, the insured must seek leave to amend the complaint, supported with affidavits, showing the factual basis for the motion. The insurer may then submit evidence to show there is no factual basis for the motion. Section 604.18 requires that the moving party (the insured) establish, by prima facie evidence, that the nonmoving party (the insurer) is liable under the statute. If the court finds such prima facie evidence, it may grant the insured leave to amend their pleading.
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Illinois’ solution to an insurance company’s delay, deny and defend tactics is section 155 of the Illinois Insurance Code, which provides an extra-contractual remedy to policyholders whose insurer’s refusal to recognize liability and pay a claim under a policy is vexatious and unreasonable.1 Section 155 of the Code is intended to aid the insured and to discourage insurers from profiting by their superior financial positions while delaying in the payment of contractual obligations.2
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