Photo of Chip Merlin

Since 1983, Chip Merlin has served as a plaintiff’s attorney with a focus on commercial & residential property insurance claim disputes and bad faith insurance litigation. Chip is a noted national authority on insurance bad faith, lecturing to national trade groups and publishing a number of papers and articles on the subject for organizations such as The American Association for Justice, The Florida Justice Association, The Windstorm Insurance Network, and Trial Magazine.

As founder and president of Merlin Law Group, Chip has dedicated his practice to the representation and advocacy of insurance policyholders in disputes with insurance companies nationwide.

Chip served as Chair for the Bad Faith Insurance Litigation Group and Secretary for the Fire and Property Insurance Litigation Group for the American Association for Justice (formerly known as the Association of Trial Lawyers of America). He was also Vice-Chair for the Subcommittee on Property Insurance Law for the American Bar Association.
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Insurance company law firm Matthiessen, Wickert & Lehrer have updated a thorough discussion of the adjustment issue of matching in an article, ”Matching Regulations” And Laws Affecting Homeowners’ Property Claims In All 50 States. From their view, they noted the current state of affairs regarding matching:

It remains one of the most difficult issues to deal with in the world of property insurance. Homeowners’ insurance policies usually contain a provision obligating the carrier to repair or replace an insured’s damaged property with ‘material of like kind and quality’ or with ‘similar material.’ They cover property damage resulting from ‘sudden and accidental’ losses. When damage caused by fire, smoke, water, hail, or other causes results in a small portion of a home or building being damaged (e.g., shingles, siding, carpet, cabinets, etc.), whether and when a carrier must replace non-damaged portions of a building in order for there to be a perfect match remains a point of contention. It is a matter of great importance to insurance companies because ‘matching’ problems with a slightly damaged section of roof or flooring can lead to a domino effect of tear out and replacement costs of many items which are not damaged. The problem of partial replacement is especially troubling where the damaged siding or shingles have been discontinued, making it virtually impossible to properly match. To replace only the damaged portion would result in an obvious aesthetic deficit due to a clear difference in the appearance of the replaced portion of the building from the portion that remains undamaged.

Would the entire structure need to be re-sided or the entire roof re-shingled? Or is it sufficient to replace just one wall of siding or just a few shingles? Whether or not the insurance company must pay to replace entire sections of the structure in order to bring the property back to its previous uniformity and aesthetics can bring various state insurance laws and regulations into play. On the one hand, many pundits claim that the terms of the insurance policy require the carrier to pay the cost to ‘repair or replace with similar construction for the same use on the premises.’ They argue that ‘similar’ doesn’t mean matching exactly. Others argue that coverage for ‘matching’ and ‘uniformity’ under a homeowner’s policy doesn’t exist without a specific endorsement. The truth lies somewhere in between and can vary greatly from state to state.
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As a follow up to the Insurance Protection Gaps webinar mentioned in yesterday‘s post, Water Loss From Toilet Overflow Is Covered Despite State Farm Denial, Professor James Hilliard of Temple University’s Department of Risk, Insurance, and Healthcare Management provided a basic outline and his presentation is somewhat similar to Professor Jay Feinman’s much more detailed work on the matter.
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The Mid-Atlantic Association of Public Insurance Adjusters (MAPIA) held a meeting this past week with about thirty-five public adjusters in attendance. President Paul Yemm, yours truly, Holly Soffer, and Tony DiUlio are pictured above. Soffer and Diulio gave a wonderful insurance gaps presentation that was highlighted Tony DiUlio’s discussion of a water loss that resulted in a bad faith verdict against State Farm.
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Insurance estimators, appraisers, and adjusters of roofing claims should read the attached partial specifications of a commercial roofing project. There has been some discussion of what a “reasonable” cost should be, but I think most would require that the scope of a commercial roofing job involving insurance be one that is going to result in a “quality” job. So, how do you determine what a quality commercial roofing job would be? I suggest you would look at specifications that the construction industry has come up with to prevent non-quality work from occurring.
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Some of the more interesting discussions about property insurance losses which I have read lately come from Steve Patrick’s “Level The Playing Field” Facebook Group. Recently, Leland Coontz wrote the following:

I’ve been triggered again. Someone mentioned on Facebook that ‘The insured is not allowed to profit from their loss.’ Show me your law license and I might respect your wrong opinion. But it would still be wrong.

His post triggered over 130 comments with very different opinions.
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Policyholders who have delayed and underpaid insurance claims from Hurricane Michael may think about taking a page from the “how to file a complaint” playbook from an Old Mutual policyholder who sent the dead body to the claims department to collect on a funeral insurance policy.
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The person that can qualify as an appraiser for a policyholder in Colorado is still a guess with policyholders not exactly knowing what to do about the selection of their appraiser. One Colorado insurance company law firm has their clients select very biased appraisers against their own customers and then challenges almost all policyholder appraisers as biased. This firm with their clients’ blessings, then tries to have the customer collect nothing arguing that the customer breached the policy by selecting a “biased” appraiser while having a “polecat” selected in the wings as their own appraiser.
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