The impact of Hurricane Delta six weeks after, and within fifteen miles of the same path of Hurricane Laura’s landfall in Southwest Louisiana, has many policyholders questioning the application of the Louisiana Homeowners’ Hurricane, Named-Storms, and Wind and Hail Deductible Law.1 We have received many calls from policyholders and public adjusters regarding various interpretations of the law, particularly, the misconception that it allows insurers to apply only one deductible in a calendar year. In recent blogs we discussed the Law and its triggers. Today we want to help Louisiana policyholders understand the legislative intent and the correct application of deductibles in the event of more than one Hurricane, Named-Storm, or Wind and Hail loss impacting their covered property in the same calendar year. Continue Reading Understanding and Applying the Louisiana Homeowners’ Hurricane, Named-Storms, and Wind & Hail Annual Deductible

Remember the old EF Hutton commercials with the point being: “When EF Hutton talks, people listen”? That is how I feel about Merlin Law Group attorney Ed Eshoo when Ed makes a point about property insurance law. Continue Reading The Ten Most Common Mistakes Made by Public Adjusters During an Insurance Claim

Outsourcing of claims functions is occurring at an increasing rate. One insurance claims expert told me that most insurers are not investing in the expertise of younger adjusters but simply outsourcing the details of property insurance adjustment to outside vendors. These outside vendors are neither licensed as insurance adjusters under the control of insurance regulators nor are they trained to appreciate the ethical obligations property insurance adjusters have to the public and especially the insurance customer. Continue Reading The Big Insurance Claims Trend—Moving From In-House Adjuster Excellence to Surrogate Unlicensed Claims Professionals

Americans hate to be told that we cannot do something. I think it is just in our DNA. Since the time we are little, we are taught to “never let somebody tell you that you cannot…..” Name the dream you want to accomplish because, in America, you can do it. Continue Reading Adjusting and The Unauthorized Practice of Law—Thoughts About What Public Adjusters Can Do in Alabama

Shawnee Tabernacle Church (“Shawnee”) is a Congregation located in Monroe County, Pennsylvania. The church was insured by GuideOne Insurance (“GuideOne) with a policy that included the following language under the title “Pennsylvania Changes”:

Notice of Acceptance or Denial of Claim

Except as provided in 3 below, we will give you notice, within 15 working days after we receive a properly executed Proof of Loss that we:

A.) Accept your claim.

B.) Deny your claim; or

C.) Need more time to determine whether claim should be accepted or denied.

1) If we deny your claim such notice will be in writing and we will state any policy provision, condition or exclusion used as a basis of denial. If we need more time to determine whether your claim should be accepted or denied, the written notice will state the reason why more time is required.

2.) If we have not completed our investigation, we will notify you again, in writing, within 30 days after the initial notice as provided in i.e., above and thereafter every 45 days. The written notice will state why more time is needed to investigate your claim and when you may expect us to reach a decision on your claim.

3.) The notice procedures in 1 and 2 above do not apply if we have a reasonable basis, supported by specific information, to suspect that an insured has fraudulently caused or contributed to the loss by arson or other illegal activity; under such circumstances, we will notify you of the disposition of your claim within a period of time reasonable to allow full investigation of your claim, after we receive a properly executed Proof of Loss.

Continue Reading Pennsylvania Bad Faith Archives: Shawnee Tabernacle Church v. GuideOne Insurance

Brian Goodman is the very able General Counsel for the National Association of Public Insurance Adjusters. He also worked tirelessly to get public adjusting licensed in Alabama. He has properly corrected me that public adjusting is not “illegal” in Alabama. Mark the time, I am making a correction to this morning’s blog. Continue Reading Stop the Presses and Mark the Time—Chip Merlin, The Wizard of Something, May Be Wrong!!!

Merlin Law Group attorney Jason Cieri received a call from a public adjuster inquiring whether Alabama licenses public adjusting and if it is illegal to represent policyholders in Alabama. The answer is that public adjusting is not licensed in Alabama and doing what most public adjusters do could be considered the unauthorized practice of law. Continue Reading Public Adjusting Is Illegal in Alabama

In recent weeks we have been hosting seminars and community events in Lake Charles, Louisiana to educate policyholders of their potential rights and obligations under their insurance policies. Along with the concern that most insureds do not yet have a copy of their full policy—including all forms and endorsements—to guide them through the process, is that those insureds who do have copies of their policies may be misled by the standard terms and provisions of their policies. Continue Reading Louisiana Catastrophe Related Deadlines Extensions: Filing Proof Of Loss and Replacement Cost Coverage

In Arkansas Insurance Department Recognizes That Policyholders Do Not Normally Climb on Roofs To Inspect For Damage, Chip Merlin blogged about a May 4, 2020, bulletin issued by the Arkansas Department of Insurance, regarding Windstorm and Hail Claims.1 Continue Reading Updated Arkansas Insurance Bulletin on Windstorm and Hail Claims

While many enjoy “smokey” notes in their wine, no one enjoys the flavor of an ashtray. But that is exactly what can occur to wine made with smoke-tainted grapes. Wildfires produce an excessive amount of smoke combustion byproducts, and currently many of the wildfires raging now are in wine country. Because wildfire season lines up with winery harvest season, smoke-tainted grapes are an unfortunate reality – especially this wildfire season. Continue Reading When Wine Grapes and Wildfire Smoke Meet: The Smoke Taint Claim