The Florida Third District Court of Appeal recently found that when a policyholder failed to substantially comply with a post-loss obligation, the insurance company is presumed to have been prejudiced by the breach.1 The burden then shifts to the policyholder to show that the failure to comply with a post-loss obligation did not prejudice the insurance company. The question remains: What have courts found to satisfy a policyholder’s burden of showing that reporting a claim late did not prejudice the insurance company? Continue Reading Overcoming the Prejudice of Late Reporting

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. Continue Reading Hurricane Michael Delayed Insurance Claim Victims Should Send Parts of Their Homes and Businesses To Their Insurers In Protest

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. Continue Reading Colorado Law Regarding Who Can Be An Appraiser is Still A Guess For Policyholders and the Insurance Industry – Colorado Is Looking For Guidance

Governor Gavin Newsom recently signed Senate Bill 240, which enacts new laws that regulate out of state independent adjusters. The law also addresses claim adjustment for declared emergencies. The new laws, described more fully below, became effective on October 3. 2019. Continue Reading California Enacts New Laws that Regulate Out of State Independent Adjusters and Address Claim Adjustment Obligations for Declared Emergencies

(NOTE: This guest post is by Barry Zalma, Esq., CFE.1 Barry Zelma is a prolific writer and scholar in the field of insurance. I have purchased numerous publications from Barry. I am currently reading a book on legal ethics he wrote, The Little Book on Ethics For The American Lawyer, which may be his finest work and that is saying a lot after reading his treatises on insurance law and adjustment. I encourage you to read this very thorough post and consider purchasing Zalma’s publications for your reference library. – Chip Merlin.)

A Policyholders Lawyer’s Take on the Obligation to Read

In its blog the Merlin Law Group cites a small portion of a lengthy Hastings Law Journal article written by Professor Chuck Knapp.2 Dr. Knapp did not like the use, by appellate courts, of the concept that there is a duty to read (DTR) an insurance policy.

The blog post by Chip Merlin proposed that Dr. Knapp’s proposals would allow the court to rewrite the terms and conditions of the policy. Dr. Knapp did not do that but spent many pages explaining why the word “duty” should not be used and the exceptions available to the courts when interpreting an insurance contract as well as other contracts. Continue Reading There is an Obligation for the Insured to Read an Insurance Policy

Business owners and owners of commercial property should not buy Farmers Insurance. Virtually every insurance company in the United States considers the entire cost of restoration right away when making payments, including at actual cash value—except Farmers Insurance. Farmers Insurance has declared war on its own customers and independent restoration contractors. Continue Reading Farmers Insurance Sells Substandard Commercial Policy and Business Owners Should Not Purchase Farmers Insurance

Como se mencionó anteriormente en mi publicación de blog, Accord and Satisfaction: Will My Insurance Claim Be dismissed If I Deposit A Payment? (publicado: 21 de julio de 2019), muchos asegurados en Puerto Rico que recibieron pagos los depositaron sin estar conscientes de las consecuencias del Pago En Finiquito. Esta ha sido una controversia común en muchas de las demandas presentadas en los tribunales y la razón por la que muchos casos se están desestimando. Afortunadamente, el Tribunal de Apelaciones (Panel V) el 24 de octubre de 2019, revocó la decisión en Samuel Valentín Negrón v. MAPFRE PRAICO Insurance Company y Otros, en relación con el Pago En Finiquito. Continue Reading Merlin Law Group (PR) LLC, Gana Caso De Pago En Finiquito En El Tribunal De Apelaciones De Puerto Rico

United Policyholders takes action and gets things done for policyholders regarding the insurance gap issue. United Policyholders is tackling the insurance gap coverage problem by providing staff and resources to collect rogue property insurance policy forms being issued by insurance companies, to show examples of how insurers are stepping over each other to silently gain a competitive advantage of lower price with cheap insurance. Continue Reading Crazy New Policy Language? Report It To United Policyholders!

Judges should stop with the fiction that policyholders have a duty to read their insurance policies before a loss. They do not read all the insurance contracts they purchase, and nobody does. Even if they read their policies, most people would not understand the policy and certainly not contemplate every circumstance which could arise in advance of how the policy would be deciphered for those hypothetical circumstances of loss and disaster. Continue Reading Nobody Should Be Expected To Read Every Insurance Contract They Purchase

South Carolina courts have not used the phrase “broad evidence rule” in addressing actual cash value, and the South Carolina Department of Insurance considers actual cash value to be the amount needed to repair or replace the damage minus a deduction for depreciation.1 Continue Reading Calculating Actual Cash Value in South Carolina