David Charles was a whistle blower about wrongful claims conduct long before yesterday’s post, Churn and Burn Adjusting—An Admission From An Independent Adjuster. In a 2014 post, National Flood Claims Do Not Get Paid Properly Because the Only Incentive is to Underpay, I noted that David Charles described a method of claims adjustment – running and gunning – which is very similar to the one posted yesterday about “churn and burn” adjusting: Continue Reading Is “Running and Gunning” Adjusting the Same As “Churn and Burn” Adjusting?

It is not often that I am able to find a property insurance issue involving my favorite sport—golf! I previously wrote in Hole in One Insurance Coverage, about a dispute involving a hole in one contest at the July 2015 PGA tour event, the Greenbrier Classic, where the charity that was operating the event, Old White Charities, Inc. (“Old White”) sought coverage for two prizes it was obligated to pay in a hole-in-one contest. Continue Reading You Had a “Hole in One” and Won a Prize!!! Not so Fast—The “Hole In One” Insurance Carrier Denies The Claim

The following is a guest blog written by an attendee whom I spoke with at the Windstorm Insurance Conference two weeks ago. I made only minor edits for easier understanding by those who are not claims professionals. I removed two sentences to maintain anonymity for the writer. Continue Reading Churn and Burn Adjusting—An Admission From An Independent Adjuster

One of the interesting aspects of having a national policyholder insurance practice is seeing regional trends of claims processing by insurers. I have come to my own philosophy that differing insurance laws in the various states, whether statutory or by common law, are not right or wrong—they are just different. I am not so certain about claims practices because pushed to the extreme, there are plenty of ways insurance companies can frustrate the purpose of insurance, such as the use of claims processes designed to delay and underpay claims. Continue Reading Puerto Rico Hurricane Maria Claims Still Not Paid—New York Times Reports on the Insurance Claims Crisis in Puerto Rico

High deductibles Following windstorm or hailstorm losses are becoming the normal state of affairs. Insurance agents as a matter of course should explore and offer their clients “deductible buy down “ coverage. But what happens and how does a policyholder pay for the otherwise huge deductibles which are becoming commonplace? Continue Reading High Deductible? Try FundMyDeductible.com

United States magistrates are federal judges with extensive authority over civil cases. Many policyholders are surprised to learn that magistrate judges can preside over mediation conferences. For example, during initial case management conferences, many districts allow litigants the opportunity to schedule a mediation conference with a magistrate judge. This can be a great option for policyholders when the case appears to have discrete litigation issues, the facts and circumstances of the case are unusual, or the matter is close to settlement. Continue Reading Mediations with Federal Magistrate Judges

A number of public adjusters and contractors have inquired whether I’ve seen recent forms that require the selection of a mediator by the flip of a coin. I was going over a policy sent from a mid-west public adjuster yesterday and came across the following negotiation and mediation condition in the loss settlement portion of the policy: Continue Reading Can A Flip of The Coin Be a Part of Mandatory Pre-Suit Insurance Dispute Mediation Process?

Javier Delgado worked his way through law school as an independent insurance claims adjuster with Merlin Law Group attorney Etienne Font as his boss. Javier has had great success with our firm after joining us shortly after Hurricane Ike in Texas where he represented hundreds of slabbed clients on the Bolivar peninsula. He has testified to the Texas legislature, taught judges and federal mediators in New Jersey and New York following Superstorm Sandy, and last week testified in front of the Florida legislature. Continue Reading Javier Delgado—A Policyholder Advocate and Leader of Policyholder Attorneys

A number of media outlets, including a news broadcast, reported on Mercury Insurance Company denying its Atlanta customers’ claims caused by squirrel damage because the policy it sells excludes damage caused by “rodents.” Mercury Insurance reasoned that since “squirrels” are “rodents” and damage caused by “rodents” are excluded from coverage, the squirrel damage is not covered. Continue Reading Squirrels Damage Your Home—Coverage or Not?

I was at the Windstorm Insurance Conference last week during a reception when the very able insurance defense attorney Melissa Sims said to me something about me speaking to a bunch of “pigs.” I have spoken to a lot of different groups, but this seemed a little derogatory about my audience. After a quizzable look, she said, “I got a notice saying you are speaking to the market at PICGS.” Maybe a cocktail or two and aging ears can make “PICGS” sound like “pigs,” but I broadly smiled and said that ‘Steve Badger and I will have a memorable speech at this Lloyds event.’ Continue Reading Chip Merlin To Speak at Lloyds PICG Conference