Many insurance companies adjusting hail damage claims have a checklist of items that each adjuster must answer before payment of a claim. One of the items at the top of the list is whether there have been any prior hailstorms at the loss location. From a policyholder’s perspective, most do not go onto a roof nor call a roofer unless a leak occurs or there is obvious damage.
Continue Reading Hail Damage?—Not From This Hailstorm

The title to this post was a question posed to me by a number of people following an April Fool’s Day Insurance Journal article, With Florida Rulings, Will More Insurers Require Arbitration in Claims Disputes? The Insurance Journal noted that the Florida Office of Insurance Regulation approved a policy form calling for mediation and then arbitration for the resolution of property insurance disputes:
Continue Reading Is Arbitration Going to Replace Appraisal in Florida?

In keeping with the recent decision in B&D Investment Group v. Mid-Century Insurance Company,1 the Northern District of Illinois, in Khalell v. AmGuard Insurance Company,2 again concluded that appraisal was appropriate where the insurer had determined that some portion of the dwelling was damaged by hail.
Continue Reading The Northern District of Illinois Compels Appraisal AGAIN!

It is never over until it is over. The $56 million appraisal award I first noted in Appraisals Can Lead to Nasty Legal Battles—Should Appraisers and Umpires Get Insurance Protecting Them? had an interim Order that vacated the $56 million appraisal award.1
Continue Reading Order Vacates $56 Million Dollar Appraisal Award—Unilateral Appointment of Replacement Umpire Breached Policy Time Requirements By One Day

Merlin Law Group attorneys Chris Mammel and Tamara Chen-See won an appraisal case pending before the 10th Federal Circuit Court of Appeals.1 The court ruled that the factual determination of damage to brick siding caused by a hailstorm is a factual matter for appraisal and not a coverage issue. The ruling was similar to the recent Connecticut Supreme Court holding involving matching noted in Matching is a Factual Determination and Can Be Resolved by Appraisal.
Continue Reading Insurers Cannot Escape Appraisal Arguing Factual Determinations of Damage Create Coverage Issues

Following Monday’s post, Appointment Of Umpires and What Qualifications Matter to a Court?, I was privately reminded that some new forms of property insurance policies may set forth additional criteria for determining the qualifications of appraisers and umpires. I previously mentioned this in a blog, State Farm New Policy Filing In California Should Be Concerning To All In the Property Insurance Industry—An Example Is the New Appraisal Language, where I noted the qualifications for appraisers and umpires in State Farm’s new California property insurance policy:
Continue Reading Umpire and Appraiser Credentials May Be Called For Under New Policy Forms—Always Read The Full Policy

Following up on the recent post, Appointment Of Umpires and What Qualifications Matter To A Court?, Robert Norton from the IAUA ( Insurance Appraisal and Umpire Association) reminded me that I wrote a blog, What is a “Competent” Umpire for a Property Insurance Appraisal. I quoted a lot of authorities in that post about what type of person would be a qualified umpire. Still, I noted the following personal view:
Continue Reading What Are the Qualifications to Be an Insurance Umpire In the Insurance Appraisal Process?

I received a number of comments and private messages about last week’s post, Do Appraisers Legally Need to Be Licensed Adjusters in Florida. One commentator raised the issue about whether umpires have to be licensed as adjusters. That question seemed novel. I cannot find anything suggesting that an umpire has to be licensed. Indeed, the policy does not call for the umpire to be licensed. No regulation on point requires an umpire to be licensed.
Continue Reading Appointment Of Umpires and What Qualifications Matter to a Court?

Neither the Illinois Supreme Court nor the Illinois Appellate Court has weighed in on whether “causation” is appropriate for appraisal. Numerous Illinois federal district trial courts have, concluding that disputes as to (a) causation (whether the damage was caused by a covered peril), (b) the scope of damage (the extent or scope of the physical damage from the covered peril), (c) the scope of repairing or replacing the damage, (d) the cost of repairing or replacing the damage, (e) matching (the cost of repairing/replacing a physically undamaged building component to remedy a mismatch with a repaired/replaced damaged building component), and (f) whether the damage is extensive enough to require employing a general contractor are disputes as to the “amount of loss,” not coverage, and thus appropriate for appraisal.1
Continue Reading Another Illinois Federal District Court Rules That Causation Can Be Determined In Illinois Appraisals

In a follow-up to a post last spring, Appraisals Can Lead to Nasty Legal Battles—Should Appraisers and Umpires Get Insurance Protecting Them, a federal judge has allowed the insurance company to file a counterclaim against the policyholder church, its appraiser, and a unilaterally appointed umpire.1 The counterclaim is one that readers of this blog should study because it raises issues about the propriety of appointing an umpire in a separate petition from a pending lawsuit concerning the controversy, how a new appointment of a new umpire after the first one resigns is to be handled, and whether the umpire was indeed appointed unilaterally.
Continue Reading $56 Million Dollar Appraisal Award Leads to Fraud Counterclaim and Lawyer Hostility