Tag Archives: California

Post-loss Assignment of Claims in California

In a prior blog, I discussed the California Supreme Court’s decision in Fluor Corporation v. Superior Court,1 regarding the post-loss assignment of insurance benefits. In Fluor, the California Supreme Court held that section 520 of California’s Insurance Code prohibits insurance companies from refusing to honor post-loss assignments of benefits, regardless of whether the assigned benefits … Continue Reading

Napa Wine Country Wildfire Town Hall

The recent fires in Napa Valley and Sonoma, California present numerous issues for homeowners and business owners alike when it comes to navigating insurance claims. Questions arise as to what coverages are provided under a given insurance policy, how determinations on what is owed are made, what are the options on rebuilding, loss of income … Continue Reading

Will Insurance Companies Fairly Adjust Claims Following Recent California Fires?

In Northern California, more than a dozen wildfires that began on Sunday are still raging. These fires have become one of the deadliest outbreaks in the state’s history, already burning through more than 100,000 acres, destroying thousands of homes, businesses, and wineries. Growing up visiting family in the Bay Area often, and attending law school … Continue Reading

Assignment of Contingent Benefits in California

In Assignment of Unaccrued or Contingent Benefits, I discussed the distinction between assignments of Contingent Benefits and assignments of Noncontingent Benefits under a property insurance policy. For purposes of this blog, a Contingent Benefit is a benefit or payment that is either not yet fixed in amount or the carrier is not yet obligated to … Continue Reading

California Supreme Court Affirms California Fair Plan Ass’n v. Garnes, and Preserves Homeowners’ Interests

The California Department of Insurance recently issued a press release announcing that the California Supreme Court affirmed the homeowner reimbursement protections recently decided in California Fair Plan Association v. Garnes.1 Back in June, my colleague Kevin Pollack wrote about the recent decision and whether actual cash value means fair market value or replacement cost minus … Continue Reading

Insurance Bad Faith Can Also Be Found When an Insurer Fails to Properly Investigate the Claim

Insurance Codes are regulated by each state, but ask any insurance company representative in any state and they will tell you it is an insurance company’s duty to place the insured’s interest ahead of the insurance company’s interests; and the proper way to handle a claim is to find coverage wherever possible.… Continue Reading

Does Actual Cash Value Mean Fair Market Value or Replacement Cost minus Depreciation?

What is an insured, who has an “actual cash value” property insurance policy, entitled to recover when their property is damaged, but not a total loss? Is the insured entitled to the cost to repair/replace the property minus depreciation? Or is the insured’s recovery limited to the property’s fair market value? What if the property’s … Continue Reading

Personal Property Depreciation by the Insurance Company After a Loss Should be Scrutinized by Policyholders

I often hear the same complaint from clients: They feel the insurance company has undervalued their personal property after a loss and are frustrated by the insurance company’s valuation and rate of depreciation. The reality is that even when an insured has a “replacement cost” policy, the insurance company can depreciate personal property values because … Continue Reading

Proof of Loss: Can an Insurer Deny Coverage and Later Argue the Claim is Barred Because the Insured Did Not Comply with the Proof of Loss Condition?

Insurers on occasion deny coverage or make claim decisions based on one ground, and then later, during litigation, seek to avoid liability based upon an entirely new defense theory. Although coverage decision letters regularly throw in boilerplate language seeking to avoid waiving coverage defenses, I was recently asked whether an insurer can deny coverage or … Continue Reading

The Genuine Dispute Defense and Bad Faith

Insurers often seek to avoid liability for bad faith by asserting the “Genuine Dispute Doctrine.” Under the genuine dispute rule, an insurer’s coverage or claim decision may not be in bad faith when it mistakenly withholds policy benefits, if the mistake is reasonable and is based on a legitimate dispute as to the insurer’s liability.1… Continue Reading

Insurers Must Provide Complete Replacement Cost Estimates

The California Supreme Court issued a unanimous ruling yesterday requiring insurers to communicate “complete” replacement cost estimates to insureds.1 The ruling not only found the regulation requiring this action to be well within the Insurance commissioner’s authority, but found the basis for the regulation to be well founded. It is a wonderful victory for policyholders … Continue Reading

Examinations Under Oath – What You Need to Know

Most property and business policies contain a provision requiring the insured to submit to an examination under oath (known as an “EUO”) by the insurance company in connection with an insurance claim. It is similar to a deposition, with the policyholder providing sworn testimony under penalty of perjury. However, it is under a contractual policy … Continue Reading

Class Action Highlights Notification Requirements When Insurers Seek to Reduce Coverage Associated with “Renewals”

A recently filed proposed class action1 accusing California health insurance giant Anthem Blue Cross of using a "bait and switch" scheme that offered insurance policy "renewals" that did not clearly disclose major policy changes offers a great example of why the law requires insurers to notify insureds of reductions in insurance coverage.… Continue Reading

Do All Insurance Policies Require a Total Collapse to Trigger Collapse Coverage?

In California, if a property insurance policy does not specifically require a collapse to be complete or actual falling down to trigger coverage, then an imminent (i.e., impending) collapse will probably trigger coverage.1 However, on the flipside, if a policy does specifically require a collapse to be “complete” or “actual” falling down, then an imminent … Continue Reading
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