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
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 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
In the recent California case, Duarte v. Pacific Specialty Insurance Company, the appellate court examined an insured’s “misrepresentations” when applying for an insurance policy and concluded that the insurer had wrongfully denied coverage.1… Continue Reading
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
Insurance Companies can breach the implied covenant of good faith and fair dealing by failing to pursue adjustment of the claim with reasonable diligence. This means that both insured and insurance companies must pay close attention to the company’s diligence (or lack thereof) in handling a claim.… Continue Reading
After denying claims, insurers sometime seek to avoid bad faith liability by taking their chances that a court will rule in their favor, and then, if the court rules otherwise, immediately tendering the monies owed under the insurance policy to the insured.… Continue Reading
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
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
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
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
Mario Lopez was a guest host on the Today show the other day, and described his recent property loss where his backyard collapsed into the street. Photos of the loss are available on Mr. Lopez’ Instagram or the Los Angeles Times. What struck me as blogworthy, other than the horrific loss of his yard, was his … Continue Reading
Insurance policies containing conditions pertaining to an insured’s obligation to submit a notice and proof of loss are “meant to give the insurer the necessary facts to facilitate an investigation of a claim and to protect it against fraudulent and excessive claims.”1… Continue Reading
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
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
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
In past years, I’ve closely followed the earthquake activity in California. I’ve blogged about “swarming,” which are clusters of earthquakes within a small period of time that geologists indicate maybe a precursor to a larger earthquake or a way for the tectonic plates to release pressure.… Continue Reading
As many of us know, mold can develop following a water loss. In California, water losses are one of the most common property damage claims we see. So how do insurers address mold in relation to water damage claims?… Continue Reading
How many of you have been faced with a fire claim where the insurer denies coverage on the grounds that the fire was the result of vandalism and therefore the claim was excluded? Well, a recent California Court of Appeal decision has held that insurers taking this position have to actually prove that the person … Continue Reading
While the rest of the country watches for hurricanes, Californians are wondering when the next large earthquake will occur. Unfortunately, there is very little time to prepare for an earthquake as there really are not sufficient warning signs that can allow homeowners and businesses to pack up or board up their breakable belongings. Although most … Continue Reading
California Insurance Commissioner Dave Jones must decide whether to approve an order signed by an administrative judge ordering State Farm pay its policyholders.… Continue Reading
The California Supreme Court will soon decide an issue of great importance to California property policyholders: Whether insurers should be required to communicate “complete” replacement cost estimates to insureds when selling homeowner policies.… Continue Reading
In this week’s episode of my continuing blog series, we travel to California to see how the Golden State defines Insurable Interests. Spoiler Alert: You need to read the policy!… Continue Reading
The law has been clear in California for quite a while that if you suffer property damage not covered under your insurance policy as a direct result of your insurance broker’s neglect you can pursue a claim against your broker for professional negligence. However, until recently what was not so clear was what your options … Continue Reading
