Does a loss in excess of a sublimit have any impact on the amount owed on an insurance claim? The Big I Virtual University is a tremendous information resource about insurance coverage for insurance agents. Insurance claims executives should learn from those underwriting and selling the polices before making wrong claims denials.
Continue Reading How Deductibles Impact Claims Payment—Sublimits and Absorbing the Deductible

A new bill is making its way through the Oklahoma legislative process that could impact policyholders and the roofing industry in Oklahoma. On March 3, by a vote of 77 to 11, the Oklahoma House of Representatives passed House Bill 1940, which would prohibit roofing contractors from waiving or paying any part of an insured’s deductible when the funds for repairing or replacing a roof come from an insurance company as a result of a property damage claim. The current form of the Bill was authored by Representative Kyle Hilbert and Senator James Leewright, and the Bill currently states:
Continue Reading Oklahoma Bill Seeks to Prohibit Roofing Contractors from Covering Insureds’ Deductibles

In order to succeed on a claim of negligence against an broker/agent for failing to procure insurance, a plaintiff must establish (1) a duty of care; (2) a breach of said duty of care; (3) injury caused by the breach; and (4) actual loss or damage resulting from the injury. Recently the Supreme Court of Wisconsin, in Emer’s Camper Corral, LLC v. Alderman, 391 Wis.2d 674 (2020), addressed the evidence a plaintiff must present under the third factor in order to establish causation.
Continue Reading Insurance Being “Commercially Available” is Not Enough in a Broker/Agent Negligence Action

Deductibles are an issue in all property insurance claims. Policyholders hate to pay them but love the discount in policy price when a higher deductible is part of the policy. I wrote about a new deductible financing product in High Deductible? Try FundMyDeductible.com. Some questioned whether this was proper and what the insurance industry response would be.
Continue Reading Insurance Industry Adopting Deductible Financing and Deductible Payments Over Time

The impact of Hurricane Delta six weeks after, and within fifteen miles of the same path of Hurricane Laura’s landfall in Southwest Louisiana, has many policyholders questioning the application of the Louisiana Homeowners’ Hurricane, Named-Storms, and Wind and Hail Deductible Law.1 We have received many calls from policyholders and public adjusters regarding various interpretations of the law, particularly, the misconception that it allows insurers to apply only one deductible in a calendar year. In recent blogs we discussed the Law and its triggers. Today we want to help Louisiana policyholders understand the legislative intent and the correct application of deductibles in the event of more than one Hurricane, Named-Storm, or Wind and Hail loss impacting their covered property in the same calendar year.
Continue Reading Understanding and Applying the Louisiana Homeowners’ Hurricane, Named-Storms, and Wind & Hail Annual Deductible

In active hurricane seasons, coastal communities may face more than one named storm in a season. Named storm and hurricane deductibles are very high, sometimes as high as 5% of the insured value of the property, which amounts to thousands of dollars in a time of diminished resources. Some states have passed laws to prohibit insurers from applying these high deductibles more than once during the calendar year. After Hurricanes Katrina and Rita impacted Louisiana’s coastal communities within two weeks of each other in 2005, Louisiana passed its Annual Deductible Law.
Continue Reading Louisiana’s Annual Named Storm / Hurricane Deductible Law

After Hurricane Georges hit Puerto Rico in September of 1998, many policyholders considered that their claims were unfairly denied due to the ambiguous language in their policies. The main issue was that the policies did not have a specific deductible language for hurricane damage. If the policy did not have specific deductible language for hurricane, the insurance companies would apply the wind damage deductible but, in some claims, they applied the deductible classified under “basic damages.” Many of the policyholders filed complaints in the Insurance Commissioner’s Office against the insurance companies for the ambiguity in the language related to hurricane damage deductible. Some of those cases were then appealed. Below is what the Court of Appeals of Puerto Rico held in United Surety & Indemnity Company v. Insurance Commissioner of Puerto Rico,1 regarding this issue.
Continue Reading Is it Correct for Your Insurance Company to Consider Windstorm Damage Synonymous with Hurricane Damage?

Deductibles are an unavoidable part of residential insurance policies. Florida case law defines a “deductible” as “a clause in an insurance policy that relieves the insurer of responsibility for an initial specified loss of the kind insured against.”1 Following a loss, a policyholder must first take on the financial responsibility of the deductible before the insurance company becomes liable.
Continue Reading Single-Season Deductibles: A Response to the Frightening 2004 Hurricane Season

The Problem: Waiving insurance policy deductibles (“you scratch my back and I’ll scratch yours”) has been common place in Texas since 1989 and came about as the result of a poorly worded statute passed that same year that contractors have basically ignored. Contractors who have broken the 1989 law by waving deductibles (primarily roofing contractors) are known as “deductible eaters.” Homeowners were lured into signing contracts with the deductible eaters based on promises, for example, of a “free roof.” And then, homeowners/policyholders were duped into committing insurance fraud when in submitting a request pursuant to their policy for replacement cost (RCV) hold-back, they failed to tell their insurance company that the deductible part of the claim had not been incurred. What this means, again for example, before the new law, is that the roof job a homeowner got where the $2000 deductible was waived or “forgiven” and buried in other ways in the contractor’s paperwork, will now be required as payment out-of-pocket and proof that it was paid before the insurer will pay the RCV hold-back.
Continue Reading No Waving of Deductibles Bill: Texas HB 2102