Victor Jacobellis left his job in San Francisco representing insurance companies to join Merlin Law Group and help policyholders obtain insurance coverage benefits. He asked me to speak with him about exceptions to exclusions of coverage which are often overlooked and lead to wrongful denials of coverage. The photo above shows yours truly speaking with Victor … Continue Reading
Lately, much of the United States have seen wild swings of severe weather. From the mid 70’s on Saturday to 47 degrees and an inch of rain on Monday, severe weather can wreak havoc on your home. With torrential rains and flash flood in most parts of the Northeast recently, many find themselves asking: my … Continue Reading
In a recent court opinion,1 the New Jersey Appellate Division interpreted a homeowner’s insurance policy’s water damage exclusion and determined whether damage from a broken municipal water main under a public street was covered under the policy. In that case, a homeowner brought an action against his insurer for breach of contract after the insurer … Continue Reading
Feenix Parkside LLC owed a commercial building that incurred a partial collapse to their ceiling. When Feenix sought coverage for the collapse, the insurer—Berkley North Pacific—denied coverage for the loss. When Feenix reported the loss, they stated the collapse was due to decay, which was a gradual decline in strength and soundness.… Continue Reading
A septic system back-up into a home can be a rotten situation for a homeowner, and depending on the extent of the back-up, can cause widespread damage throughout the home. When researching coverage for septic system back-ups I was surprised by the number of Florida cases addressing this very issue.… Continue Reading
An Illinois Public Insurance Adjuster recently contacted me regarding an insurer’s denial of a smoke damage claim. The facts were as follows. While a condominium unit owner was using the fireplace in the unit (“unit 1”), smoke began to fill up in the condominium unit above (“unit 2”). The condominium association made a claim to … Continue Reading
Buy Bill Wilson’s book! This is the least I can say after quoting him about “resulting” or “ensuing” loss provisions following “wear and tear” exclusionary language. I am certain his book helped a judge understand how the coverage works.… Continue Reading
“One size fits all” is a phrase used to describe pieces of clothing or accessories designed to fit all people. Over time, it has been used to refer to anything meant to apply in all circumstances. Obviously, one size cannot fit all people. The same holds true when it comes to “freezing” exclusions in homeowner’s … Continue Reading
A homeowner’s policy will, no doubt, help you sleep better at night. It’s a new year after all – everyone should read their insurance policy. But if you have not read your policy lately, or ever, then you may have a rude awaking when a sudden loss is not covered and leaves you financially devasted. … Continue Reading
In the recent case of Rainforest Chocolate, LLC v. Sentinel Insurance Company, Ltd.,1 the Supreme Court of Vermont found coverage for Rainforest where Sentinel’s “false pretense” exclusion turned out to be ambiguous as there were at least two reasonable interpretations of what constituted “physical loss or physical damages.”2… Continue Reading
My son, Chase, father, Bill, and I went to the Peach Bowl in Atlanta this past weekend to cheer on the mighty Florida Gators as they defeated the Michigan Wolverines. Afterwards, I was curious how alligators would fare in litigated property insurance cases and the results of my legal research were not so good for … Continue Reading
Are you covered if your pet cat causes a CATastrophe to your property? I was posed this question after being referred to an article on celebrity Frankie Muniz who found his home “flooded with 3 feet of water because his cat had accidentally turned on the faucet while he was away at his uncle’s funeral.” … Continue Reading
Possibly. Many policies exclude or limit coverage for interior water damage unless there is evidence of a wind-created opening in the roof, outside wall, door or window where rain entered the home or business. I often see carriers deny coverage in a manner similar to the below scenario:… Continue Reading
Insurance policies are to be interpreted in the light most favorable to the insured. Narrowly interpreting policy language can help find coverage for an insured, as was the case in Tuscarora Wayne Insurance Company v. Hebron.1… Continue Reading
The photos from Hurricane Michael show catastrophic loss from not only the storm surge, up to fourteen feet in some areas, but from winds and rain as well. For those that live far enough inland where surge and flood was not an issue, but still sustained water damage from rain, you may think your homeowners … Continue Reading
Is loss or damage caused by a tenant covered under an all-risk insurance policy? Like most issues addressed in the Merlin blog posts, the answer is: it depends on the facts and the policy language.… Continue Reading
In March, I posted a blog on the Hicks v. American Integrity Insurance Company opinion,1 in which a Florida court ruled that policy language stating: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days,” did not preclude coverage for damage caused during the first … Continue Reading
Most insurance policies are voluminous, trying to encompass everything from what is covered to what is not. They included with some profound confusion between covered and uncovered situations.… Continue Reading
Certain types of water damage are likely to fall under a water exclusion clause such as damage caused by flood, tsunami, standing water, groundwater and drain or sewage backup. Despite these categories, disputes often arise whether damages caused by water are covered under the standard homeowner’s policy. The type of water damage that may be … Continue Reading
Whether residential or commercial, most property coverage policies exclude loss caused by freezing, unless the insured either: Uses reasonable or best efforts to maintain heat in the building; or drains the plumbing lines. Application of this freezing exclusion, however, often turns on interpreting or defining what the terms “reasonable,” “best efforts,” and “building” mean.… Continue Reading
I commonly get asked coverage questions that relate to a commercial client’s claim for damages. My response is always the same, “send me the policy and I will take a look.” I know this sounds obvious but with the multitude of policies out there it is impossible to relate a policy to a factual situation … Continue Reading
Many property insurance policies have a provision that states something similar to the following: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days.” Insureds may find their claims for water loss under their homeowners’ policy denied on the grounds that the leak was present … Continue Reading
Most homeowners and commercial insurance policies contains exclusions for loss or damages caused by mudflow or other similar occurrences. An example of on such exclusion is included below: b. Earth Movement and Settlement, meaning earthquake, which includes land shock wavers or tremors before, during or after a volcanic eruption; landslide; mudflow; sinkhole; earth sinking, rising … Continue Reading
I recently received a call from a public adjuster who told me that his client’s property was flooded when a municipal water main broke which caused damage to his property when it flooded.… Continue Reading
