The appraisal clause in a typical residential and commercial property insurance policy provides for an appraisal if the parties disagree as to “the amount of loss.”1 That phrase has been the subject of extensive legal debate between insureds and insurers in terms of its meaning and scope. While most courts have concluded that ascertaining the amount of loss does not include interpreting the policy or making coverage determinations, little guidance has been provided as to what coverage means and whether an appraisal can still proceed even if coverage issues exist.
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Matching
Is a “Matching” Dispute Appropriate for Appraisal?
By Edward Eshoo on
Posted in Insurance
In my last blog post, I discussed Windridge of Naperville Condominium Association v. Philadelphia Indemnity Insurance Company,1 and the issue whether appraisal is appropriate to resolve a dispute over the need for a general contractor to perform repairs following a covered loss. Windridge of Naperville also involved whether appraisal is appropriate to resolve a dispute over the cost of repairing physically undamaged sides of townhome buildings to remedy a mismatch with repaired damaged sides.…
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Matching Damaged Property of Residential Losses
By Chip Merlin on
Posted in Insurance
Rutgers Law Professor Jay Feinman was commissioned by United Policyholders to write a report on the issue of "matching" following property losses to residential structures. He summarized the issue of matching as following:
Pair, Set and Match
By Chip Merlin on
Posted in Commercial Insurance Claims
A public adjuster recently asked me about a hotel that was under a specific brand and the contract to maintain the brand required the rooms and furniture to match. Following a loss, the insurance company has refused to pay for the portions of the physically undamaged property and the policyholder paid millions to match the old undamaged property with the new replacement property. Should an insurance company pay to match hotel property following a loss—especially if the policyholder has legal obligations to match all property which sometimes cannot be done because of age and obsolescence?
Is matching required in Missouri?
By Merlin Law Group on
Posted in Insurance
In the area of property damage law, one of the hot topics these days is matching. If only a portion of a structure is damaged and the material to be used to repair or replace the damaged portion is no longer available, is the insurance company required to replace the entire area so the siding, shingles, etc. all match? The Missouri Court of Appeals recently reversed a case regarding matching and sent it back to the trial court. The case is Alessi v. Mid-Century Insurance Company.1
Important Decision in Favor of Policyholders on Matching Issue
By Shane Smith on
Posted in Insurance
One area of dispute in property insurance claims involving hail or storm damage is how much needs to be replaced. When part of a building’s roof or siding is damaged as a result of a storm, sometimes the replacement material is no longer available. The issue becomes does the entire roof or siding have to be replaced in order to achieve a perfect match?
“You Break It, You Bought It” and Other Repair to Undamaged Property
Florida Statute § 626.9744(1) requires a Florida homeowner’s property insurance to cover repair or replacement of undamaged property when it is damaged during repair. Specifically, subsection (1) of this statute (2011) states:
When a loss requires repair or replacement of an item or part, any physical damage incurred in making such repair or replacement which is covered and not otherwise excluded by the policy shall be included in the loss to the extent of any applicable limits. The insured may not be required to pay for betterment required by ordinance or code except for the applicable deductible, unless specifically excluded or limited by the policy.
Matching Lawsuit and Order that Makes the Policyholder’s Point
By Chip Merlin on
The Minnesota Attorney General had enough of insurance companies failing to live up to the promise of putting policyholders back into the same position they were before the loss. Currently, the situation is the same throughout the nation, where insurers say they will do one thing, but have their attorneys argue out of the bargain based on obscure policy wording. Matching the damaged portion of the structure to the remaining parts of a structure is one such issue, and we literally tracked down this State action by the Minnesota Attorney General because we feel the issue is that important.
Coverage Issue of “Matching” Roof Tiles or Shingles Shows How to Use the Search Function of this Blog
By Chip Merlin on
Posted in Insurance, Insurance Claim
I received a comment to my post, Cosmetic Damage is "Physical Damage" and Recoverable Under a Property Insurance Policy, asking the following:
What about matching of the roof tiles or shingles?
The new ones are always going to be different. But, the insurance companies are not paying for the entire roof.
In this case the purpose of insurance of "to put the insured in the same position they were before the loss" is not true as long as the insurance companies continue to pay part of the roof.
Your opinion, please.
Thank you.
Matching Coverage Disputes and Disagreements are Routine and Not Going Away–Don’t Miss Our September 11 Seminar in Houston Which Covers This Topic
By Chip Merlin on
Insurance claim denials and disputes involving “matching” are frequent. I received this recent comment on the topic of matching:
Hey Chip
Back on 5/17/09, Cat adjuster posted a comment regarding matching of aged paneling and tile floors. You advised that maybe the adjusters were relying on Texas Case Law regarding causation. In my experience, the adjusters and appraisers I am dealing with in Texas simply don’t feel they owe for match. For instance, I am dealing with an adjuster who agrees that the siding on this Galveston Home was discontinued in the 1930’s and is obviously unavailable and can not be matched. He agrees to replacement of the two damaged sides, but insists the carrier does not owe for match of the two remaining sides.
I have argued that failure to replace all 4 sides will not completely indemnify the Insured. He is not moving at all. I have not found any case law or statutes dealing directly with this issue.
Any thoughts??