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In 1990, the National Association of Insurance Commissioners adopted a new section to its model regulations relating to unfair property claims.1

Section 9 of the model regulation provides:2

A. When the policy provides for the adjustment and settlement of first-party losses based on replacement cost, the following shall apply:

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(2) When a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer shall replace all such items in the area so as to conform to a reasonably uniform appearance. This applies to interior and exterior losses. The insured shall not bear any cost over the applicable deductible, if any.…
Continue Reading Matching Protections for Hurricane Irma Claims in Florida

Policyholders purchase property insurance and pay lofty premiums with the intention of their insured property being restored to where it was prior to a loss. But what happens when the loss affects only a portion of the siding or has destroyed only a handful of discontinued roofing tiles? Is the policyholder forced to accept mismatching materials? The trial court in Hamlet Condominium Association v. American Family Mutual Insurance Company, recently entered an order1 which discussed an insurer’s obligation under a replacement cost value policy to provide a reasonable match between the replacement and existing materials.…
Continue Reading An Insurer’s Obligation to Match: Comparable Materials and Quality

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.…
Continue Reading The Scope of Appraisal in Illinois

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.…
Continue Reading Is a “Matching” Dispute Appropriate for Appraisal?

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?

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Continue Reading Pair, Set and Match

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

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Continue Reading Is matching required in Missouri?

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?

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Continue Reading Important Decision in Favor of Policyholders on Matching Issue

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.

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Continue Reading “You Break It, You Bought It” and Other Repair to Undamaged Property

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.

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Continue Reading Matching Lawsuit and Order that Makes the Policyholder’s Point