A Colorado public adjuster asked me a question about replacement cost coverage. The question had to do with a remodeling of the structure rather than spending money only on damaged items.   

Continue Reading Can a Policyholder Use Replacement Cost Benefits to Remodel or Replace at Another Location? What is the Standard to Collect Replacement Cost Benefits? The Three Prong Limitation

Isn’t it great when people work collaboratively on a noble cause and grand success happens? 

Merlin Law Group attorneys Drew Houghton from Oklahoma and Dan Ballard from Redbank, New Jersey, worked with policyholder attorney Jason Liss from Michigan to obtain a significant ruling yesterday in the Southern District of New York.1

Continue Reading Blockbuster New York Appraisal Decision Impacts Causation and Period of Restoration Determinations

During the First Party Claims Conference last week, New York attorney Jonathan Lerner and I discussed the new public adjuster regulations that had just come into effect in New York on October 8. The New York Department of Financial Services listed the following in a press release announcing these new regulations:
Continue Reading New York Public Adjusters Have New Consumer Protections To Follow

Recently the New York Statute of Limitations has become a heated topic of litigation. Governor Cuomo issued Executive Orders tolling the Statute of Limitations, but the question has become, what is the effect of those orders? The Statute of Limitations in New York is generally six years,1 however, this can be altered by contract. Many Insurance Policies shorten this six-year period to only twelve months.
Continue Reading New York Statute of Limitations and the Effect of the COVID-19 Closures

My Red Bank colleague, Dan Ballard, and I recently gave a presentation about Misrepresentations & Mistakes at the 2020 Fall Conference of the Professional Public Adjusters Association of New Jersey (PPAANJ). During that presentation, I discussed New York case law providing that a homeowners insurance policy may be voided if the insured willfully and fraudulently places in the proof of loss a statement of property lost which the insured did not possess, or places a false and fraudulent value upon the articles which the insured did not own.
Continue Reading Incorrect Information Within Proof of Loss Not Enough To Void Insurance Policy

Every state has some general rules to follow when interpreting insurance contracts. While New York is often thought of as a state whose laws favor insurance companies, there are very good examples of New York following most of the standard insurance contract laws of interpretation.
Continue Reading New York Insurance Contract Interpretation—General Rules to Follow

In New York they can! I’ve fielded many calls from public adjusters who are worried their client will be waiving their rights to further pursue insurance proceeds if they sign the proof of loss sent by the insurance carrier or cash the check issued by the carrier. The short answer to those questions is…it depends.
Continue Reading Can an Insurance Company Include a Release in a Proof of Loss Form?

Back in June 2018, I blogged about the New Jersey Insurance Fair Conduct Act passing the Senate and heading to the Assembly. Unfortunately, many roadblocks (insurance company lobbyists) prevented the Bill from going forward by using propaganda to spread lies about the detrimental effect of passing it. For the foreseeable future, New Jersey will continue to be one of the most difficult states in the country to prove bad faith given their court’s “fairly debatable” standard.1
Continue Reading New York’s Bad Faith Bill Advances Through Assembly Insurance Committee

(Note: This guest blog is by Kathryn Ray, a Summer Law Clerk in our Tampa office)

When sustaining property or casualty damage and after filing a claim with an insurance company, the insurance company may then request a proof of loss. A proof of loss is defined as “a policyholder’s statement of the amount of money being requested, signed to and sworn to by the policyholder with documentation to support the amount being requested.”1 In New York, if an insurance company gives the insured a written notice, after a loss, requesting a proof of loss the insured shall then have 60 days after receiving this notice to comply with the insurance company’s request.2 This compliance period to provide the insurance company with a proof of loss may also be longer than 60 days if the insurer specifies so in their written notice.3
Continue Reading Misrepresentations and Proofs of Loss in New York