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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

With COVID-19 business closures, legislatures across the country have been grappling with new questions, including what protections may be afforded by business income insurance. As of late, members of legislatures in states like New York1 and Pennsylvania2 have all proposed legislation in favor of affording coverage for claims that might otherwise be excluded. While these bills have not passed, they may offer some indication about what legal issues could arise in the future.3…
Continue Reading State Legislatures Aim to Afford COVID-19 Coverage

A New York court of appeals recently ruled that an insured’s claim for business interruption losses in excess of policy limits may proceed as the insured alleged the additional losses were the result of its insurers’ delay in payments.…
Continue Reading Delay in Payment May Lead to Insurer’s Liability in Excess of Policy Limits

We’ve all seen it before. The insured files a claim, the insurance company sends out an adjuster to adjust the loss, the loss is more complex, or a situation arises that the adjuster cannot handle so the insurance company forwards the claim to their legal department. At that point, an attorney becomes involved and the adjustment of the claim, as well as the communication between the parties is limited and calculated.…
Continue Reading Court Holds Documents Created by Counsel During Claims Handling Were Not Privileged

Linda A. Lacewell, Superintendent of the New York State Department of Financial Services

Since the New York Department of Insurance was abolished in October 2011, the New York State Department of Financial Services has supervised and regulated all insurance companies that do business in New York. The Department of Financial Services attempts to ensure fair and equitable dealings between insurers, agents, and policyholders regarding all insurance transactions. The Department of Financial Services also receives and investigates all complaints against agents or insurers.…
Continue Reading How To File A Complaint With The New York Department of Financial Services About Your Delaying, Denying and Bad Treating Insurance Company