Late notice of loss lead to denials in Florida at a very high rate. Insurers claim that they are prejudiced and that a presumption of prejudice arises from late notice. A federal trial court has questioned older legal authority about whether a presumption exists and whether the insurer bears the burden to prove prejudice based on policy language.1
Continue Reading Is Your Denial Based on Late Notice of Loss—Who Has To Prove Prejudice?

Many insurance companies adjusting hail damage claims have a checklist of items that each adjuster must answer before payment of a claim. One of the items at the top of the list is whether there have been any prior hailstorms at the loss location. From a policyholder’s perspective, most do not go onto a roof nor call a roofer unless a leak occurs or there is obvious damage.
Continue Reading Hail Damage?—Not From This Hailstorm

With cold temperatures gripping my home State of New Jersey, my mind (and research) brings me to warmer locations. In a recent case,1 a federal court in Georgia held that an insured’s 11-month delay in filing a claim after a loss was not justified and provided the insurer with a reasonable ground to deny the claim.
Continue Reading Is Eleven Months Too Long a Delay in Filing a Claim with an Insurer After a Loss?

The International Roofing Expo in Las Vegas finished on Thursday. Roofers were asking me all kinds of questions. For example, they asked why insurance company pricing can be so low, could insurance companies ask for releases from their customers if the insurance company gave up its right to repair, and what they could do about mortgage companies holding onto their money after repairs were complete. The most controversial question was why Florida public adjusters supported Florida legislation that restricted roofers from being able to solicit business. I will let public adjuster leaders from FAPIA answer the last question.
Continue Reading A Question For Roofers and Public Adjusters—Should insurers deny claims for hail or windstorm damage if the damage is not discovered and reported within 6 months of the storm? Should insurers be able to prohibit lawsuits on this basis?

Last week the United States District Court for the Southern District of Indiana granted Travelers Indemnity Company’s Motion for Summary Judgment allowing them to dodge hail damage claims made by policyholder Mapleton at Countryside Condominium Association Inc. (“Mapleton”).1 Mapleton brought suit against Travelers for breach of contract and bad faith following two hailstorms impacting their buildings in June 2016 and April 2017. The hailstorms caused damage to the condominium’s siding estimated at $2.58 million.
Continue Reading Court Finds Hailstorm Claims Made “Unreasonably Late”

Defendant Insureds, Lonergan Law Firm, PLLC, et al. (“Lonergan”), recently appealed to the Fifth Circuit Court of Appeals a Northern District of Texas ruling against it, which found it failed to meet a material condition of the policy by not sending its Notice of Claim (“Notice”) to the Claims Department. Landmark American Insurance Co. (“Landmark”) filed suit against its insureds seeking to avoid liability for coverage by arguing that, even though it received notice via a Claim Supplement during the policy period, the insureds failed to send the notice to the location mandated by the Policy.1
Continue Reading Notice of Claim: Precatory “Please” Does Not a Mandatory “Shall” Make

Insurance policies always have time deadlines to do something after a loss happens. The failure to follow these may prevent recovery. I will be discussing and answering questions about these policy time requirements over the next several weeks during our Tuesdays at 2 With Chip Merlin.
Continue Reading Time Deadlines To Be Wary Of When Filing Property Insurance and Business Income Loss Claims—Do Not Miss Tuesday At 2 With Chip Merlin

Can you imagine your 85-year-old grandmother or your uncoordinated friend who has never climbed a ladder going up on a slanted roof and inspecting it for wind or hail damage after a storm? Most insurance company lawyers argue the position that their client’s customers have to do this to satisfy the requirement that a loss must be reported “promptly.”
Continue Reading Arkansas Insurance Department Recognizes That Policyholders Do Not Normally Climb on Roofs To Inspect For Damage