Recently, it seems like I have been privy to a relatively high number of insureds asked by their carrier, following a loss, to submit to an examination under oath (commonly referred to as an EUO). The most common question I received was, “Can I just choose not to answer or attend?” Although the choice is … Continue Reading
In December of last year, my colleague Ashley Harris discussed Security First Insurance Co. v. Florida Office of Insurance Regulation,1 where the Florida Fifth District Court of Appeal (Fifth DCA) upheld the Office of Insurance Regulation (“OIR”) prohibition of proposed language in an insurance policy that would require “all insureds, all additional insureds and all … Continue Reading
Most property insurance policies provide additional coverage for direct physical loss of or damage to covered property caused by or resulting from an “abrupt collapse.”1 In Hoban v. Nova Casualty Company,2 a California federal district court recently addressed the meaning of the phrase “abrupt collapse,” which the commercial insurance policy at issue defined as “an … Continue Reading
Frequent readers of our blog know that property insurance losses center on the insurance policy. The Policy provisions are the most fundamental and are always important in a breach of contract case. Despite the importance of the policy, you would think that insurance company adjusters, independent adjusters, and the representatives working on insurance claims would … Continue Reading
In a recent unpublished Appellate Division case in New Jersey,1 AIG was held not responsible for a wig and beauty distributor’s business loss claim. Beauty Plus, a wholesale distributor of human hair wigs and other beauty products had a shipment of 487 cartons of human hair wigs stolen from their Moonachie, New Jersey, warehouse back … Continue Reading
Denied water damage claims are one of the more frequently handled claims by our law firm. The cost to repair these claims can be quite high depending on many factors including the length of time the water leaked, the length of the leak, the nature of the water, and the location of the water leak … Continue Reading
In March, I posted a blog on the Hicks v. American Integrity Insurance Company opinion,1 in which a Florida court ruled that policy language stating: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days,” did not preclude coverage for damage caused during the first … Continue Reading
Some insurance policies will contain a clause within the conditions section entitled “Conformity to State Law.” This provision contains language similar to: “Conformity to State Law. When a policy provision is in conflict with the applicable state law of the State in which this policy is issued, the law of the state will apply.”… Continue Reading
Most insurance policies are voluminous, trying to encompass everything from what is covered to what is not. They included with some profound confusion between covered and uncovered situations.… Continue Reading
At least one Michigan court has ruled that even when the execute general adjuster calls a building’s damage a collapse and labels it as a “cave in,” the denial will stand where the policy language supports an exclusion.1 This case arises out damages that occurred to a large commercial shop that repairs commercial trucks. There … Continue Reading
It is no secret that there are problems with the appraisal process. The ever-growing issues with appraisal include, but certainly are not limited to, exorbitant expenses pushed onto policyholders and insurance companies, gamesmanship, and the never-ending questions of: When is appraisal appropriate What can be addressed and assessed within appraisal, and Whether a policyholder’s claims … Continue Reading
As spring heats up and amusement parks gear up for an influx of summer visitors, a reminder to amusement park owners to make sure the amusement rides and equipment have been added to your policy.… Continue Reading
When personal contents or business personal property are damaged or lost in a covered event, most policies require the policyholder to provide an inventory of the damaged or lost items to the carrier. But often, the carrier and the policyholder clash on the level of specificity required and whether the policyholder has submitted adequate proof … Continue Reading
This week’s blog topic is a question I received from a reader who came across one of my prior blog posts on matching: Important Decision in Favor of Policyholders on Matching Issue.… Continue Reading
Whether residential or commercial, most property coverage policies exclude loss caused by freezing, unless the insured either: Uses reasonable or best efforts to maintain heat in the building; or drains the plumbing lines. Application of this freezing exclusion, however, often turns on interpreting or defining what the terms “reasonable,” “best efforts,” and “building” mean.… Continue Reading
The Eleventh Circuit Court of Appeals recently ruled that a policy’s exclusionary language did not apply to an insured’s previously denied water loss.… Continue Reading
Replacement cost insurance generally allows recovery for the actual value of property at the time of loss, without deduction for deterioration, obsolescence, and similar depreciation of the property’s value. Depending on the circumstances, the difference between the actual cash value and the replacement cost value of a loss can be significant.… Continue Reading
I commonly get asked coverage questions that relate to a commercial client’s claim for damages. My response is always the same, “send me the policy and I will take a look.” I know this sounds obvious but with the multitude of policies out there it is impossible to relate a policy to a factual situation … Continue Reading
Navigating the Mighty Mississippi and the English language have quite a bit in common. Sometimes it takes a lot of skill and creativity to get where you want to go. Due to a recent dispute in Continental Insurance Co. v. L&L Marine Transportation, Inc.,1 regarding the meaning of the undefined policy term “tow” and the … Continue Reading
A court in Georgia found coverage for a loss based on the presence of a semicolon. In the case Lee v. Mercury Insurance Company,1 the court found coverage for a home destroyed by fire based on the potential ambiguity created by a semicolon.… Continue Reading
Many property insurance policies have a provision that states something similar to the following: “we do not insure…for loss…caused by…constant or repeated seepage or leakage of water…over a period of 14 or more days.” Insureds may find their claims for water loss under their homeowners’ policy denied on the grounds that the leak was present … Continue Reading
A common theme I have noticed lately is the tendency of homeowners, having just weathered a major natural disaster, to compare their ability to recover insurance proceeds to that of their neighbors. Wondering if you can recover alternative living expenses? Curious to know if you can recover for your sewage back-up claim? Rather than looking … Continue Reading
Section 708.1.1 of the Florida Building Code, often referred to as the “25% Rule,” implements guidelines for roof replacement requirements. The section states, Not more than 25 percent of the total roof area or roof section of any existing building or structure shall be repaired, replaced or recovered in any 12-month period unless the entire … Continue Reading
I recently received a call from a frustrated homeowner following a fire that broke out in his family home while they were out to dinner. The despair he felt about the property damage was exacerbated by the fact that he was having trouble with his mortgage company releasing payments for the repairs. The homeowner wanted … Continue Reading
