Insurance companies and insurance agents know that their customers do not read their insurance policies. Proof is found by the Squaremouth Insurance Company offering a prize which could only be found if a policyholder read the insurance policy and won a secret contest. Here is the story:… Continue Reading
Easthampton Congregational Church submitted an insurance claim to Church Mutual Insurance Company when their roof suddenly collapsed. Church Mutual denied coverage for faulty construction after they sent their engineer, Joseph Malo, out to inspect the property. Mr. Malo noted, and the insured agreed, there was “progressive failure of the fasteners used to attach the layers … Continue Reading
I am often asked questions about how a detached apartment/game room/pool house/guest house is covered under a homeowner’s policy. The answer is dependent on the policy language, the case law in the jurisdiction of the claim, and the specifics of the structure.… Continue Reading
Recently, I presented at the Professional Public Adjusters Association of New Jersey educational conference on the area of insurance appraisal to roughly 30 public adjusters. During my preparation, I reviewed current and past appraisal provisions contained within standard insurance policies. In my research, I found some very interesting differences contained within insurance policy appraisal provisions … Continue Reading
Whether labor can be depreciated in arriving at an actual cash value property loss settlement has been a hot topic of debate over these past five years. A federal district court in Ohio recently weighed in on the issue in ruling on motions to dismiss two putative class action lawsuits, one against State Farm Fire … Continue Reading
A recent decision by the Supreme Court of Wisconsin1 might predict how other courts would analyze coverage under commercial general liability insurance policies for wildfires. In May 2013, a fire broke out on forest land owned by Lyme St. Croix Forest Company. The fire burned nearly 7,500 acres over the course of three days and … Continue Reading
In a Second Circuit decision, the court of appeals revived Madelaine Chocolate Novelties Inc.’s Superstorm Sandy claim against Chubb for property damage and business interruption for an additional $49 million in coverage. In overruling the lower court, the appellate court found that the lower federal court failed to properly evaluate all the relevant policy provisions.1… Continue Reading
A federal court in the Northern District of Georgia recently found that State Farm’s contamination clause was ambiguous regarding its application to a meth lab claim.… Continue Reading
Insurance policies are to be interpreted in the light most favorable to the insured. Narrowly interpreting policy language can help find coverage for an insured, as was the case in Tuscarora Wayne Insurance Company v. Hebron.1… Continue Reading
Is loss or damage caused by a tenant covered under an all-risk insurance policy? Like most issues addressed in the Merlin blog posts, the answer is: it depends on the facts and the policy language.… Continue Reading
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
