In 2016, State Farm came out with a new appraisal provision for its homeowner insurance policy.1 This new provision makes the appraisal process extremely burdensome for policyholders. While I have always felt the new provision violates the Standard Fire Policy, a Michigan federal district court recently reached the same conclusion.
Continue Reading State Farm’s Appraisal Provision Violates the Standard Fire Policy

Don Malecki was an insurance coverage guru. He wrote many treatises regarding insurance coverage. He was respected and a much sought-after insurance coverage expert. Malecki wrote an article in an insurance agent publication, Rough Notes, entitled, Troubled Terminology: “Risks of Direct Physical Loss” Wording Is Currently Read Broadly By Courts.1 He noted that most policyholders do not understand the basic meaning of “risks of direct physical loss”:

Continue Reading The Troubled Understanding of “Risks of Direct Physical Loss”

History is important. Insurance history gives context and meaning to the thoughts and views of what should be and why things should be the way they were and are. Those historic views have been ever increasingly challenged in social media and very dynamic processes throughout the United States in the past few years. I want to know what people were thinking and what their intent was regarding insurance policy forms. Insurance history and policyholder advocacy is my life.
Continue Reading The History of the Business Interruption Policy In the United States

Throughout my years at Merlin Law Group, I have noticed a troubling pattern with insurance carriers: denying claims based on confusing and ambiguous policy language. Perhaps you are challenging a continuous seepage or leakage exclusion or a protective safeguard requirement on your collectibles. It is unlikely the policy defines “seepage” “leakage” or what qualifies as a protective safeguard. However, the Arizona courts and Legislature have brought some clarity to interpreting these unclear provisions.
Continue Reading Clearing Things Up: Interpreting Ambiguities in Arizona Policies

It is no secret that insurance adjusters will not hesitate to cite multiple policy provisions justifying a claim denial. I refer to this method as the “kitchen sink” approach, as it accurately describes the attempt to utilize every conceivable exclusion/condition remotely applicable in various insurance claims. It is quite common for an insured to receive a denial letter citing a laundry list of excluded causes of loss.
Continue Reading Denying Claims Based Off Conflicting Policy Provisions Violates Florida Law

Many people think the declarations page and subsequent coverage and exclusion sections make up the important part of an insurance policy. However, add-on forms known as “endorsements” or “riders” may be just as important as they have the ability to significantly change the policy, depending on their language. For example, an endorsement to an insurance contract can add, remove, or change the coverage in the policy. While these pages often come at the end of the contract, they should be read in conjunction with the declarations page and the entirety of the policy.
Continue Reading Reading the Fine Print of Add-On Forms in Policies – Catastrophe Area Notice Limitations and More