Policy Language

Subscribe to Policy Language

A lawsuit filed by Church Mutual seems to be part of a trend of insurers analyzing high-value appraisal awards and not paying them. I recently mentioned the nationwide non-payment of appraisal awards by State Farm in
Why Has State Farm Stopped Paying Appraisal Awards? The instant lawsuit1 argues that the award inherently is subject to coverage determinations of unowned amounts because the appraisal panel said they never applied any of the policy conditions:…
Continue Reading Are More Appraisals Being Challenged By Insurers—Why Go to Appraisal If Insurers Will Not Pay the Appraisal Award?

Ever get so curious about something that is not so meaningful, but you just have to know the answer to satisfy your curiosity? I have been on a very nerdy quest about older appraisal clauses in property insurance policies because I challenged a commentator to this blog about not simply repeating what others have said about the origin of appraisal found in property insurance policies.
Continue Reading Were Older Appraisals Arbitration? One Older Appraisal Clause Clearly Was Not an Arbitration Clause

Conflicting policy provisions seem to be an increasing byproduct of the ever-growing number of coverage exclusions and limitations that insurance carriers are sneaking into policies. With the news of an upcoming special legislative session to address insurance premium hikes and rumors of potential changes, the best practice is for homeowners to read their policies and understand what is covered in the event of a loss. The truth is, however, reading a homeowner insurance policy these days seems like a game of “musical policy provisions.”…
Continue Reading Ambiguities in Florida Policies: Comprehending Coverage Should Not Require the Proverbial Philadelphia Lawyer

One of the lessons from the treble damage case noted in yesterday’s blog, Treble Damages for Insurance Company Misconduct in North Carolina and Collapse Coverage Confirmed, is that denial letters from insurance companies should be accurate. They should not be quoting irrelevant policy language. Denial letters should only cite the policy language the insurer is relying upon to deny a claim. By law in most states, the letter should accurately state facts and the applicable policy language for denial.
Continue Reading Overbroad Denial Letters Are Deceptive and Not in Good Faith

The qualifications of pilots and captains under aircraft and marine policies are important. Aircraft policies and more significant marine policies have criteria that pilots and captains must meet for the policy to be fully in force at the time of an incident. For those of us who are not owner-operators, it is important to make certain that your paid crew are up to date with their licenses and that their credentials meet the policy requirements.
Continue Reading Aircraft and Marine Insurance Claims—Is The Pilot or Captain Qualified Under The Policy Terms?

Pipe failures leading to a washout underneath a foundation can be a significant loss for policyholders. The question is whether it is covered and how much may be covered. While many insurers will pay to fix the pipe, most will deny coverage for the foundation damage that is caused by the soils being washed out.
Continue Reading Is Pipe Failure Resulting in Foundation Damage from Washout Covered? Policy Form and Jurisdiction is Important

Property insurance policies with language that gives insurers the power to invoke their “Right to Repair” is a trend that is, unfortunately, becoming more and more common. While the provision in these policies does sound like a good idea in theory, the way insurers utilize them is anything but as intended.
Continue Reading Right to Repair: The Intersection of the Managed Repair Program and the Faulty Workmanship Exclusion

Read the full policy after the loss—RTFP. When doing so, it is also important to check for the manner in which disputes are to be resolved and the applicable rules, including the time frames to invoke them. This is especially true with foreign insurers where an arbitration provision will apply.
Continue Reading Check For Arbitration Provisions—Especially When Dealing With Foreign Insurers