Tag Archives: Policy Language

Follow-Up: My Insurance Claim Was Denied Because My Water Leak Lasted Over a Period of 14 Days or More – Was the Denial Proper?

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

Policy Conditions “Conformity to State Law” May Extend the Period Time to File Suit.

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

When the Insurance Company Labels Your Loss a Collapse, Can It Still Deny Your Collapse Claim?

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

Texas Insurance Appraisal: Who is Grading Insurance Company Papers and the Policies They Sell?

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

Post-Loss List Created Solely From Memory Can Satisfy the Insured’s Duty to Furnish an Inventory

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

Freezing Exclusion – What Does It Really Mean to Use Reasonable Efforts to Maintain Heat in the Building?

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

Replacement is Not Always a Prerequisite for an Insured to Claim Replacement Cost Benefits

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

When Words Allide, Plain Meaning Wins

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

My Insurance Claim Was Denied Because My Water Leak Lasted Over a Period of 14 Days or More – Was the Denial Proper?

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

My neighbor had coverage, so why was I denied?

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

How Does the Ordinance Section of My Insurance Policy Affect the Florida “25% Rule”?

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
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