Tuesday @2 With Chip Merlin, is going to focus on something the property insurance law blog should discuss upon more often: the basics of property insurance contract interpretation. How can any claims adjuster provide all the policy benefits without identifying the policy terms and determine the applicable coverages so that an investigation of the facts and evaluation of damages can be completed?
Continue Reading Property Insurance Contract Interpretation Basics for Policyholders, Public Insurance Adjusters, Company or Independent Adjusters, and Insurance Agents

As the year goes on, state and federal trial courts will continue to tackle legal issues brought on by COVID-19. One recent decision comes from the Middle District of Florida, which recently granted an insurance carrier’s Motion to Dismiss a dental practice’s Complaint brought under the business income and civil authority provisions of the policy.
Continue Reading Trial Court Grants Motion to Dismiss Complaint Based on Virus Exclusion in Policy

Many of the homeowner policies we review exclude water damage resulting from, “continuous or repeated seepage or leakage of water or stream, or the presence of condensation of humidity, moisture or vapor which occurs over a period of weeks, months or years.” Courts have interpreted this clause to exclude water damage that occurs over 14 days. But what happens when you have a situation where there is significant water damage caused in the first thirteen days? Aren’t coverage clauses interpreted broadly so as to afford the greatest protection to the insured, while exclusion clauses interpreted narrowly?
Continue Reading The “Continuous or Repeated Seepage or Leakage of Water” Exclusion

Concurrent is defined as: “Having the same authority; acting in conjunction; agreeing in the same act; contributing to the same event; contemporaneous.”1 Now, within the insurance universe, conflict may exist when an insurer has concurrent damages and/or concurrent policies. For example, policies may include an exclusion clause such as:

EXCLUSIONS

1. We will not pay for loss or damage caused directly or indirectly by any of the following. Such loss or damages excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss.2


Continue Reading What Does Your Policy State Regarding: Concurrent Damages & Concurrent Policies?

Insurance coverage actions often turn on the interpretation of standard, industry-wide language used in liability policies. Insurance Companies use the services of the Insurance Services Office, Inc. (ISO), to draft standard language for their policies and are also often participants in the drafting of these forms. As a result, policyholders will often seek documents and information relating to the insurance companies’ interpretation of the meaning of the policies, including the drafting history information.
Continue Reading Internal Records From The Insurance Services Office Can Be Obtained In Insurance Policy Interpretation Disputes

The vast majority of property owners have never read the dozens (sometimes hundreds) of pages that comprise their property insurance policy. For most, the contents of the policy read like a foreign language, and how the conditions, exclusions, and other provisions could potentially apply to a future loss is not easily understandable.
Continue Reading Read Your Policy Renewal Closely – Important Changes May Be Buried in the Fine Print

In litigation, this type of question can come up more than one might imagine. For example, in response to a Complaint, an insurance carrier may allege that an insured failed to attend an Examination Under Oath (“EUO”) or submit a sworn proof of loss, only to later discover that no such request had ever been made. Florida’s Third District Court of Appeal addressed this very issue in First Home Insurance Company v. Fleurimond.1
Continue Reading When is an Insured Required to Attend an EUO or Submit a Sworn Proof of Loss?

“No matter what people tell you, words and ideas can change the world.”
—Robin Williams

Carefully reading your insurance policy is crucial because the interpretation of just one word can impact whether a policy provides coverage for your loss. Sometimes coverage can turn on a simple conjunction such as the word “and.”
Continue Reading Every Word Matters in a Property Insurance Policy