A policy is a contract and should represent the clear intent of both parties under the agreement. But what happens if what was intended to be covered under a policy is not actually described in the policy?
Continue Reading Can An Insurance Claim Be Denied If The Policy’s Property Description Does Not Match The Property That Has Been Under The Same Insurance For Years?

In reviewing policies, I have noticed a scary trend for policyholders: Insurance companies are often making changes to policy language limiting insureds coverage or ability to recover when renewing the policy. If you are like many policyholders when you get your renewal every year and the declarations page shows that your limits went up and the premiums went up you assume you have the same coverage as last year.
Continue Reading A Policy Renewal May Cost Insureds

A few years ago, I asked Merlin Law Group attorney Doug Grose, “How did we end up in arbitration in London, England with policy delivered in Texas, a loss in Houston, Texas and our client from Houston, Texas?” He told me there was an arbitration provision and the federal court ordered us to go to arbitration in London because that is where the policy required the arbitration take place. I asked Doug: ”Geez, forgetting the extraordinary increased cost to our client do this, what chance do you think we have in arbitration in London against Certain Underwriters at Lloyd’s of London?”
Continue Reading Choice of Law and Arbitration Provisions in Texas—Beware of These Provisions Which May Apply Laws of Another State

The title to this post would almost certainly be answered “no” by any insurance regulator or consumer advocate. But Liberty Mutual Insurance Company argues this is exactly what it can do with no consequence because the fraudulent and deceptive statements in the declarations should have been found by the policyholder reading the fine print in the policy endorsement—which is anything other than an enhanced product.
Continue Reading Can Insurance Companies Send Declaration Pages Which Indicate Enhanced Coverage Yet Deliver Diminished Coverage In The Fine Print In The Back of Endorsements?

The Mid-Atlantic Association of Public Insurance Adjusters (MAPIA) held a meeting this past week with about thirty-five public adjusters in attendance. President Paul Yemm, yours truly, Holly Soffer, and Tony DiUlio are pictured above. Soffer and Diulio gave a wonderful insurance gaps presentation that was highlighted Tony DiUlio’s discussion of a water loss that resulted in a bad faith verdict against State Farm.
Continue Reading Water Loss From Toilet Overflow Is Covered Despite State Farm Denial

(NOTE: This guest post is by Barry Zalma, Esq., CFE.1 Barry Zelma is a prolific writer and scholar in the field of insurance. I have purchased numerous publications from Barry. I am currently reading a book on legal ethics he wrote, The Little Book on Ethics For The American Lawyer, which may be his finest work and that is saying a lot after reading his treatises on insurance law and adjustment. I encourage you to read this very thorough post and consider purchasing Zalma’s publications for your reference library. – Chip Merlin.)

A Policyholders Lawyer’s Take on the Obligation to Read

In its blog the Merlin Law Group cites a small portion of a lengthy Hastings Law Journal article written by Professor Chuck Knapp.2 Dr. Knapp did not like the use, by appellate courts, of the concept that there is a duty to read (DTR) an insurance policy.

The blog post by Chip Merlin proposed that Dr. Knapp’s proposals would allow the court to rewrite the terms and conditions of the policy. Dr. Knapp did not do that but spent many pages explaining why the word “duty” should not be used and the exceptions available to the courts when interpreting an insurance contract as well as other contracts.
Continue Reading There is an Obligation for the Insured to Read an Insurance Policy

Business owners and owners of commercial property should not buy Farmers Insurance. Virtually every insurance company in the United States considers the entire cost of restoration right away when making payments, including at actual cash value—except Farmers Insurance. Farmers Insurance has declared war on its own customers and independent restoration contractors.
Continue Reading Farmers Insurance Sells Substandard Commercial Policy and Business Owners Should Not Purchase Farmers Insurance

United Policyholders takes action and gets things done for policyholders regarding the insurance gap issue. United Policyholders is tackling the insurance gap coverage problem by providing staff and resources to collect rogue property insurance policy forms being issued by insurance companies, to show examples of how insurers are stepping over each other to silently gain a competitive advantage of lower price with cheap insurance.
Continue Reading Crazy New Policy Language? Report It To United Policyholders!

Judges should stop with the fiction that policyholders have a duty to read their insurance policies before a loss. They do not read all the insurance contracts they purchase, and nobody does. Even if they read their policies, most people would not understand the policy and certainly not contemplate every circumstance which could arise in advance of how the policy would be deciphered for those hypothetical circumstances of loss and disaster.
Continue Reading Nobody Should Be Expected To Read Every Insurance Contract They Purchase