A recent Florida appellate opinion addresses common issues regarding the death blow or failure to comply with policy conditions. It should be well-known that a material breach of a policy condition may be fatal to a claim and grounds for voiding the policy.… Continue Reading
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
It is no secret that insurance policies are confusing: they are long – often 40 or more pages – and contain vague language that can be unclear and difficult to understand, even for the most educated people. After large scale natural disasters like Hurricane Harvey, insurance companies and their adjusters frequently rely on vague and … Continue Reading
In Florida, an insurer’s denial of coverage constitutes a waiver of its right to require an insured to comply with policy conditions before filing suit.1 But, what if insured requests an insurer to reconsider its coverage denial before filing suit? Does the request to reconsider nullify the insurer’s previous denial of coverage requiring the insured … Continue Reading
Insurance policies containing conditions pertaining to an insured’s obligation to submit a notice and proof of loss are “meant to give the insurer the necessary facts to facilitate an investigation of a claim and to protect it against fraudulent and excessive claims.”1… Continue Reading
I suppose a lot of professions are cyclical. In my 25 years if practice I have sometimes found that I will go years without getting certain types of cases and then I will get two or three all at once. Lately, I have been asked to look at cases where the carrier is claiming that … Continue Reading
Some losses are not as readily apparent to policyholders as a fire or significant water loss. The policyholder may not discover the damage until days, weeks or months after the loss occurred. This can often be the case for hail losses to roofs. However, when the policyholder gives notice weeks or months after the loss, … Continue Reading
As attorneys for first-party property claims, we must vet through claims to see if we can be “The Policyholder’s Advocate” on any case. Some of the initial questions I ask a potential client are: 1) When was the date of loss? 2) When did you notify the carrier? 3) How and when did you notify … Continue Reading
On Wednesday, Florida’s Third District Court of Appeal issued an opinion affirming a trial court’s order compelling appraisal of a homeowners’ supplemental Hurricane Katrina claim.1 The insureds, the Cardelles, had filed claims with State Farm after Hurricanes Katrina and Wilma in 2005. After each hurricane the insureds reported property damage to State Farm. They obtained … Continue Reading
When a loss occurs, policyholders must always be mindful of their property insurance policy’s section titled “Duties after Loss.” A policyholder is required to perform specific duties after a loss and failure to meet the obligations may jeopardize a claim.… Continue Reading
In a case recently decided in Texas, the insurance carrier prevailed against the policyholder when the appellate court found that the policyholder failed to adhere to its post-loss duties under a homeowner’s insurance policy.1 This blog entry examines the facts and holdings in the hope policyholders and professionals assisting them can avoid facing a similar … Continue Reading
In my last few posts, wrote about policyholders’ obligations and duties in notifying insurance carriers of a loss and the proof of loss obligations. I focused on New York in particular. What about the duties of insurance carriers once they are notified of a loss by a policyholder? I have heard people say insurance carriers … Continue Reading
Most policies contain language along these lines: In case of a loss to covered property, you must see that the following are done: … f. As often as we reasonably require: … (3) Submit to examination under oath, while not in the presence of any other ‘insured,’ and sign the same. A few of my … Continue Reading
My previous seventeen posts in this blog series have discussed what you are required (or not required) to do under various post-loss / pre-suit insurance policy conditions. This post discusses the extent of “you.” Is “you” just you, or does “you” include your spouse, your family members, your public adjuster, and others? Who is “you” … Continue Reading
When arguing with an adjuster over the value of your personal property claim, receipts can be an invaluable tool. But who keeps receipts? When dealing with theft or loss of property, you may actually have receipts; however in a total loss situation such as a fire, often the receipts are destroyed along with the property. … Continue Reading
Most insurance policies contain a “suit against us” condition that usually reads along these lines: “No action can be brought against us unless the policy provisions have been complied with and the action is started within five (5) years from the date the loss occurs.” So, do pending requests (e.g., loss inspection or document production) … Continue Reading
Insurance policies have certain provisions that must be complied with in a property insurance claim. These are called duties after loss, and if reasonably requested by the insurer, they must be complied with. Recently, an insurer in New York became involved in litigation over whether the policyholder had shown it the damaged property following a … Continue Reading
On October 26, 2012, I touched upon Examinations Under Oath (“EUO”). On June 19, 2009, Chip Merlin also touched upon EUOs. This post expounds upon both posts by responding to pointed questions we recently received in response to Chip’s June 19, 2009, post: (1) Why are some people chosen for EUOs? (2) Should I have … Continue Reading
This blog post is an extension of my December 14, 2012, post, which addressed damage mitigation provisions and a couple different ways that carriers try to wield the insured’s mitigation efforts against the insured. Here is some more food for thought.… Continue Reading
Most policies contain a post-loss condition requiring the insured to “[t]ake the following steps: (1) Protect the property from further damage; (2) Make reasonable and necessary repairs to protect the property; (3) Keep an accurate record of repair expense.” And most policies back that up with “reasonable repair” coverage like this: In the event that … Continue Reading
Most policies contain a post-loss condition requiring the insured to show the insurer damaged property “as often as [the insurer] reasonably require[s].” It is rare to find a policyholder bothered by the fact that an insurance company over-inspected damages during claim adjustment. Sure, sometimes insurers request one inspection after another in an effort to exhaust … Continue Reading
In my October 13, 2012, blog post, I gave an overview of an ongoing blog topic for me – post-claim / pre-suit insurance policy conditions. In my October 26, 2012, blog post, I gave some insight on compliance with an insurer’s request for examination. In my November 2, 2012, blog post, I gave some insight … Continue Reading
In my October 13, 2012, blog post, I gave an overview of what will be an ongoing blog topic for me – post-claim / pre-suit insurance policy conditions. In my October 26, 2012, blog post, I gave some insight on compliance with an insurer’s request for examination. Prospective posts may further address today’s topic, proofs … Continue Reading
An insurer generally may not deny a claim solely because of an insured’s delayed notice of a claim "unless the insurer was substantially prejudiced thereby."1 Typically, the insurer will argue prejudice if the delayed notice impaired its ability to investigate a claim. But what if an insured gave timely notice of a claim, but failed … Continue Reading
