Recent trends of insurers revising the appraisal provisions in insurance policies have clouded the original effect of the appraisal process as an alternative dispute resolution process in lieu of litigation. For many years the insurers reaped a benefit of an appraisal award as a bar to the insured’s breach of contract case after payment of the award pursuant to the policy’s appraisal provision.
Continue Reading Clear Waters of Texas Appraisals – Prompt Payment Claim After Appraisal

Several weeks ago, the Texas Supreme Court issued a trilogy of per curiam opinions: TopDog Properties v. GuideOne National Insurance Company,1 Alvarez v. State Farm Lloyds,2 and Lazos v. State Farm Lloyds,3 and remanded these cases because the trial courts and appellate courts failed to follow the Texas Supreme Court’s opinions in Barbara Technologies Corp. v. State Farm Lloyds,4 and Ortiz v. State Farm Lloyds.5 Except for TopDog which has a unilateral appraisal clause in its policy, all three cases have nearly identical facts.
Continue Reading Policyholders Continue to Prevail As “Top Dogs” – Court Confirms Payment of Appraisal Award Not a Bar to Insurer’s Liability Under Prompt Payment of Claims Act

Last week, the Texas Second Court of Appeals issued Lambert v. State Farm Lloyds,1 which follows the Texas Supreme Court’s recent opinion in Barbara Technologies Corp. v. State Farm Lloyds.2

In a recent blog post, Payment of an Appraisal Award: Is There More, I reviewed Barbara Tech and its companion case, Ortiz v. State Farm Lloyds.3 These two landmark cases hold that an insurer’s full and timely payment of an appraisal award, bars an insured’s causes of action for breach of contract and any common law and statutory bad faith claims, to the extent the bad faith claims seek only actual damages that are considered lost policy benefits.
Continue Reading Invoking Appraisal – Be Careful What You Ask For

Crawford has acknowledged that the insurance industry it serves is not living up to its good faith claims obligation in a recent publication. Here is the confession about the 2017 Hurricane season which it reported in Today’s Large & Complex Claims Landscape: Preparing for the Perfect Storm:

To adequately respond to today’s evolving catastrophe landscape, insurers need to be prepared with contingency plans for their contingency plans to make sure the “perfect storm” of 2017 doesn’t happen again. Through streamlined, coordinated team response, expert scenario planning and the vast knowledgebase of worldwide claims expertise, insurers can rest easy knowing they’re getting the best possible resources working on the frontlines of catastrophe.


Continue Reading Insurance Claim Payment Delay Following Expected Disasters is Epidemic

Current Justices of the Texas Supreme Court

The Texas Supreme Court recently answered the question above in two cases with different results depending on what type of insurance code violations the insured is alleging. The court addressed Texas Insurance Code chapter 542 violations (often called prompt payment of claims) in Barbara Technologies Corporation v. State Farm Lloyds.1
Continue Reading Does Payment of an Appraisal Award Wipe Out Claims Handling Insurance Code Violations?

The Colorado Supreme Court issued two opinions favorable to Colorado policyholders earlier this week:

  1. American Family Mutual Insurance Company v. Barriga; and
  2. Rooftop Restoration, Inc. v. American Family Mutual Insurance Company.

Both cases address the unreasonable delay or denial of insurance benefits statute in Colorado. This post addresses the Barriga opinion, and the Rooftop Restoration, Inc. will be discussed in the coming days.
Continue Reading Colorado Supreme Court Clarifies Unreasonable Delay or Denial Statute

Almost every policy I read contains an appraisal clause in it. These clauses often allow one party to demand appraisal to set the amount of loss in an insurance claim. Simply put if the insured and insurer disagree on the dollar amount to fix covered damage the appraisal policy can be used to determine the dollar amount of the damage.
Continue Reading Prompt Payment Statute Penalties Not Applicable to Post-Appraisal Payments