Insurance adjusters and their attorneys should demand examinations under oath on a timely basis. Prompt adjustment requires it. However, the current technique and growing practice by many insurers is to request an examination months and even years after the loss. Sometimes, the demands are made after suit has been filed. This is a wrongful delay tactic that needs to stop.


Continue Reading Timing of Examinations Under Oath and a Practical Tip to Speed the Claims Process

Sandy Burnette won an appeal and had a matter remanded for appraisal. In American Capital Assurance Corp v. Courtney Meadows Apartment, 35 Fla. L. Weekly D802a (Fla. 1st DCA  April 7, 2010), the court held:

[T]here is no language in the policy that requires appraisal to be invoked, if at all, within any set time from receiving or waiving the sworn proof of loss. Thus, under the terms of the instant policy, the insurer’s demand for appraisal was not untimely. Furthermore, the insurer has not waived its right to appraisal as it has not acted inconsistently with that right from the time of demand…

Accordingly, because the insurance contract provided for appraisal, the insurer’s demand for such was not untimely, and the insurer did not waive its right to appraisal, the trial court erred in partially denying the motion to compel appraisal.


Continue Reading Appraisal Ordered Where Insurer’s Demand Found Timely—And No Appraisal if No Adjustment

Imagine a situation where a butcher sliced some meat you ordered, weighed your cut, and then told you that you owed $43.79—but refused to tell you how he calculated the price. Would you simply agree and pay the butcher? Of course not. But this is what happens all the time when insurers refuse to turn over engineering reports or honestly explain how evaluations of damage were arrived.


Continue Reading Insurance Companies Have a Good Faith Obligation to Share Evaluations of Damage and Engineering Reports With Their Customers

Yesterday’s post, Appraisals Better Be Won Because They are Difficult to Overturn–Even if Unfair in Result or Procedure, generated a comment which I spent considerable time thinking about and responding to last night. I appreciate everyone that takes time to post comments to this blog. Many regular readers are from insurance companies, independent adjusting firms, insurance defense counsel, and those with interests and opinions often opposed to mine . The free exchange of ideas is important. True learning often results from the difficulty of understanding and respecting different views and philosophies.


Continue Reading Appraisers, Umpires and Appraisals as Valid Substitutions for the Right to a Jury Trial Depend on Viewpoint

Fire was the major peril insured by the insurance industry over a hundred years ago. In the tradition that is still commonplace today, insurers wrote specific exclusions into the insurance contracts which limited when they had to pay for loss caused by fire. I guess my friends along the coasts of Mississippi and Texas could relate when they found their all-risk insurance policies which cover hurricanes excluded damage from the waters that came with the hurricane.


Continue Reading Fireworks are Loved by Americans–and Insurance Companies Seeking Not to Pay Fourth of July Fires

The insurance industry is probably calling and writing the editors of the FC&S Bulletin because the June 2009 edition correctly notes that Ensuing Loss Damage is covered under the ISO form policies for typical Chinese Drywall losses. I recently noted various coverage issues related to Chinese Drywall. A number of these cases are coming to our office because insurers are not affording first party coverage.


Continue Reading FC&S Says Ensuing Loss Coverage Applies to Chinese Drywall Claims

Why are major insurance companies selling insurance with "feel good" messages rather than explaining how many different types of accidents and catastrophes they will not cover? If they were honest, wouldn’t they explain to customers what is not covered before the purchase? Sandy Burnette wrote a comment to "Is the State Farm Policy Really Worth Anything?" As I indicated in yesterday’s "Some Public Adjuster and Insurance Attorney Concerns and My Blogging Mistakes," he made a valid criticism which I corrected and appreciate him calling to my attention.


Continue Reading The Dirty Secret of Exclusions Some Major Insurance Companies Like State Farm, Allstate, Nationwide and even USAA, Do Not Want You to Think About

When you write things for the public, mistakes and opposite views will be pointed out. The public nature of blogging is a relatively new experience for me. I speak, write, and advocate in private all the time. Indeed, most of what I do on behalf of clients is very private. Further, some public matters and cases later become private matters much to the chagrin of third parties. So, regarding this Blog, I appreciate comments that point out when I am wrong or when there is a differing opinion or explanation.


Continue Reading Some Public Adjuster and Insurance Attorney Concerns and My Blogging Mistakes

Paul Butler was my first legal mentor. John Pappas was a classmate of mine at the University of Florida School of Law, and the best man in my wedding. They have built a hundred attorney law firm representing solely insurance companies. We have cases against them all the time. As they are physically located several floors below us in the same office building, and both David Pettinato and I worked at the firm in different eras, we have a pretty good idea of what our familiar foes are about.


Continue Reading Butler Pappas–A Familiar Foe