The Townes of Cedar Ridge Condominium Association (“Cedar Ridge”) was damaged as a result of a March 2019 hailstorm. Cedar Ridge informed its insurer, Travelers Indemnity Company of America (“Travelers”), which inspected the complex and concluded that some gutters, downspouts, air conditioning units, and one shingle on one roof had sustained hail damage. As a result, Travelers issued payment for $17,140.88 for the damages it found were covered and denied the remainder of the claim.
Continue Reading Insurer’s Declaratory Judgment Action After Denial Ruled Untimely

Merlin Law Group attorneys Chris Mammel and Tamara Chen-See won an appraisal case pending before the 10th Federal Circuit Court of Appeals.1 The court ruled that the factual determination of damage to brick siding caused by a hailstorm is a factual matter for appraisal and not a coverage issue. The ruling was similar to the recent Connecticut Supreme Court holding involving matching noted in Matching is a Factual Determination and Can Be Resolved by Appraisal.
Continue Reading Insurers Cannot Escape Appraisal Arguing Factual Determinations of Damage Create Coverage Issues

Occasionally, an attorney representing an insured will run into a Motion to Compel Appraisal filed by the carrier’s attorney. Upon receipt of the motion, a few considerations must be made with the most important being:

  1. Is the demand for appraisal timely? and
  2. Is appraisal proper considering the “amount of loss”?
    Continue Reading Amount of Loss: Appraisal Considerations in New Jersey

Appraisal provisions in property insurance policies are intended to provide an alternative dispute resolution process for resolving property insurance claim disputes involving the amount of loss. The amount awarded by the appraisal panel is, with limited exceptions, binding on both parties under the terms of the policy. While the appraisal process is intended to bring finality to a dispute, what happens when the appraisal panel fails to consider certain items due to limitations or restrictions on the scope of the appraisal or unanticipated factual issues not considered by the panel? Such a situation poses the question of whether Colorado appraisal awards preclude any further breach of contract claims for unanticipated circumstances.
Continue Reading Subsequent Claims for Items Not Considered by Appraisal Panel

Following a loss, the issue of replacement with “like kind and quality” often arises whether it be with the replacement of personal property or building materials. The phrase “like kind and quality” is typically not defined in an insurance policy, so whether construction is of “like kind and quality” can easily become a dispute. But is this dispute subject to appraisal?
Continue Reading “Like Kind and Quality” Is an Appraisable Issue

The appraisal clause in a typical residential and commercial property insurance policy provides for an appraisal if the parties disagree as to “the amount of loss.”1 That phrase has been the subject of extensive legal debate between insureds and insurers in terms of its meaning and scope. While most courts have concluded that ascertaining the amount of loss does not include interpreting the policy or making coverage determinations, little guidance has been provided as to what coverage means and whether an appraisal can still proceed even if coverage issues exist.
Continue Reading The Scope of Appraisal in Illinois

The trend continues for courts to interpret the scope of appraisal to include the determination of causation. The Iowa Court of Appeals joins the list of courts stating that the appraisal panel should consider causation in determining the amount of loss. In North Glenn Homeowners Association. v. State Farm Fire & Casualty Company,1 the Court concluded:

Continue Reading The Scope of Appraisal, Part 7: Iowa

This is part two of my earlier post, Florida Appellate Court Defines The Meaning Of The Term "Disinterested" As It Relates To Appraisal Provision, concerning the recent opinion in FIGA v. Branco.1 The 5th DCA opinion discussed the scope of appraisal. This is often a common issue that policyholders and insurance carriers have when a claim proceeds to appraisal – does the dispute concern coverage or amount of loss? Often the insurance carrier will assert that the dispute involves a question of coverage which is not appropriate for appraisal. Appraisal deals with an amount of loss question. Well the Branco case has a good discussion and analysis on this topic.

Continue Reading Florida Appellate Court Opinion Regarding the Extent or Scope of Appraisal