This was an issue recently in a Florida case from the Second District Court of Appeal, Jyurovat v. Universal Property & Casualty Ins. Co., No. 2D11–712 (Fla. 2d DCA April 13, 2012). The Court stated “[t]he insurance policy does not address a breakdown in the appraisal process.” The policyholder’s appraiser had fired the neutral umpire from the appraisal process, apparently being dissatisfied with the pace of the umpire’s efforts.

Continue Reading What Are The Parties To Do When There Is A Breakdown In The Appraisal Process?

Hurricane Wilma litigation carries on in Florida courts, now almost 6 and a half years after the storm. One issue often raised in the litigation is timely notice of the claim. While policies differ, most require that the insured provide notice of a loss to the insurer with some degree of expediency. Late notice of a claim is generally ground for an insurer’s defense in not paying the claim. Whether notice was timely is generally a question of fact for the jury that precludes summary judgment. However, a South Florida federal court reminded us a few weeks ago that this is not always the case.

Continue Reading Summary Judgment on Late Notice Even Without Per Se Deadlines

Last month, in Service One Cable T.V., Inc. v. Scottsdale Ins. Co., 2011-1469 (La. App. 1st Cir. February 10, 2012), the Louisiana First Circuit Court of Appeals decided that a cable service company did not have coverage under its commercial property damage or business income provision after a hurricane damaged the company’s cable distribution system.

Continue Reading Will Your Business Be Covered When It Needs it The Most? – Understanding Business Interruption Claims

Earlier this month, I wrote about a few cases where insurance company motions for summary judgment failed. This week, I am writing about another. Although I prefer to write about reported appellate opinions, the state trial court opinion in Carden v. Allstate Insurance Company, issued by New York’s Supreme Court in Westchester County in December 2010, is of interest to policyholders both in New York and elsewhere.

Continue Reading Carrier’s Motion for Summary Judgment Does Not Hold Water

In yet another “which came first, the wind or the water” debate over hurricane damage, the Fifth Circuit Court of Appeals recently analyzed whether so called “self-serving” affidavits could be used to get the case past summary judgment and on to the jury.

Continue Reading “Self-Serving” Affidavits Move Hurricane Damage Case Past Summary Judgment

Last week in my post titled Carrier’s Motion for Partial Summary Judgment in Bad Faith Action Denied, I wrote about a court in Ohio that denied a carrier’s motion for summary judgment. In that case, the carrier asked the Court to find that it did not act in bad faith when using fraud as a basis to deny coverage for a fire loss. This week, I am writing about a case in South Carolina where another insurance company’s motion for summary judgment was also denied.

Continue Reading Carriers’ Motions for Summary Judgment Don’t Always Hold Water

In the case of Garcia v. State Farm Lloyds, 287 S.W.3d 809 (Tex. App.—Corpus Christi 2009, pet filed.), the Texas Court of Appeals reversed the lower trial court’s summary judgment ruling in favor of State Farm with respect to certain water damage. In Garcia, State Farm argued that the insureds’ failed to raise a fact issue because they did not demonstrate the amount they actually spent on repairs, and they failed to show that they spent more than the amount already paid by State Farm. The appellate court noted that although State Farm’s arguments were good, State Farm bore the initial burden to prove that no genuine issue of material fact existed with respect to the Garcia’s breach of contract claim.

Continue Reading No Summary Judgment in Texas for Insurance Company when Repairs Had Not Been Completed

Guideone Mut. Ins. Co. v. Rock,
1:06-CV-218, 2009 U.S. Dist. LEXIS 54717
(N.D. Miss. June 29, 2009)

On August 27, 2005, the Rocks’ home and two vehicles were destroyed by a fire. The Rocks had a homeowner’s and auto insurance policy with Guideone Mutual Insurance Company. Following the Rocks’ loss, the Rocks filed claims with their insurer for damage to their home, damage to the contents of their home, and vehicle damage.

On July 31, 2006 Guideone denied the Rocks’ insurance claims. Guideone denied the claims based on alleged material misrepresentations regarding Mr. Rock’s criminal history on the homeowner’s insurance policy application, and the Rocks’ failure to comply with their contractual duties throughout the claim investigations, such as concealment regarding their claims, intentional acts, and failure to produce their children for examinations under oath.

Continue Reading Mississippi Federal Court: An Insured Cannot Misrepresent if the Insured is Not Asked

Surplus lines insurance companies are a different breed of insurance cat. They are not admitted carriers in the state in which they do business. Thus, most states have consumer protection laws specifically regarding how surplus lines insurance carriers can do business.

Surplus lines carriers are very important to the insurance marketplace. They will often insure the risks many admitted carriers find too risky or novel. For example, when a property owner buys surplus flood insurance or a complex Difference in Conditions policy, it is often sold through the surplus lines market.

Continue Reading Surplus Lines Insurers, Sinkholes, and the Law of Mars