Stone Creek Condominium Owners Association, Inc. (“Stone Creek”),1 suffered a hail loss in 2016 for which it submitted a claim to its property insurance carrier, Charter Oak Fire Insurance Company (“Charter”). Charter inspected and issued payment in accordance with its estimate. Charter determined that four of the twenty buildings had sustained damage, although no damage was noted to any of the roofs.
Continue Reading Jury to Decide if Adjuster’s Instruction to Insured Waived Date of Loss

Corey Harris and I will present a final discussion about proofs of loss, analyze a case about forfeiture of insurance benefits, and discuss claim implications from impending Tropical Storm Cristobal. This discussion will be held at 2 pm EST today.
Continue Reading Proofs of Loss, Avoiding Forfeiture of Coverage Benefits, and Tropical Storm Cristobal — Check In with Chip Merlin and Corey Harris at 2PM

Iris Kuhn

The purpose of Section 627.7015, Florida Statutes titled “Alternative procedure for resolution of disputed property insurance claims” is to encourage insurance companies and policyholders to resolve their disagreements regarding disputed property insurance claims without the necessity of litigation or appraisal. The statute requires, in part:

(2) At the time a first-party claim within the scope of this section is filed by the policyholder, the insurer shall notify the policyholder of its right to participate in the mediation program under this section.1
Continue Reading Can An Insurer Waive Its Right to Appraisal?

Florida’s Federal Middle District believes it can.1 After Hurricane Irma struck its commercial building in Port Charlotte, Florida, building owners Etcetera, Etc, Inc., filed an insurance claim under their policy with Evanston Insurance Company (“Evanston”). Evanston began its investigation, and as that was underway Charlotte County also inspected the building and issued a “Notice of Unsafe Building” stating the building “was in danger of collapse.”
Continue Reading Can Appraisal Take Place Over Property That Has Been Demolished?

It happens frequently: The insurance company admits the policy covered part of the loss but refuses payment at the time because the amount of the loss falls below the deductible. The insurer then admits the insured also suffered other damages to the property, but denies coverage for this damage for a variety of exclusions or limitations. The insured then files suit. But what happens when the insurer, after it has answered the suit and made a jury demand, invokes the appraisal provision?
Continue Reading Does a Partial Denial and Jury Demand Prohibit the Insurer From Proceeding with Appraisal?

Several posts on this blog have discussed how important it is to request appraisal timely and to not act inconsistently with the right to appraisal—or it can be waived. Actively litigating a case has been held to be a waiver of appraisal. There has been another recent case in Florida dealing with this issue.1

Continue Reading Policyholder Waits Too Long to Request Appraisal–So “Waive” Goodbye to the Appraisal Remedy

Recently, Florida’s Fifth District Court of Appeal affirmed an order compelling Florida Insurance Guaranty Association (FIGA) to participate in an appraisal of a policyholder’s sinkhole claim.1 The insureds had originally filed suit against Homewise Preferred Insurance Company in 2010, after Homewise denied coverage. But in 2012, FIGA notified the insureds that it was assuming the handling of the claim because Homewise had become insolvent and, for the first time, FIGA admitted that the sinkhole claim was covered under the subject policy.


Continue Reading Question of Whether Insured Waived Appraisal Should Focus on Conduct After Coverage Has Been Admitted

In Dike v. Valley Forge Insurance Company,1 U.S. District Judge Lee Rosenthal ruled that the insurer’s compliance with the policy’s claims handling provisions and with provisions of Texas Insurance Code were not conditions precedent for compelling appraisal; and the carrier’s delay in seeking appraisal did not waive insurer’s right to appraisal.


Continue Reading When is a Showing of Prejudice Required to Determine Waiver of Appraisal

Recently Florida’s Fifth District Court of Appeal (“5th DCA”) issued a ruling related to whether a policyholder had waived the right to participate in the appraisal process.1 The right to participate in appraisal under the policy can be waived if actions are taken that are inconsistent with that right.


Continue Reading Recent Florida Appellate Court Case Involving Waiver Of Appraisal

Insurance applications are important in the insurance marketplace. Applications are part of the risk analysis insurers make in determining whether they will issue a policy. There is exhaustive case law on issues of misrepresentations, ambiguities, and incomplete applications. The issue I want to discuss is whether an insurer can waive its right to deny a claim based on an application misrepresentation.


Continue Reading In North Carolina, the Insurer Can Waive Its Right to Claim Forfeiture