"Maybe if we think and wish and hope and pray it might come true"
            –The Beach Boys

A recent Florida case that involves examinations under oath demonstrates that insurers should  cooperate with policyholders and not try to use technicalities to prevent payment. In First Home Ins. Co. v. Fleurimond, 3D09-2034, 2010 WL 2178839 (Fla. 3rd DCA June 2, 2010), policyholders were allegedly yelled at and badgered during an examination under oath. They left, obtained counsel, and the insurer then refused to reconvene the examination under oath. The policyholders filed suit, demanded an appraisal, and the insurer refused. The trial court ruled that the matter should proceed to appraisal, and the insurer appealed.

Continue Reading Insurers Should be Nice and Cooperate with Policyholders During Post Loss Obligations

(Note: This guest blog is by Sergio Leal, an attorney with Merlin Law Group in the Houston, Texas, office).

The appraisal process has been around for a long time, and it is not going anywhere anytime soon. In fact, records indicate that the Texas Supreme Court has enforced appraisal clauses in insurance policies as far back as 1888. Typically, appraisal clauses do not specify a time frame for when a party can invoke the appraisal process. Many of you out there might think that this means that a carrier can invoke the appraisal process whenever it wants. However, that is not necessarily the case.

Continue Reading Texas Insurance Law: When a Carrier Waives its Right to Appraisal

(Note: This Guest Blog is by Javier Delgado, an attorney with Merlin Law Group in the Houston, Texas, office. This is the eighth in a series he and fellow attorney Tina Nicholson will be writing on Texas property insurance issues).

Often times, an insurance adjuster fails to properly investigate the damages to the insured risk and does not properly evaluate the obvious insurance exclusions for many reasons. After suffering a loss, the insured a business owner is making decisions to get the business up and running as soon as possible, and many of those decisions are based upon the representations of the adjuster, or the lack of information given by the adjuster. The business decisions of whether to move to new location, lease more of the building to offset the additional costs or debt, replace or repair the improvements and betterments installed by a tenant, hire security to protect the premises, purchase a new policy that will cover theft and vandalism on a vacant building thought to be insured under the existing policy, etc., have a significant impact on the amount of money the insured will pay out of pocket and may never recover under the policy.

Continue Reading Waiver and Estoppel – Insurance Companies Must Assert Their Applicable Exclusion or Limitation When the Insured Makes the Claim

(Note: This Guest Blog is by Corey Harris, an attorney with Merlin Law Group in the Tampa, Florida, office. This is the fourth part in a series he is writing on post-loss duties).

Last week, I received a great question regarding my post, Who Can Accept My Notice of Loss. The entire question and my response are rather long to re-post, but the gist of the question was:

Continue Reading The Basics of Agency as It Relates to Waiver and Estoppel

Recently, I was handling a case where I felt the insurer had waived its right to a Proof of Loss. In this particular case, the insurer initially demanded a Proof but when the policyholder contacted the adjuster to inquire about the specific requirements, the adjuster specifically told the client the obligation was being waived…
Continue Reading Filing a Proof of Loss When It is Not Required

(Note: This Guest Blog is by Corey Harris, an attorney with Merlin Law Group in the Tampa, Florida, office. This is the fifth of a twelve part series he is writing on proof of loss).

Let me begin here by saying that this is only intended to be a general overview of some of the instances where an insurance company may have waived its Proof of Loss requirement. Determining whether a waiver has indeed occurred is usually very fact specific and can vary in different jurisdictions. Proof of Loss requirements under the National Flood Insurance Program, for instance, are very strict and allow waiver only in very limited circumstances. Thus, any waiver questions should be viewed and analyzed on a case by case basis.

Continue Reading Proof of Loss: Waiver, Part I