After Hurricane Georges hit Puerto Rico in September of 1998, many policyholders considered that their claims were unfairly denied due to the ambiguous language in their policies. The main issue was that the policies did not have a specific deductible language for hurricane damage. If the policy did not have specific deductible language for hurricane, the insurance companies would apply the wind damage deductible but, in some claims, they applied the deductible classified under “basic damages.” Many of the policyholders filed complaints in the Insurance Commissioner’s Office against the insurance companies for the ambiguity in the language related to hurricane damage deductible. Some of those cases were then appealed. Below is what the Court of Appeals of Puerto Rico held in United Surety & Indemnity Company v. Insurance Commissioner of Puerto Rico,1 regarding this issue.
Continue Reading Is it Correct for Your Insurance Company to Consider Windstorm Damage Synonymous with Hurricane Damage?

What exactly is a Named Windstorm? Many policyholders ask this very question following hurricanes, tropical storms, tornados, and other storms with high winds. A New Jersey Appellate panel recently questioned parties about the purpose of a “named windstorm” definition in insurance policies. This is just the most recent update to the continued saga of New Jersey Transit’s attempt to receive $400 million in insurance coverage under their policies with Lloyd’s of London and other insurance companies stemming from a Superstorm Sandy loss.
Continue Reading What Exactly is a “Named Windstorm?” More Views As Appellate Case Progresses

As I sit in my living room writing this blog, my home is being bombarded by what I consider a freakishly violent windstorm. I contemplated videotaping the windstorm but as the night wears on, I find the howling winds and bent trees to be too disturbing to watch. It’s not very often that Southern California has winds of these magnitude. The weather report indicates sustained winds of 25-40 mph with gusts of 60 to 70 mph.


Continue Reading Windstorm Rocking Southern California Bound to bring Insurance Claims

This is a quote from a recent trial court order in a New York state case where Nationwide asked the judge to decide in its favor without submitting the case to the jury. Congregation Chesed L’Avraham d/b/a V’Kollel Ohel Moshe Society v. Nationwide Mutual Insurance Co., No. 19954/09 (N.Y.S. Sup.Ct. Kings County 2011). Since the practice of law is an art, there is not a bright line rule as to when the facts of a case support an insurance company’s motion for summary judgment. Some insurers file them regularly to see if they can get a favorable ruling without the need for a jury trial.

Continue Reading “Credibility Determinations, The Weighing Of The Evidence, And The Drawing Of Legitimate Inferences From The Facts Are Jury Functions, Not Those Of A Judge…On A Motion For Summary Judgment”

Two weeks ago, Southern California experienced unusually strong Santa Ana winds which brought gusts up to 140 mph in some places. Southern Californians, particularly in the Pasadena area, were forced to clean up debris left by the storm. A staggering 18,000 tons of debris was cleaned up in Pasadena, which is the city’s normal total for one year. Parts of Pasadena were left without power for seven days; approximately 419,000 customers effected by the outages at one time. The State estimates that the hurricane force winds caused at least $40 million in damage.


Continue Reading Southern California Braces for More Strong Winds; Damage to Structure Interiors May Not Be Covered

Adjusters hate to listen to lawyers pontificate about case law. I know because of surveys we have done asking adjusters what they want to get out of presentations and how they best can learn. Instead, adjusters want lawyers that are making presentations to explain the practical implications of how they can better do their job.


Continue Reading Practical Points From Gulf Coast Case Law Update

Insurance defense attorneys will not agree with this post. However, they fear the argument enough to falsely argue in some cases that a hurricane is not a “windstorm,” in order to avoid policy language that may provide coverage for total losses where wind and water combine to destroy a structure. As promised in yesterday morning’s post, The Insurance Industry Recognizes Hurricanes are "Windstorms"–An Important Admission, I am providing legal suggestions to help TWIA policyholders and others “slabbed” to obtain full coverage for their losses. Randy Santa Cruz, William Weatherly, and I came up with this idea while working in Mississippi following the devastation of Hurricane Katrina. I’ve attached a draft memorandum of law so others may use this argument with their own facts and policy language.


Continue Reading Total Destruction Caused By Hurricane Wind and Flood May Be Covered Under the Additional Coverage of Collapse: Why Defining a “Hurricane” as a “Windstorm” is Significant

Zurich Insurance Company has a new web site, Zurich HelpPoint Windstorm. Zurich’s risk engineering and claims groups recently unveiled a micro-web site which provides Zurich customers and distributors with tools and information to help them prepare for, and recover from, “windstorm” events in North America. Some insurance company attorneys have been arguing that a “windstorm” is only the “wind” part of a hurricane and not the entire tropical cyclone that has wind, storm surge, and everything else that causes damage from a tropical windstorm. Their clients know better, but it does not prevent defense attorneys from arguing this unsupported bad faith position.


Continue Reading The Insurance Industry Recognizes Hurricanes are “Windstorms”–An Important Admission

As the New York Times explained, mobile homes burn easily. Governor Arnold Schwarzenegger called for a review of building standards following the complete destruction of 500 manufactured homes in the Oakridge Mobile Home Park. California building officials have noted that building regulations must be strengthened to account for the wildfire hazards in California. Regulators asking for tougher building codes to prevent widespread catastrophe are nothing new and, in the long term, are generally good for society and insurance companies.


Continue Reading What Do Katrina, Ike, And The California Wild Fires Have In Common?