I was in attendance at a conference in Denver yesterday when an expert toxicologist suggested that there is evidence of many insurance company wildfire testing companies looking for smoke and toxic residue in all the wrong places. It reminded me of a conference I was at last week in California, where a claims expert warned …
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Why You Must Bring More Than Invoices: What Public Adjusters and Policyholders Must Learn About Proof of Damages
By Chip Merlin
In a recent decision that should raise red flags for public adjusters and policyholders, a federal judge granted summary judgment in favor of Indian Harbor Insurance Company. 1 The ruling is a lesson that when it comes to insurance claims and litigation, it is not enough to argue about fairness or merely present repair invoices. ……
The Role of the Examination Under Oath and Procedural Compliance with Insurer Demands
By Chip Merlin
I will deliver a presentation at the Annual Meeting of the National Association of Public Insurance Adjusters (NAPIA) next month, focusing on two cornerstones of property insurance claims: proofs of loss and examinations under oath. It’s a topic I first addressed for NAPIA exactly forty years ago. This year’s session will be something of an ……
NFIP Escapes Payment with Form Over Substance Rules: The Need for Reform of the National Flood Insurance Program
By Chip Merlin
A recent appellate decision in Woodland Villas Condominiums v. Wright National Flood Insurance Company 1 highlights a harsh reality for policyholders seeking to recover under the National Flood Insurance Program (NFIP). Strict compliance with federal procedural requirements, especially the federal proof of loss requirement, can override substantive claims for damages, even when there is no real ……
Vacancy, Occupancy, and Arson Will Always Invite Coverage Issues
By Chip Merlin
A federal Arkansas court issued a recent ruling that reminds everyone in the property insurance claims business of the serious consequences policyholders face when the insured building is vacant or unoccupied. 1 Kenneth Milligan purchased a long-vacant house for $7,000 and immediately obtained a landlord insurance policy from Travelers Personal Insurance Company. The policy came ……
What Do Judges Consider When Selecting Umpires? Proximity Is a Factor
By Chip Merlin
A United States District Court for the District of Hawai‘i recently issued an order that highlights a critical but sometimes overlooked geographic proximity factor in the appointment of appraisal umpires. 1 Though both parties proposed highly qualified retired judges to serve as umpire in a court-ordered appraisal, the court ultimately appointed the Honorable James E. ……
Why Did a Judge Select the Policyholder’s Umpire Over State Farm’s Nominees?
By Chip Merlin
What do judges look for in the appointment of an umpire? Insurance disputes requiring appraisal make the selection of a neutral umpire a critical turning point. Assuming the appraisers reach an impasse, the umpire becomes the tie-breaking person. In a recent federal case arising from a property damage claim, the court was asked to break ……
Underinsured and Unprotected: Are California Insurance Agents to Blame?
By Chip Merlin
The devastating wildfires that have ravaged California in recent years show that an increasingly disturbing pattern has emerged, demonstrating that most homeowners discover they are grossly underinsured when they attempt to rebuild. A recent in-depth investigative report by the San Francisco Chronicle, “A Broken System is Keeping California Homes Underinsured. Millions Have No Idea They’re at Risk,” shed ……
The Unappreciated Role of the Insurance Defense Attorney
By Chip Merlin
It’s easy to fall into the trap of demonizing the lawyers on the other side. I’ll admit that I’ve done it myself. When you advocate for policyholders, as I have for decades, you get used to seeing insurance company attorneys as obstacles. These are professionals who stand in the way of justice for your client. ……
Understanding the Total Constructive Loss Doctrine in Property Insurance Policies
By Chip Merlin
Hugh Wood’s 1994 University of Miami Law Review comment, The Insurance Fallout Following Hurricane Andrew: Whether Insurance Companies Are Legally Obligated to Pay for Building Code Upgrades Despite the “Ordinance Or Law” Exclusion Contained in Most Homeowners Policies, 1 is an important discussion about the “constructive total loss” doctrine at the center of the post-Hurricane Andrew coverage fights. The article ……