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You are here: Home / Archives for Policy Conditions/Prerequisites

Court Finds Animals Incapable of Vandalism or Malicious Mischief for Insurance Purposes (and all other purposes, too)

October 31, 2019 by Alex B. Silverman

I am willing to go out on a limb and say that if asked whether an animal, say, a raccoon, is capable of committing malicious criminal acts, most humans would agree that the issue is beyond dispute. But, alas, most humans would be wrong (apparently it very much can be disputed). There is good news, however. The nation’s courts have been quietly tackling the issue, and, thankfully, they have been able to allay any fear of a raccoon uprising occurring in the near future. A ... Keep Reading »

The Conflict Between Choice-of-Law Provisions in Insurance Policies and a State’s Fundamental Public Policy

October 18, 2019 by Carlton Fields

Large clock tower

Many contracts include a choice-of-law provision in which the parties agree to use a particular jurisdiction's set of laws to govern the contract. These provisions promote predictability. No matter where a dispute may arise under the contract, the contract will always be interpreted under the laws of the chosen jurisdiction. This practice of including choice-of-law provisions extends to policies of insurance. However, these choice-of-law provisions are not always ... Keep Reading »

Appraise Away Says Florida’s Fifth DCA

September 24, 2019 by Andrew Daechsel

Tug of war with rope with a stack of coins on top

Many homeowners insurance policies allow the insurer or the insured to invoke appraisal to resolve disagreements about the amount of the loss. Nonetheless, when one party invokes appraisal, the other party will sometimes refuse to participate in the process, forcing the party invoking appraisal to obtain a court order compelling the other party to participate. Fortunately, the recent decision in Underwriters at Lloyd's, London, ICAT Syndicate 4242 v. Sorgenfrei, No. ... Keep Reading »

The Insurer’s Howler, or How Travelers Proved Its Insured’s Case

September 16, 2019 by D. Barret Broussard

Surfer falling off his board

What happens when an insurer presents evidence at trial that supports the insured's case? Answer: The evidence can be used to sustain the jury verdict for the insured-plaintiff. That is the lesson learned by Travelers in the Connecticut Supreme Court, despite: (1) Travelers' moving for directed verdict after the plaintiff's case-in-chief; (2) the trial court's reserving its ruling until after the defense's case; and (3) Travelers' renewing its motion for directed ... Keep Reading »

Florida Legislature Passes Sweeping Assignment of Benefits Legislation

April 30, 2019 by Andrew Daechsel

Florida Property Insurance Beach House

Significant changes appear to be in the pipeline for Florida property insurers after the Florida legislature passed sweeping assignment of benefits (AOB) reform legislation last week. If the legislation is signed into law (Governor DeSantis has indicated it will be), it will take effect on July 1, 2019. The legislation applies to residential and commercial property insurance policies and includes new restrictions on AOBs, changes to the fee-shifting framework for AOB ... Keep Reading »

Related Decisions: Three Recent Cases Emphasize Breadth of “Related Wrongful Acts”

November 30, 2018 by Daniel G. Enriquez

Lady Justice

Third-party liability policies often include aggregation clauses. As the name suggests, these clauses aggregate "related claims" or "interrelated wrongful acts" into one claim or occurrence. This provides the parties with certainty as to when a claim was "first made" or when an occurrence "first occurred." These clauses often lead to litigation, with carriers and policyholders asserting narrow or broad readings of the language, depending on the desired result. A trio ... Keep Reading »

Florida Court Enforces Condition on Post-Loss Assignment of Benefits, Creating Conflict Between District Courts of Appeal

September 7, 2018 by Heidi Hudson Raschke

As we have reported, an assignment of benefits (AOB) is a legal tool that allows a third party, like a contractor, to be paid for services performed, like repairs following an insured loss, for an insured property owner who would normally be reimbursed by the insurance company directly after making a claim. Most AOBs allow the contractor to stand in the shoes of the property owner for insurance collection purposes. Such post-loss assignments are enforceable in most ... Keep Reading »

Defining ‘Logical Connection’: NC Federal Court Tackles ‘Related Claims’

July 6, 2018 by Daniel G. Enriquez

Insurance carriers and policyholders often argue about the scope of policy provisions. Generally, policyholders take an expansive view of insuring agreements, while carriers often construe them more narrowly. But not all coverage arguments follow these familiar lines. Take, for instance, the “related claims” debate. Most third-party liability policies contain aggregation language. Such policies deem “related claims” to be a single claim “first made” when the first ... Keep Reading »

Opening the Pandora’s Box of Flood Policies, or How Filing Suit Against Flood Insurers Can Effectively Reduce the Suit Limitations Period

February 16, 2018 by Jason Morris

When is an insurer’s “Rejection of Proof of Loss” letter for flood insurance damage, which states on its face that it “is not a denial of your claim,” nevertheless a written denial of claim? According to the Third Circuit in Migliaro v. Fidelity National Indemnity Ins. Co., No. 17-1434 (3d Cir. Jan. 29, 2018), the answer is whenever “the policyholder treats it as such by filing suit against the carrier.” If a flood policyholder treats a proof of loss rejection as a claim ... Keep Reading »

No Coverage for Hole-In-One Contest, Says Fore-th Circuit Court of Appeals

January 26, 2018 by Gregory Gidus

Golf Tee

They say a bad day on the golf course is better than a good day at work. For Old White Charities, Inc., a non-profit that conducted a hole-in-one contest during the Greenbrier Classic Pro-Am golf tournament, this could not be further from the truth. In All Risks, Ltd. v. Old White Charities, Inc., No. 17-1180 (4th Cir. Dec. 20, 2017), the Fourth Circuit affirmed the district court’s grant of summary judgment to insurers because Old White failed to satisfy the policy ... Keep Reading »

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