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Why Has State Farm Stopped Paying Appraisal Awards?

State Farm has a new claims process involving appraisal. The problem for many policyholders is that it is often resulting in payment for amounts less than the appraisal panel decided—sometimes, nothing is paid. How does it work? State Farm has a new appraisal section that reviews appraisal awards from weather events. It consists of four... Continue Reading

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Should Umpires Be Allowed to Have Ex Parte Communications With Appraisers? — The Colorado 2015 Revision to DORA Bulletin No. B-5.26

The Property Loss Appraisal Network (P.L.A.N.) is holding its appraisal and umpire and certification course in Denver. It was a pleasure for me to speak at this event. In my preparation, I noticed that when I searched Google for DORA Bulletin No. B-5.26, the 2011 and 2014 editions were easily found. However, a revision issued... Continue Reading

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Sewage and Backups From Sewers—Always Check For the Changing Case Law

Case, statutory, and regulatory law changes. Insurance policies change language. Property insurance law is always in a state of flux. A fairly recent example is an Ohio case discussing sewage backup and overflow which found for a policyholder but was then reversed by the Ohio Supreme Court.1 The bottom line holding and discussion overruling the... Continue Reading

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Merlin Law Group Chicago Wins Wisconsin Trial—It Does Not Come Easy

Mike Duffy sent me the jury verdict questionnaire form early yesterday morning. He and Christina Phillips were in a trial representing a condominium association in Wisconsin. After I read it, I asked how we could win because the questions seemed so unfair. It seemed impossible. Then Mike Duffy wrote back about Christina Phillips’s tremendous job... Continue Reading

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Federal Flood Claim—File a Timely Proof of Loss Even If Claim Denied

A recent case1 shows that every technical step regarding proof of loss requirements in the flood claims process has to be followed, even if the steps are meaningless. Federal law regarding flood claims is draconian. It is the worst law against policyholders. Attempts at legal reform of the claims processes have fallen on deaf ears.... Continue Reading

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The Roofing Claim Video

Roofing damage claims are the most common and contentious adjustment experiences. This video went viral. From speaking with many restoration contractors and public adjusters, the events of this video are unfortunately repeated more often than not. Please take some time to read through the comments section. There are a number of former adjusters who write... Continue Reading

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How & why to report application changes ASAP

Did you recently get a new job or have a baby? Changes to your expected income for 2022 or your household size may impact your health coverage options or amount of savings you qualify for. It’s important to let the Marketplace know immediately after you experience a change so you don’t miss out on new, better options or owe money when you file next year’s taxes.

Let the Marketplace know about these changes:

• Getting higher or lower income from when you applied
• Adding or losing household members, like through birth or adoption
• Getting offers of other health coverage, like someone in your household getting an offer of job-based insurance or becoming eligible for Medicaid, the Children’s Health Insurance Program, or Medicare

Get the full list of changes to report.

How to report changes on your application

• Update your application online by following these steps
• Call us to speak to a representative who can help you update
• Find someone in your community who can work with you to make changes

Learn more about reporting income and household changes after you're enrolled.

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Is Wind Driven Rain Covered? Is Water Damage Occurring Over Many Years From Rainstorms Covered?

A motion for summary judgment motion1 caught my attention because the argument is that wind driven rain and water damage occurring for many years is covered by a condominium’s insurance policy. The case is pending in Washington federal court and applies Washington state insurance law. The introduction to the motion indicated the following: This lawsuit... Continue Reading

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CAPIA Conference on Earthquake & Earth Movement on August 25—With an Appraiser and Umpire Certification Class on August 24

The California Association of Public Insurance Adjusters (CAPIA) is hosting a two-day conference on August 24 and 25. The details are as follows: CAPIA Conference on Earthquake & Earth Movement August 24-25, 2022 at Second Home in Los Angeles, CA. Registrants can sign up for day one, day two, or both days. Registration for the... Continue Reading

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How Not To Win A Bad Faith Hail Damage Case

If you want to win a bad faith case, you better hire attorneys that are contenders and not pretenders. Bad faith cases are not easy, and the term is overused by those ignorant on the topic. Larry Bache told me a story about a relatively new attorney from another firm on the speaking circuit who... Continue Reading

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