Claim and Insurance - Insurance Industry Brief

Report: Long COVID Accounted for Three Quarters of California Comp Virus Claim Payments

Insurance Journal

JUNE 3, 2025

of the treatment payments on COVID claims and 73.7% of all COVID-19 claim payments in California’s workers’ compensation system, according to a study. Long COVID cases accounted for 82.1% The study from the California Workers’ Compensation Institute shows one-in-21 California …

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Understanding Leadership from Inside the Insurance Claims Machine: Reflections on Mike Fiato’s Vision

Property Insurance Coverage Law

MAY 13, 2025

The Senate Subcommittee on Disaster Management will hold a hearing this afternoon titled Examining the Insurance Industrys Claims Practices Following Recent Natural Disasters. Among those testifying is Mike Fiato, Executive Vice President and Chief Claims Officer at Allstate.

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Top Mistakes That Can Destroy Your Flood Insurance Claim

Property Insurance Coverage Law

MAY 27, 2025

Westfield Insurance Company 1 shows how even well-intentioned policyholders can lose a flood insurance claim before their lawsuit ever begins. A recent court decision in Sublett v. This case is not just about a technical legal loss.

Insurance Claim

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Top Mistakes That Can Destroy Your Flood Insurance Claim

Property Insurance Coverage Law

MAY 27, 2025

Westfield Insurance Company 1 shows how even well-intentioned policyholders can lose a flood insurance claim before their lawsuit ever begins. A recent court decision in Sublett v. This case is not just about a technical legal loss.

Insurance Claim

Insurance Claim Claim Policyholder Property Insurance

Take the Hassle Out of Claims Management

Advertiser: Trellis

Insurance professionals use Trellis to streamline claims management by analyzing legal trends, predicting outcomes, and strategizing effectively to serve clients better. Adjusters can evaluate claim validity, estimate settlement amounts, and identify potential litigation risks.

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Understanding Leadership from Inside the Insurance Claims Machine: Reflections on Mike Fiato’s Vision

Property Insurance Coverage Law

MAY 13, 2025

The Senate Subcommittee on Disaster Management will hold a hearing this afternoon titled Examining the Insurance Industrys Claims Practices Following Recent Natural Disasters. Among those testifying is Mike Fiato, Executive Vice President and Chief Claims Officer at Allstate.

Insurance Claim

Insurance Claim Claim Property Insurance Insurance Industry

Examinations Under Oath in New York Property Insurance Claims

Property Insurance Coverage Law

JANUARY 23, 2025

When navigating contested property insurance claims, insured parties may receive a request from their insurer for an Examination Under Oath (EUO). It is a formal proceeding, not unlike a deposition, where an insured is required to answer questions under oath about their insurance claim.

Property Insurance

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California Commissioner Investigating State Farm’s Handling of LA Wildfire Claims

Insurance Journal

JUNE 12, 2025

California Insurance Commissioner Ricardo Lara on Thursday said he has launched a formal investigation into State Farm’s handling of thousands of insurance claims from wildfire survivors affected by the Palisades and Eaton wildfires in January. The California Department of Insurance …

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Insurance Company Claims File Transparency Supports Honest and Good Faith Claims Conduct

Property Insurance Coverage Law

JANUARY 21, 2025

The Florida House Insurance and Banking Subcommittee was obviously upset with rising insurance rates and poor claims handling, as noted inParticipate In Your DemocracyEven If You Are Called a Bazooka. I was always told that an honest person has nothing to hide.

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Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

Property Insurance Coverage Law

JANUARY 22, 2025

I am snowed in after taking the deposition of a 1099 temporary claims adjuster in South Carolina. Much of his testimony has me thinking about the plight of the modern independent claims adjuster doing catastrophe work. During his deposition, the independent catastrophe adjuster said he had asked to have his claims load reduced.

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Florida Appeals Court Says Plaintiff Can’t Harp on Adjusting Delays in Claims Dispute

Insurance Journal

JUNE 10, 2025

Some Florida policyholders and their attorneys have long complained about real or perceived delays in the claims-handling process after a loss. A Florida appeals court ruled last week that telling a jury about those delays may be prejudicial and out …

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When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

Property Insurance Coverage Law

FEBRUARY 14, 2025

The latest revelations about Allstates use of artificial intelligence (AI) in drafting insurance claims emails should serve as a wake-up call for policyholders, insurance regulators, and insurance industry claims handlers.

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Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

Property Insurance Coverage Law

JANUARY 22, 2025

I am snowed in after taking the deposition of a 1099 temporary claims adjuster in South Carolina. Much of his testimony has me thinking about the plight of the modern independent claims adjuster doing catastrophe work. During his deposition, the independent catastrophe adjuster said he had asked to have his claims load reduced.

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Claim Property Insurance Insurance Insured

When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

Property Insurance Coverage Law

FEBRUARY 14, 2025

The latest revelations about Allstates use of artificial intelligence (AI) in drafting insurance claims emails should serve as a wake-up call for policyholders, insurance regulators, and insurance industry claims handlers.

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Claim Policyholder Property Insurance Insurance Claim

What If Every Insurance Company Engineer Report Suggests a Denied Claim? We’re About to Find Out

Property Insurance Coverage Law

APRIL 21, 2025

A recent conversation on LinkedIn has sparked serious questions about the objectivity of engineering reports used by insurance companies. Our firm is now taking the first step to find out whether the claims of systemic bias hold water. Were About to Find Out appeared first on Property Insurance Coverage Law Blog.

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Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Property Insurance Coverage Law

JANUARY 30, 2025

A recent federal court decision favoring Liberty Mutual Insurance Company in a pipe burst claim1 left me thinking about two lessons. First, this case strongly reminds policyholders to be aware of time limits in their insurance policies and take action as soon as they believe their claim is not being handled fairly.

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Claim Policyholder Property Insurance Insurance Policy

Florida OIR Wants More Data, Warns Insurers about Concurrent Causation Denials

Insurance Journal

FEBRUARY 23, 2025

As consumer complaints have apparently mounted over unpaid hurricane losses, Florida’s top insurance regulator and some lawmakers are signaling new scrutiny on insurance carriers’ claims-handling and other practices. Florida Insurance Commissioner Michael Yaworsky late last week posted a memo, demanding …

Insurance Carrier

Insurance Carrier Insured Insurer Insurance

Uber Alleges Insurance Fraud Scheme in Florida as It Goes on Legal Offensive

Insurance Journal

JUNE 11, 2025

sued a group of lawyers, medical providers and rideshare drivers it claims staged car accidents, manufactured damages and received unnecessary medical procedures to take advantage of insurance policies in Florida, costing the rideshare giant “several million dollars” … Uber Technologies Inc.

Damage

Damage Insurance Policy Claim Insured

Homeowners Suing AAA Insurers and USAA over LA Wildfires

Insurance Journal

JUNE 6, 2025

Some homeowners who lost their homes in the Los Angeles wildfires have filed lawsuits against three large insurers over claims payouts they say didn’t cover their losses. The lawsuits were filed in Los Angeles County Superior Court this week. They …

Insured

Insured Insurer Insurance Claim

Can Claims Managers in Florida Ethically Tell Adjusters Not to Share Estimates with Policyholders?

Property Insurance Coverage Law

JUNE 10, 2025

If you were found to give your estimate to anyone, … The post Can Claims Managers in Florida Ethically Tell Adjusters Not to Share Estimates with Policyholders? appeared first on Property Insurance Coverage Law Blog. TSI Adjusters warns their field adjusters: Warning: Do not share your estimate with anyone.

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Policyholder Claim Property Insurance Insurance

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Property Insurance Coverage Law

APRIL 14, 2025

When handling National Flood Insurance Program (NFIP) claims, public adjusters and policyholders must be alert to critical warning signs. One of the most important phrases to recognize is: “We denied a portion of your claim.” ” Those few words, even if buried in a lengthy letter, should ring loud alarm bells.

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Claim Policyholder Property Insurance Insurance

Florida Policyholders Are Upset with Stupid Denials of Claims

Property Insurance Coverage Law

FEBRUARY 17, 2025

The Florida House Committee on Banking and Insurance seemed to have many constituents upset with delays and denials when I was testifying in front of them a month ago. The insurance representative tried to explain that many of the denials were because most policies do not cover flood.

Policyholder

Policyholder Claim Property Insurance Policy

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Property Insurance Coverage Law

APRIL 14, 2025

When handling National Flood Insurance Program (NFIP) claims, public adjusters and policyholders must be alert to critical warning signs. One of the most important phrases to recognize is: “We denied a portion of your claim.” ” Those few words, even if buried in a lengthy letter, should ring loud alarm bells.

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Claim Policyholder Property Insurance Insurance

Homeowner’s Failure to Read Doesn’t Clear Agency of Negligence Claim – NC High Court

Insurance Journal

JUNE 2, 2025

A North Carolina insurance agency cannot escape a lawsuit brought by a homeowner who was denied coverage after a hurricane because key elements of the property were not mentioned in the coverage application. In a case that began almost a …

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Brotherhood Mutual Hit With $35 Million Punitive Award on Roof Damage Claim

Property Insurance Coverage Law

FEBRUARY 3, 2025

We have battled insurance companies, co-counseled on cases, and discussed property insurance case law at a depth most … The post Brotherhood Mutual Hit With $35 Million Punitive Award on Roof Damage Claim appeared first on Property Insurance Coverage Law Blog.

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Damage Claim Policyholder Property Insurance

Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Property Insurance Coverage Law

JANUARY 30, 2025

A recent federal court decision favoring Liberty Mutual Insurance Company in a pipe burst claim1 left me thinking about two lessons. First, this case strongly reminds policyholders to be aware of time limits in their insurance policies and take action as soon as they believe their claim is not being handled fairly.

Claim

Claim Policyholder Property Insurance Insurance Policy

Should Congress Enact a Federal Unfair Claims Practice Law? A Question That Needs Serious Consideration Following Congressional Investigation

Property Insurance Coverage Law

MAY 16, 2025

This weeks Senate hearing on the insurance industrys claims practices following natural disasters wasnt just a made-for-TV moment. It was a five-alarm warning siren for policyholders and insurers across the country.

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Claim Policyholder Property Insurance Insurance Industry

Are Supplemental Flood Claims Subject to the Original One-Year Statute of Limitations?

Property Insurance Coverage Law

MAY 20, 2025

Occidental Fire and Casualty Company of North Carolina 1has reignited an important and often misunderstood question regarding supplemental claims. Are supplemental flood claims under the National Flood Insurance Program subject to the same one-year statute of limitations as the original claim?

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Canada’s Insurance Sector Faces Deluge of Climate-Related Catastrophe Claims

Insurance Journal

SEPTEMBER 3, 2024

Hotter summers in Canada that have sparked wildfires in tourist areas, intense hailstorms and thunderstorms with severe flooding in major cities, all likely linked to climate change, are leading to personnel shortages and potentially claims adjustment delays, according to insurance …

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Claim Insured Insurer Insurance

Heritage Files Libel, Defamation Suit vs. Adjuster After ’60 Minutes’ Report

Insurance Journal

APRIL 29, 2025

Six weeks after Tampa-based Heritage Property & Casualty Insurance Co. filed a libel suit against a whistleblower claims adjuster, the adjuster’s lawyer has pushed back, arguing that the suit is an attempt to silence those who question insurers’ damage estimates.

Casualty Insurance

Casualty Insurance Damage Claim Insurance

Are Supplemental Flood Claims Subject to the Original One-Year Statute of Limitations?

Property Insurance Coverage Law

MAY 20, 2025

Occidental Fire and Casualty Company of North Carolina 1has reignited an important and often misunderstood question regarding supplemental claims. Are supplemental flood claims under the National Flood Insurance Program subject to the same one-year statute of limitations as the original claim?

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Claim Property Insurance Insurance Insured

Noncompliance With Policy’s “Duties After Loss” Provision Leads to Denial of Fire Loss Claim

The Property Insurance Law Observer

MAY 20, 2025

Insurer) motion for summary judgment, holding that the Insurer was prejudiced by its insureds failure to cooperate with the Policys Duties After Loss provision. Billie (Plaintiff) purchased a house in Waterbury, Connecticut, and obtained homeowners insurance through the Insurer. Background Caribe D.

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Claim Damage Property Damage Policy

Mistakes in setting sums insured / declared value where the Insured elects an Indemnity Period of less than 12 months.

Prof. Allan Manning

FEBRUARY 10, 2025

I recall the very first business interruption claim I did was for a risk in Toowoomba and to my horror found that the Insured had only declared 3 months insurable gross profit with a 3-month Indemnity Period. In fact, around 75% of interruption claims by number have an Indemnity Period of less than 3 months.

Business Interruption

Business Interruption Claim Insured Insurer

California Commissioner Launches Smoke Claims & Remediation Task Force

Insurance Journal

JUNE 1, 2025

A new task force has been formed to develop standards in California for insurance coverage and clean-up of smoke-damaged homes. California Insurance Commissioner Ricardo Lara announced the formation of a Smoke Claims & Remediation Task Force within the California Department …

Claim

Claim Damage Insurance Insured

California FAIR Plan: Ignoring Laws and Gouging Californians on Smoke Damage Claims

Property Insurance Coverage Law

MARCH 20, 2025

Imagine a state-run insurance program so brazen that even when explicitly ordered by the Department of Insurance to remove unlawful policy language, it shrugs and continues business as usual.

Damage

Damage Claim Property Insurance Policy

Dog Bite Claims Soar in Frequency and Cost: Report

Insurance Journal

APRIL 24, 2025

Insurers in the U.S. billion in dog-related injury claims in 2024, according to data compiled by the Insurance Information Institute (Triple-I) and State Farm. The number of dog bite and related injury claims last year totaled … paid out about $1.6

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Claim Injury Insurance Insured

Claims Satisfaction Leaders Reveal Secrets to Success

Insurance Journal

DECEMBER 25, 2024

What is the secret to an insurance claims experience that satisfies customers? Power has conducted surveys and curated lists recognizing insurers that succeed at providing satisfactory claims experiences. Carrier Management recently asked claims leaders at two of … For years, J.D.

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CBS 60 Minutes Exposes Alleged Insurance Company Fraud: Adjusters Reveal Altered Hurricane Damage Estimates by Claims Management

Property Insurance Coverage Law

SEPTEMBER 30, 2024

In a shocking exposé aired last night on CBS’s 60 Minutes, allegations of widespread insurance fraud by insurance companies following Hurricane Ian were exposed.

Insurance Companies

Insurance Companies Damage Claim Property Insurance

Report: Over 250,000 US Properties Have Repeated NFIP Claims

Insurance Journal

SEPTEMBER 19, 2024

properties have repeated claims for federal flood insurance, costing the National Flood Insurance Program billions of dollars in claims, according to new federal data compiled by the National Resources Defense Council. More than a quarter million U.S. Four states account …

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Claim Insurance Insured Insurer

Insured Losses Could Hit $145B in 2025, Driven by Rising Claims From Secondary Perils

Insurance Journal

APRIL 30, 2025

Global insured losses from natural catastrophes hit US$137 billion in 2024, following the 5%-7% annual growth rate that has been the norm in recent years, according to Swiss Re analysis. If this trend continues, global insured losses will approach US$145 …

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Claim Insured Insurer Insurance

Florida Insurance Regulators Demand Fair Treatment for Policyholders

Property Insurance Coverage Law

FEBRUARY 22, 2025

How do insurance claims work when your home has already been damaged once? A recent Florida Office of Insurance Regulation (OIR) Bulletin clarifies how insurers must handle claims for multiple hurricanes. But what happens when two hurricanes strike in the same season?

Policyholder

Policyholder Property Insurance Damage Insurance Claim

Tech Update: Lloyd’s Backs BreachBits; ZoJacks Prevents Water Claims; Eagleview Expands Drone Options

Insurance Journal

APRIL 24, 2025

based BreachBits has received an investment of an undisclosed amount from Lloyd’s in what is the London-based global insurance marketplace’s third strategic innovation investment from among over 150 alumni of the Lloyd’s Lab. Washington, D.C.-based

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Protect Your Packaging Business With the Right Insurance

Central Insurance

MAY 27, 2025

Learn how the right insurance policies can help protect your packaging business from equipment breakdowns, liability claims, and costly interruptions. The post Protect Your Packaging Business With the Right Insurance appeared first on Central Insurance Blog.

Protection

Protection Liability Insurance Policy Insured

How Big Was the Cat? Investigator Warns About Claims of Clogged Toilets

Insurance Journal

SEPTEMBER 12, 2024

Did you hear the one about cat poop clogging a toilet, resulting in thousands of gallons of sewage water in the home and a big insurance claim? Lin Werkheiser, an insurance fraud investigator, has heard that one and many more …

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Claim Insurance Claim Insurance Insured

Report: Long COVID Accounted for Three Quarters of California Comp Virus Claim Payments

Understanding Leadership from Inside the Insurance Claims Machine: Reflections on Mike Fiato’s Vision

Trending Sources

Top Mistakes That Can Destroy Your Flood Insurance Claim

Top Mistakes That Can Destroy Your Flood Insurance Claim

Take the Hassle Out of Claims Management

Understanding Leadership from Inside the Insurance Claims Machine: Reflections on Mike Fiato’s Vision

Examinations Under Oath in New York Property Insurance Claims

California Commissioner Investigating State Farm’s Handling of LA Wildfire Claims

Insurance Company Claims File Transparency Supports Honest and Good Faith Claims Conduct

Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

Florida Appeals Court Says Plaintiff Can’t Harp on Adjusting Delays in Claims Dispute

When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

What If Every Insurance Company Engineer Report Suggests a Denied Claim? We’re About to Find Out

Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Florida OIR Wants More Data, Warns Insurers about Concurrent Causation Denials

Uber Alleges Insurance Fraud Scheme in Florida as It Goes on Legal Offensive

Homeowners Suing AAA Insurers and USAA over LA Wildfires

Can Claims Managers in Florida Ethically Tell Adjusters Not to Share Estimates with Policyholders?

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Florida Policyholders Are Upset with Stupid Denials of Claims

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Homeowner’s Failure to Read Doesn’t Clear Agency of Negligence Claim – NC High Court

Brotherhood Mutual Hit With $35 Million Punitive Award on Roof Damage Claim

Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Should Congress Enact a Federal Unfair Claims Practice Law? A Question That Needs Serious Consideration Following Congressional Investigation

Are Supplemental Flood Claims Subject to the Original One-Year Statute of Limitations?

Canada’s Insurance Sector Faces Deluge of Climate-Related Catastrophe Claims

Heritage Files Libel, Defamation Suit vs. Adjuster After ’60 Minutes’ Report

Are Supplemental Flood Claims Subject to the Original One-Year Statute of Limitations?

Noncompliance With Policy’s “Duties After Loss” Provision Leads to Denial of Fire Loss Claim

Mistakes in setting sums insured / declared value where the Insured elects an Indemnity Period of less than 12 months.

California Commissioner Launches Smoke Claims & Remediation Task Force

California FAIR Plan: Ignoring Laws and Gouging Californians on Smoke Damage Claims

Dog Bite Claims Soar in Frequency and Cost: Report

Claims Satisfaction Leaders Reveal Secrets to Success

CBS 60 Minutes Exposes Alleged Insurance Company Fraud: Adjusters Reveal Altered Hurricane Damage Estimates by Claims Management

Report: Over 250,000 US Properties Have Repeated NFIP Claims

Insured Losses Could Hit $145B in 2025, Driven by Rising Claims From Secondary Perils

Florida Insurance Regulators Demand Fair Treatment for Policyholders

Tech Update: Lloyd’s Backs BreachBits; ZoJacks Prevents Water Claims; Eagleview Expands Drone Options

Protect Your Packaging Business With the Right Insurance

How Big Was the Cat? Investigator Warns About Claims of Clogged Toilets

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