Claim and Policy - Insurance Industry Brief

Is terrorism covered under an Australian home and contents policy?

Prof. Allan Manning

JANUARY 29, 2025

Last week I posted an article in regard to terrorism coverage under commercial property, and/or business interruption policies. In a day or two I will address Strata and after than residential landlord policies, and finally private motor. I also touched on commercial liability coverage. ” [ emphasis mine] 1.

Policy

Policy Business Interruption Commercial Risk

Florida Policyholders Are Upset with Stupid Denials of Claims

Property Insurance Coverage Law

FEBRUARY 17, 2025

The insurance representative tried to explain that many of the denials were because most policies do not cover flood. Our firm was asked to represent a … The post Florida Policyholders Are Upset with Stupid Denials of Claims appeared first on Property Insurance Coverage Law Blog.

Policyholder

Policyholder Claim Property Insurance Policy

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

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

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 Insurer

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.

Claim

Carolina Woman Charged with Using Mom’s Name to Get Policy, Filing Bogus Claim

Insurance Journal

DECEMBER 2, 2024

A North Carolina woman is set for a court appearance later this month after she was charged with filing a claim on her deceased mom’s house – for damage that occurred before the insurance policy was purchased. Cindy Ramzi Hanna, …

Policy

Policy Claim Damage Insurance Policy

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. Shortly after the Plaintiff purchased the Policy, the house was damaged by a fire. Plaintiff submitted a claim to the Insurer for the damage. Background Caribe D.

Claim

Claim Damage Property Damage Policy

Agents Beware: Homeowner’s Failure to Read Policy Doesn’t Clear Agency of Negligence Claim, North Carolina High Court Says

Insurance Journal

JUNE 15, 2025

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

Claim

Claim Policy Agents Insurance Agency

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

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

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

Uber Alleges Fraud Scheme by New York Groups Faking Car-Crash Injuries

Insurance Journal

JANUARY 30, 2025

filed a racketeering lawsuit against a group of law firms, doctors and pain-management clinics it claims staged fake car accidents and performed unnecessary surgeries to take advantage of New York’s lucrative no-fault insurance policies. Ride-sharing giant Uber Technologies Inc. Since …

Injury

Injury Insurance Policy Claim Policy

Avoid Claim Denials: Key Policyholder Duties After a Loss

Property Insurance Coverage Law

MARCH 11, 2025

All insurance policies include a section placing specific responsibilities and obligations on policyholders to act in a certain way before entitling them to policy benefits for what should be a covered loss.

Policyholder

Policyholder Claim Property Insurance Insurance Policy

Pirates Invade Tampa! Is an Invasion Covered Under a Commercial Insurance Policy?

Property Insurance Coverage Law

JANUARY 26, 2025

Is an Invasion Covered Under a Commercial Insurance Policy? where I gave a short explanation of the day: Tampas Mayor refused to hand over the keys to the city on Tuesday to … The post Pirates Invade Tampa! appeared first on Property Insurance Coverage Law Blog.

Commercial Insurance

Commercial Insurance Insurance Policy Commercial Policy

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

Property Insurance Coverage Law

APRIL 9, 2025

Sometimes, decisions come along that make me wonder if judges are reading the same insurance policies and insurance laws the rest of us are. The recentFloridaClark opinion 1 is one of them.

Claim

Claim Property Insurance Insurance Policy Insurance Companies

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. Fast forward 40 or so years and in Vanuatu last week with the earthquake claims I saw many occasions of the very same issue.

Business Interruption

Business Interruption Claim Insurer Insurance

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

Property Insurance Coverage Law

APRIL 9, 2025

Sometimes, decisions come along that make me wonder if judges are reading the same insurance policies and insurance laws the rest of us are. The recentFloridaClark opinion 1 is one of them.

Claim

Claim Property Insurance Insurance Policy Insurance Companies

Court, Not Board, Must Decide If Insurer’s Conduct After Canceling Policy Was Negligent

Insurance Journal

AUGUST 12, 2024

Claims that a workers’ compensation insurer’s conduct after it canceled a policy were negligent are for a court, not the state’s workers’ compensation board, to decide, the Connecticut Appellate Court has ruled. Liberty Mutual Insurance Co. had succeeded before both …

Policy

Policy Compensation Claim Workers Compensation

LMI Claims Conference

Prof. Allan Manning

JULY 29, 2024

Realising the importance of ongoing learning, LMI held their annual conference for the claims team in Sydney last week. During the conference it was appropriate to acknowledge and present 10 year service awards to Caroline Stevens from LMI Forensics and Georg Froeschl from LMI Claims.

Claim

Claim Business Interruption License Policy

Lowe’s Scraps Some DEI Policies as Activist Claims a New Win

Insurance Journal

AUGUST 27, 2024

Lowe’s Cos. is scaling back its diversity, equity and inclusion programs, the latest American company to end such initiatives following a series of activists attacks on firms that promote DEI. The home-improvement retailer will no longer participate in surveys for …

Policy

Policy Claim Liability

Allied World Policy Doesn’t Cover Troubled Sperm Bank’s Lawsuits, Court Says

Insurance Journal

DECEMBER 25, 2024

At what point does a demand from an injured party constitute an insurance claim? In the case of a Georgia-based sperm bank, it’s when the injured party sends the letter a date that came before the clearly worded policy …

Policy

Policy Insurance Claim Claim Insurance

Should Citizens Do More to Assist With Coming Flood Claims in Florida? Can it?

Insurance Journal

SEPTEMBER 25, 2024

Florida’s largest insurer, has suspended policy binding ahead of predicted Hurricane Helene, and a board member asked if the carrier could do more to help policyholders manage flood insurance claims from the looming storm. Citizens Property Insurance Corp., “My question …

Claim

Claim Policyholder Property Insurance Insurance Claim

Court Finds Ambiguity But No Bad Faith by Insurer in Bible App Data Claim

Insurance Journal

OCTOBER 16, 2024

The Pennsylvania Supreme Court has let stand a state appeals court ruling that tackled for the first time what is meant by “your computers” under electronic data coverage in a commercial property policy. The case involves claims by Bible video …

Commercial Property

Commercial Property Claim Commercial Policy

From Exclusions to Coverage: Court Says No to Insurer’s Overly Broad Use of Exclusions

Property Insurance Coverage Law

FEBRUARY 2, 2025

Ropicky, 1 the court held that insurers may not deny legitimate claims based on policy exclusions that the insurer has broadly applied. In a recent case from the Wisconsin Court of Appeals, Cincinnati Insurance Company v.

Property Insurance

Property Insurance Policy Insurance Companies Claim

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 Insurer

Texas SB 458: What Homeowners and Drivers Need to Know About the New Appraisal Law

Property Insurance Coverage Law

JUNE 13, 2025

In 2025, the Texas Legislature passed Senate Bill 458 (SB 458), 1 a significant reform aimed at protecting policyholders in disputes over insurance claims. … The post Texas SB 458: What Homeowners and Drivers Need to Know About the New Appraisal Law appeared first on Property Insurance Coverage Law Blog.

Policyholder

Policyholder Property Insurance Insurance Claim Insurance Policy

Avoid Claim Denials: Key Policyholder Duties After a Loss

Property Insurance Coverage Law

MARCH 11, 2025

All insurance policies include a section placing specific responsibilities and obligations on policyholders to act in a certain way before entitling them to policy benefits for what should be a covered loss.

Policyholder

Policyholder Claim Property Insurance Insurance Policy

Reminder on Time Limitations to File Suit for California Wildfire Claims

Property Insurance Coverage Law

FEBRUARY 16, 2025

California fire insurance policies must provide an insured a minimum of 12 months from the inception of the loss to bring any suit or action on the policy for recovery of any claim. Code 2071.

Claim

Claim Property Insurance Insurance Policy Policy

Is the Exact Date of Loss Required in Pleadings Rather Than a Claim and Proof That a Loss Occurred During the Policy Period?

Property Insurance Coverage Law

SEPTEMBER 22, 2024

A recent ruling by a federal trial court stated that the policyholder claimed that a severe hailstorm on May 28, 2021, caused extensive damage to his property, including damage to the roof, vents, flashings, windows, window screens, fascia, gutters, downspouts, and HVAC system. appeared first on Property Insurance Coverage Law Blog.

Claim

Claim Policy Policyholder Damage

ACV, RCV, and GCOP: Why the Ninth Circuit’s Ruling Matters to Claims Professionals and Policyholders

Property Insurance Coverage Law

APRIL 18, 2025

Safeco Insurance Company of America 1 serves as a timely reminder for claims professionals to revisit how to interpret actual cash value (ACV), replacement cost value (RCV), and general contractor overhead and profit (GCOP) under property insurance policies which define the terms.

Policyholder

Policyholder Claim Property Insurance Insurance Policy

Is the Address Correct on the Property Insurance Policy?

Property Insurance Coverage Law

SEPTEMBER 25, 2024

In my basic course about property insurance coverage to public adjusters, and as a standard issue regarding case intake at Merlin Law Group, I first emphasize to always make certain the named insureds and clients have a right to bring the claims. appeared first on Property Insurance Coverage Law Blog.

Property Insurance

Property Insurance Insurance Policy Policy Insurer

Insurer’s Use of Conflicting Reports Not Bad Faith, Says Court

The Property Insurance Law Observer

JUNE 12, 2025

2025)), the Tenth Circuit Court of Appeals affirmed summary judgement on behalf of the insurer on the basis that the insurer did not act in bad faith when it denied the insured’s claim based on an engineering report that contradicted an adjuster’s initial findings. The subject insurance policy covered direct physical loss caused by hail.

Damage

Damage Claim Insurance Companies Policyholder

Law Students Sue Civil Rights Agency Over Crackdown on Law-Firm DEI Policies

Insurance Journal

APRIL 15, 2025

civil rights agency, claiming that its probe into diversity policies at 20 large law firms is illegal and could expose the personal information of lawyers and job applicants. Three law students on Tuesday sued a U.S. The lawsuit filed in …

Policy

Policy Claim

Trust or Family Trust Owns Your Home? Beware of Insurance Complications to Avoid Insurance Claim Denials

Property Insurance Coverage Law

FEBRUARY 5, 2025

A recent viral social media post following the California wildfires has brought to light a critical issue: homeowners are finding their insurance claims denied because their properties are held in trusts, yet the trusts are not listed on their insurance policies.

Insurance Claim

Insurance Claim Claim Insurance Policy Insurer

The Critical Role of Insurance Adjusters and the Growing Disenchantment in the Industry

Property Insurance Coverage Law

MARCH 26, 2025

Property insurance adjustersboth company-employed and independentserve as the backbone of the claims process, ensuring that policyholders receive the full benefits of their coverage as swiftly and fairly as possible.

Policyholder

Policyholder Property Insurance Damage Claim

Insurance Company’s Two-Year Claims Handling Waives Proof of Loss Requirement

Property Insurance Coverage Law

NOVEMBER 5, 2024

A recent Indiana Court of Appeals decision where Merlin Law Group’s Ed Eshoo was counsel for the policyholder provides a textbook example of how an insurance company’s conduct can waive strict policy requirements, even when attempting to preserve those rights through reservation letters.

Claim

Claim Policyholder Insurance Companies Property Insurance

Jackson v. Spinnaker: Court Rules a Thorough Investigation is Just Good Business, Not Bad Faith

The Property Insurance Law Observer

FEBRUARY 25, 2025

However, the court granted summary judgment in favor of the insurer on the bad faith claim, emphasizing that a thorough investigation into a questionable claim does not amount to bad faith Background Spinnaker Insurance Company (Spinnaker) issued a homeowners policy to Donald Jackson (Jackson) for a designated residence premises.

Claim

Claim Policy Insurance Companies Damage

The Critical Role of Insurance Adjusters and the Growing Disenchantment in the Industry

Property Insurance Coverage Law

MARCH 26, 2025

Property insurance adjustersboth company-employed and independentserve as the backbone of the claims process, ensuring that policyholders receive the full benefits of their coverage as swiftly and fairly as possible.

Policyholder

Policyholder Property Insurance Damage Claim

Collateral Agreement Didn’t Mention Tort Claims, Cutting SUNZ Out of BP Funds

Insurance Journal

JANUARY 9, 2025

If insurance carriers want to have dibs on a company’s assets as premium security or collateral, they had better specify that those assets include potential tort-claim settlements, a federal appeals court said Wednesday. In a case that involved a Florida …

Claim

Claim Insurance Carrier Premium Workers Compensation

How Lag Time Sabotages Claims—And What You Can Do About It

AMAXX

MAY 27, 2025

In the world of workers compensation, few factors have a more immediate and measurable impact on claim outcomes than lag time the delay between when an injury occurs and when it is reported to the carrier or third-party administrator (TPA). Beyond four weeks , claim costs jumped 31%. Here’s what you need to know. litigation rate.

Claim

Claim Workers Comp Injury Workers Compensation

Miss. Supreme Court Orders USAA to Pay $15M in Hurricane Katrina Bad-Faith Claim

Insurance Journal

DECEMBER 8, 2024

When hurricanes hit coastal areas, property insurers often breathe a sigh of relief when much of the damage appears to be the result of storm surge and flooding losses that aren’t covered by most homeowners’ policies. But after Hurricane …

Claim

Claim Damage Property Insurance Policy

How Fear Impacts Workers’ Compensation Claims (and What to Do About It)

AMAXX

MARCH 4, 2025

Research has shown that fear of being fired is one of the top predictors of negative claim outcomes, including increased litigation rates and extended time off work. By understanding the role fear plays in workers compensation claims, employers can implement strategies to foster trust, improve outcomes, and reduce costs. Heres how: 1.

Workers Compensation

Workers Compensation Compensation Claim Workers Comp

Mistake: Accepting Every Workers’ Compensation Claim

AMAXX

MARCH 18, 2025

Many companies operate under an unwritten rule: accept every workers compensation claim, no questions asked. A well-managed workers compensation program should pay 100% of legitimate claimsand 0% of the claims that arent. Employees come to believe that every claim will be accepted, regardless of the circumstances.

Workers Compensation

Workers Compensation Compensation Claim Workers Comp

Lack of Insurable Interest Precludes Recovery for Property Damage

The Property Insurance Law Observer

MARCH 20, 2025

Consequently, the plaintiff was not entitled to indemnity for damage to the property it purported to insure under a commercial property insurance policy. [1] During the policy term, the business claimed that the properties suffered damage caused by a hurricane and submitted a claim to the insurer. Hawley Insurance Co.

Property Damage

Property Damage Damage Insurer Insurance

US High Court Declines Appeal, Upholds Coverage Ruling on Treated Wood

Insurance Journal

NOVEMBER 19, 2024

Insurance carriers may want to examine policy language – and what information they request from insureds – after the U.S. Supreme Court let stand a lower court’s ruling which could force Argo Group to cover claims that a wood-treating company …

Insurance Carrier

Insurance Carrier Claim Policy Insurance

Is terrorism covered under an Australian home and contents policy?

Florida Policyholders Are Upset with Stupid Denials of Claims

Trending Sources

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

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

Take the Hassle Out of Claims Management

Carolina Woman Charged with Using Mom’s Name to Get Policy, Filing Bogus Claim

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

Agents Beware: Homeowner’s Failure to Read Policy Doesn’t Clear Agency of Negligence Claim, North Carolina High Court Says

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

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

Uber Alleges Fraud Scheme by New York Groups Faking Car-Crash Injuries

Avoid Claim Denials: Key Policyholder Duties After a Loss

Pirates Invade Tampa! Is an Invasion Covered Under a Commercial Insurance Policy?

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

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

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

Court, Not Board, Must Decide If Insurer’s Conduct After Canceling Policy Was Negligent

LMI Claims Conference

Lowe’s Scraps Some DEI Policies as Activist Claims a New Win

Allied World Policy Doesn’t Cover Troubled Sperm Bank’s Lawsuits, Court Says

Should Citizens Do More to Assist With Coming Flood Claims in Florida? Can it?

Court Finds Ambiguity But No Bad Faith by Insurer in Bible App Data Claim

From Exclusions to Coverage: Court Says No to Insurer’s Overly Broad Use of Exclusions

Protect Your Packaging Business With the Right Insurance

Texas SB 458: What Homeowners and Drivers Need to Know About the New Appraisal Law

Avoid Claim Denials: Key Policyholder Duties After a Loss

Reminder on Time Limitations to File Suit for California Wildfire Claims

Is the Exact Date of Loss Required in Pleadings Rather Than a Claim and Proof That a Loss Occurred During the Policy Period?

ACV, RCV, and GCOP: Why the Ninth Circuit’s Ruling Matters to Claims Professionals and Policyholders

Is the Address Correct on the Property Insurance Policy?

Insurer’s Use of Conflicting Reports Not Bad Faith, Says Court

Law Students Sue Civil Rights Agency Over Crackdown on Law-Firm DEI Policies

Trust or Family Trust Owns Your Home? Beware of Insurance Complications to Avoid Insurance Claim Denials

The Critical Role of Insurance Adjusters and the Growing Disenchantment in the Industry

Insurance Company’s Two-Year Claims Handling Waives Proof of Loss Requirement

Jackson v. Spinnaker: Court Rules a Thorough Investigation is Just Good Business, Not Bad Faith

The Critical Role of Insurance Adjusters and the Growing Disenchantment in the Industry

Collateral Agreement Didn’t Mention Tort Claims, Cutting SUNZ Out of BP Funds

How Lag Time Sabotages Claims—And What You Can Do About It

Miss. Supreme Court Orders USAA to Pay $15M in Hurricane Katrina Bad-Faith Claim

How Fear Impacts Workers’ Compensation Claims (and What to Do About It)

Mistake: Accepting Every Workers’ Compensation Claim

Lack of Insurable Interest Precludes Recovery for Property Damage

US High Court Declines Appeal, Upholds Coverage Ruling on Treated Wood

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