In determining ACV, actual expenses incurred in making a repair may also be considered in determining the validity of that estimate. Greenspoint Investors, Ltd v. Travelers Lloyds Ins. Co., No. H-10–4057, 2015 U.S. App. Lexis 293 (S.D. Tex. March 3, 2015) (memo. op.). (emphasis added) When Repairs Are Complete It is tempting for an appraiser, when repairs… Continue reading Actual Expenses Incurred for Repair: Does One Data Point (or Bid) Impact Estimate Validity? A Guide to Appraisal
“An appraisal clause binds the parties to have the extent or amount of loss determined in a particular way.” State Farm Lloyds v. Johnson, 290 S.W.3d 886, 888 (Tex. 2009). Always check your policy's appraisal clause to see if the policyholder must first provide an estimate or description of the differences prior to requesting an… Continue reading Must I Play Ball with the Insurance Company and Submit an Estimate Prior to Appraisal? A Guide to Appraisal
“If a plaintiff were allowed to invoke appraisal, await the estimates, and then determine whether to risk an unfavorable award or commence litigation, the entire purpose of an appraisal—to resolve the parties’ dispute over the amount of loss for a covered claim without incurring the time and expense of litigation—would be vitiated.” Scalise v. Allstate… Continue reading May I Take My Toys and Go Home? Once you start, you may not stop. A Guide to Appraisal
“Just as we have concluded Texas case law does not require disinterested appraisers when the parties have not included that requirement in their contract, we conclude also that the policy here does not require appraisers be disinterested merely by requiring that they be competent. To do so would be to read into the policy a… Continue reading Must Appraisers Always Be Disinterested? There’s always an exception to the rule. A Guide to Appraisal
The ‘estimate’ included in the Claim Disposition Packet relates to the association’s ‘payment’ of the claim. ‘Payment’ of a claim is not the same as ‘denial’ of a claim. The appraisal panel may not look to the estimate as a means to determine or limit coverage. See Texas Windstorm Ins. Ass’n v. Jones, 512 S.W.3d 545,… Continue reading Hurricane Harvey: May Appraiser Argue TWIA Adjuster’s Estimate Limits the Scope of Appraisal?
Missing Items of Damage: TWIA's Failure to Admit or Deny Coverage for Items of Damage When, in a Notice of Claim Acceptance letter, TWIA properly denies coverage for a portion of a claim, coverage for the remaining portions of the claim is by default accepted in full. See Texas Windstorm Ins. Ass’n v. Jones, 512 S.W.3d 545… Continue reading Hurricane Harvey: When TWIA Communicates Coverage for the Claim is Accepted in Part and Denied in Part–How Do Appraisers Know What Was Accepted?
When, in a Notice of Claim Acceptance letter, TWIA fails to provide notice of the portion of the loss for which TWIA denies coverage and a detailed summary of the manner in which TWIA determined not to accept coverage for that portion of the claim, TWIA is deemed to have accepted ‘coverage’ for the claim… Continue reading Hurricane Harvey: When TWIA Tells You “We Have Accepted Your Claim in Full”–Is it more about what TWIA didn’t deny?