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Claims, Case Law, and Legal Articles


Latest Articles

Claims Practices

Notice-Prejudice Rule Doesn't Apply to Claims-Made-and-Reported Policy

2023-07-21 | Barry Zalma

Barry Zalma relates a recent Kentucky Supreme Court case.

Construction Law

Construction Business in Challenging Times

2023-07-07 | Robert J Miletsky

Fulfilling contracts and being paid and dealing with undocumented workers are critical issues for construction firms. Robert Miletsky explains.

Claims Practices

Mortgagee Has No Right to Insurance Proceeds after Debt Paid

2023-05-12 | Barry Zalma

Barry Zalma relates a case holding that satisfaction of a mortgage eliminates the right of the mortgagee to recover from a homeowners policy.

Claims Practices

Building Must Fall To Trigger Collapse Coverage

2023-01-04 | Barry Zalma

Where policy requires an abrupt collapse, the court rules no coverage for a still-standing building. Barry Zalma explains.

Regulation and Compliance

How Are Commercial Service Contracts Regulated?

2022-12-01 | Aaron E Lunt

Aaron Lunt discusses the key considerations in determining how states regulate business service contracts.

Claims Practices

Insured's Release of Insurer Defeats Claim of Third Party

2022-08-05 | Barry Zalma

An assignment of claim against insurers after insureds sign a release is worthless. Barry Zalma relates the case.

Courts and Coverage

Courts Rule on Insurance for Violations of Biometric Privacy Laws

2022-07-15 | David M Knapp

Recent decisions address whether a policy exclusion bars coverage. David Knapp relates the cases and issues.

Regulation and Compliance

New Enhancements to Auto Service Contract Laws

2022-06-15 | Aaron E Lunt

Aaron Lunt examines the legislative status of auto protection products.

Claims Practices

Appreciative Inquiry—A Transformational Change Management Tool

2022-05-12 | Peter G Furst

Peter Furst explains this tool for improving business outcomes by focusing on the potential for future enhancements.

Claims Practices

An Adjuster Is Not a Party to an Insurance Contract

2022-04-08 | Barry Zalma

The Colorado Supreme Court makes it clear that an adjuster may not be sued for the tort of bad faith Barry Zalma relates the case.

Construction Law

Thinking of Sending or Receiving a Wire of Funds? Use Checks Instead

2022-01-28 | Robert J Miletsky

Robert Miletsky explains why the check in the mail system works best.

Claims Practices

Malpractice Insurance Policy Rescinded When Lawyer Lies on Application

2022-01-13 | Barry Zalma

Barry Zalma relates a recent Utah case involving a lawyer's dishonesty on an insurance application.

Courts and Coverage

NY High Court Rules Disgorgement Is Not a Penalty

2021-12-16 | David M Knapp

Courts look beyond thelabel, as illustrated by this case related by David Knapp.

Claims Practices

Investigation of Qui Tam Suit Not Covered by D&O Policy

2021-11-15 | Barry Zalma

Barry Zalma relates a case finding no coverage for a qui tam suit filed before the inception of the policy.

Defense and Settlement

Fifth Circuit Finds Defense Duty for Credit Card Data Breach

2021-08-12 | Lyndon F Bittle

Giving "publication" the broadest possible definition, the court held for the insured. Lyndon Bittle relates the case.

Claims Practices

The Many "Victims" of "Mostly Peaceful Demonstrations"

2021-07-02 | Barry Zalma

Barry Zalma takes issue with calling the 2019–2020 riots "victimless" and looks at those impacted.

Defense and Settlement

Texas Supreme Court Holds Insurer Not Liable under "Stowers"

2021-05-07 | Lyndon F Bittle

The insured's liability must be in excess of policy limits but can arise from a judgment or settlement. Lyndon Bittle relates the case.

Claims Practices

Insurance Fraud by Agent Is Fraud by Insured

2021-04-23 | Barry Zalma

Insurance Fraud by Agent Is Fraud by Insured—A false home loss estimate by a "consultant" that is adopted by an insured is fraud. Barry Zalma relates the case.

Claims Practices

Professional Insurance Adjusting and Insurance Fraud

2021-02-05 | Barry Zalma

Professional Insurance Adjusting and Insurance Fraud—Barry Zalma looks at the role of the claims adjuster and offers a suggestion for fighting fraud.

Claims Management 03

The Dilemma of Insuring Virus Claims

2021-01-15 | Christopher E Mandel

The Dilemma of Insuring Virus Claims—It's going to take risk mitigation strategies as well as risk transfer, per Chris Mandel.

Defense and Settlement

Texas Supreme Court Confronts Another "Stowers" Question

2020-11-25 | Lyndon F Bittle

Texas Supreme Court Confronts Another Stowers Question—Is an excess judgment required? Lyndon Bittle relates the case.

Claims Practices

Insurer Loses Summary Judgment by Claiming Evidence It Never Had

2020-11-13 | Barry Zalma

Insurer Loses Summary Judgment by Claiming Evidence It Never Had—Barry Zalma relates a case where the insurer failed to prove all elements of the motion.

Claims Practices

Conversion Is an Intentional Tort and Can Never Be an Occurrence

2020-10-16 | Barry Zalma

Conversion Is an Intentional Tort and Can Never Be an Occurrence—There's no duty to defend if there is no occurrence. Barry Zalma relates a case alleging theft.

Claims Management 03

Telemedicine in the Age of the Pandemic

2020-10-02 | Christopher E Mandel

Telemedicine in the Age of the Pandemic—Telemedicine and its derivatives are more relevant than ever during COVID-19. Chris Mandel explains.

Courts and Coverage

Lessons from Recent COVID-19 Business Interruption Decisions

2020-09-11 | David M Knapp

Lessons from Recent COVID-19 Business Interruption DecisionsDavid Knapp relates the threshold requirement of "direct physical loss or damage" in recent pandemic litigation.

Claims Practices

It's Not Nice To Lie to Your Insurance Company

2020-08-07 | Barry Zalma

It's Not Nice To Lie to Your Insurance CompanyBarry Zalma relates a case where fraudulently obtained no-fault insurance was subject to rescission.

Defense and Settlement

The Eight-Corners Rule Is Alive and Well in Texas

2020-07-31 | Lyndon F Bittle

Lyndon Bittle relates two recent cases involving this rule and the "very narrow" Northfield exception.

Claims Management 03

Presumption of WC Claim Compensability in the Age of COVID

2020-07-03 | Christopher E Mandel

Presumption of WC Claim Compensability in the Age of COVID—From the "Grand Bargain" to the pandemic, Chris Mandel looks at the impacts.

Courts and Coverage

The Two "I's" of Risk Transfer: Indemnity and Insurance

2020-06-12 | David M Knapp

The Two "I's" of Risk Transfer: Indemnity and Insurance—Scope matters. David Knapp explains the concepts and applications.

Construction Law

Modify Construction Documents in Light of COVID-19

2020-05-15 | Robert J Miletsky

Modify Construction Contracts in Light of COVID-19—Reexamine partial releases, waivers of lien, and language on time extensions, per Robert Miletsky.

Defense and Settlement

Texas Recognizes Collusion as Exception to Eight-Corners Rule

2020-05-15 | Lyndon F Bittle

Lyndon Bittle discusses the recent Loya collusion exception to the eight-corners rule.

Claims Practices

Failure to Give Notice Defeats Coverage

2020-04-17 | Barry Zalma

Failure To Give Notice Defeats Coverage—Judgment creditor who did not comply with policy condition had no coverage. Barry Zalma relates the case.

Construction Law

Personal Guarantees in Construction

2020-04-17 | Robert J Miletsky

Personal Guarantees in Construction—Know the facts, the risks, and the implications. Robert Miletsky reviews these and more.

Claims Management 03

Claims Management and Effective Risk Management

2020-03-20 | Christopher E Mandel

Claims Management and Effective Risk Management—Claims are the outgrowth of risk and exposure. Chris Mandel relates their relationship.

Courts and Coverage

Coverage for Ransomware Losses under Property Policies

2020-02-28 | David M Knapp

Coverage for Ransomware Losses under Property Policies—If hardware has been impaired, there may be coverage, per David Knapp.

Defense and Settlement

Texas Court Adopts Time-on-the-Risk Allocation

2020-02-28 | Lyndon F Bittle

Lyndon Bittle discusses recent Vines-Herrin decision.

Claims Practices

Insured's Obligation To Read the Insurance Policy

2020-01-24 | Barry Zalma

Insured's Obligation To Read the Insurance Policy—Most people do not read their insurance policy. Barry Zalma explains why they should.

Claims Management 03

Bad Faith, Litigation Trends, and Emerging Tactics

2020-01-10 | Christopher E Mandel

Bad Faith, Litigation Trends, and Emerging Tactics—Chris Mandel examines legal costs that contribute significantly to the total cost of claims.

Regulation and Compliance

Motor Vehicle Service Contract Ancillary Products

2020-01-03 | Aaron E Lunt

Motor Vehicle Service Contract Ancillary Products—Aaron Lunt takes a look at coverage for auto tires and wheels, theft, vehicle appearance, and fobs.

Courts and Coverage

Why Insurance Policy Language Matters

2019-12-13 | David M Knapp

Regulation and Compliance

New Trends in Insurance

2019-11-01 | Aaron E Lunt

New Trends in Insurance—Aaron Lunt highlights a few innovative changes emerging in insurance.

Claims Practices

Crazy or Not, the Insured Intended to Kill His Wife

2019-10-11 | Barry Zalma

Crazy or Not, the Insured Intended To Kill His Wife—Inability to form criminal intent does not make murder an accident. Read the case related by Barry Zalma.

Claims Management 03

The Future of Workers Compensation Claim Systems

2019-09-27 | Christopher E Mandel

The Future of WC Claim Systems—Chris Mandel reviews Scenarios for the 2030s: Threats and Opportunities for Workers' Compensation Systems.

Courts and Coverage

Beyond the Eight Corners: Additional Insureds and Workers Comp

2019-08-16 | David M Knapp

Additional Insureds and Workers Comp—David Knapp discusses what happens when the named insured is immune under workers compensation law.

Defense and Settlement

Eight-Corners Rule under Siege

2019-08-16 | Lyndon F Bittle

The evolution of the rule continues in Texas. Lyndon Bittle relates the case currently pending in the Fifth Circuit.

Construction Law

UCC Rights and Responsibilities for Purchasing Materials or Equipment

2019-08-02 | Robert J Miletsky

UCC Rights and Responsibilities for Purchasing Materials or Equipment—Robert Miletsky explains the requirements in UCC Article 2.

Claims Practices

Subrogation Waiver Held Enforceable by Wisconsin Supreme Court

2019-07-19 | Barry Zalma

Subrogation Waiver Held Enforceable by Wisconsin Supreme Court—Barry Zalma relates a case where an insurer sought to negate its agreement to waive subrogation.

Claims Management 03

Federal Terrorism Reinsurance Claim Recovery

2019-06-28 | Christopher E Mandel

Christopher Mandel reviews the history and the Federal Terrorism Reinsurance claims process.

Regulation and Compliance

Warren Buffett Likes Insurance Companies

2019-06-28 | Aaron E Lunt

Warren Buffett Likes Insurance Companies—Aaron Lunt looks at the attraction to and how insurers make money.

Courts and Coverage

More Confusion Regarding the "Damage to Property" Exclusion

2019-05-17 | David M Knapp

More Confusion Regarding the "Damage to Property" Exclusion—The latest circuit court decision does little to help, per David Knapp.

Regulation and Compliance

What Is an Insurance Model Law?

2019-05-17 | Aaron E Lunt

What Is an Insurance Model Law?—Do you know how insurance laws develop? Aaron Lunt explains the process.

Claims Management 03

Examining WC Waivers of Subrogation

2019-04-12

While often required by contract, waivers pose significant risk to subcontractors' loss experience. Glenn Brown explains.

Claims Management 03

Examining WC Waivers of Subrogation

2019-04-12

While often required by contract, waivers pose significant risk to subcontractors' loss experience. Glenn Brown explains.

Claims Practices

Purchasing Higher Deductibles Than Desired Is Not Broker Negligence

2019-04-12 | Barry Zalma

Purchasing Higher Deductibles Than Desired Is Not Broker Negligence—Barry Zalma relates a case where the policy didn't provide the coverage expected.

Claims Management 03

WC Court Rulings, Legislation, and Advocacy-Driven Claim Outcomes

2019-03-29 | Christopher E Mandel

WC Court Rulings, Legislation, and Advocacy-Driven Claim Outcomes—Worker advocacy is worth the investment and does have an impact, per Chris Mandel.

Defense and Settlement

Endorsement Did Not Apply to Defense Costs in Deepwater Horizon Suit

2019-03-01 | Lyndon F Bittle

Lyndon Bittle relates the ruling by the Texas Supreme Court.

Claims Management 03

Captive Claim Management

2019-01-18 | Christopher E Mandel

Captive Claim Management—Chris Mandel looks at the similarities and differences of managing claims for a captive.

Claims Practices

Agent Has No Duty to Advise Insurance Coverage Needs

2019-01-18 | Barry Zalma

Agent Has No Duty To Advise Insurance Coverage Needs—Barry Zalma relates a recent Alabama case.

Defense and Settlement

New Liability Restatement and Settlement of Catastrophic Claims

2018-12-07 | Lyndon F Bittle

Where a defendant is insured by multiple policies, adopting this approach could make a big difference, per Lyndon Bittle.

Regulation and Compliance

What Is Subrogation?

2018-11-30 | Aaron E Lunt

What Is Subrogation?—Subrogation benefits all. Aaron Lunt explains how it works and the benefits.

Claims Practices

Infrared Detection of Water Damage

2018-11-16 | Barry Zalma

Barry Zalma discusses a new tool that can be used by claims investigators, remediators, and consultants to detect and help eliminate mold infestations.

Claims Practices

California Case Comes Down Hard on Insurers

2018-10-19 | Barry Zalma

California Case Comes Down Hard on Insurers—Barry Zalma relates a case finding single acts in violation of the regulations can constitute a business practice.

Claims Management 03

Workers Compensation Claims and the Opioid Impact Revisited

2018-09-28 | Christopher E Mandel

Workers Compensation Claims and the Opioid Impact Revisited—Chris Mandel looks at the crisis and efforts to quell the tide.

Claims Management 03

Appraiser Disqualified for Contingent Fee

2018-08-24 | Barry Zalma

Appraiser Disqualified for Contingent Fee—Barry Zalma discusses a Colorado case emphasizing the need for appraisers and umpires to be impartial and fair.

Regulation and Compliance

Credit Card Insurance Benefits

2018-08-17 | Aaron E Lunt

Credit Card Insurance Benefits—Aaron Lunt discusses the variety of offers available from financial institutions vying for customers.

Claims Management 03

Greedily Contesting Claim Recovery Can Backfire

2018-07-27 | Barry Zalma

Greedily Contesting Claim Recovery Can BackfireBarry Zalma relates a suit for total disability that didn't go well for the insured.

Claims Management 03

Insurtech and the Claim Function

2018-07-13 | Christopher E Mandel

Insurtech and the Claim Function—The insurance claim process has much to gain from technological advances, per Christopher Mandel.

Defense and Settlement

Settlement Relationships—Insurer, Insured, and Defense Counsel

2018-05-25 | Lyndon F Bittle

Is defense counsel a "sub-agent" of the insured client? Lyndon Bittle relates the case.

Regulation and Compliance

An Insurer's Framework To Hire outside Counsel

2018-05-11 | Aaron E Lunt

Aaron Lunt offers advice on when to hire outside counsel, especially for regulatory compliance issues.

Claims Practices

Taking Months to Hire a Public Adjuster Is No Excuse for Late Notice

2018-04-13 | Barry Zalma

Taking Months to Hire a Public Adjuster Is No Excuse for Late NoticeBeing too busy is not a tenable excuse. Barry Zalma relates a California case.

Claims Management 03

Insurance Claim Resolution and Settlement

2018-03-23 | Christopher E Mandel

Insurance Claim Resolution and Settlement—Chris Mandel looks at ways to reach faster and more equitable and efficient claim closure.

Regulation and Compliance

Can a Legal Department Become More Efficient?

2018-03-02 | Aaron E Lunt

Can a Legal Department Become More Efficient?—Companies can improve efficiencies and quantify value with a few tweaks, per Aaron Lunt.

Claims Management 03

Claim Evaluation: Determining Valuation

2018-01-19 | Christopher E Mandel

Claim Evaluation: Determining Valuation—Establishing claim value is the heart of the process. Chris Mandel describes the components.

Claims Practices

Coconspirator's Civil Testimony Convicts Arsonist

2018-01-19 | Barry Zalma

Coconspirator's Civil Testimony Convicts Arsonist—No hearsay protection in a recent Connecticut case related by Barry Zalma.

Defense and Settlement

Defenseless? Beware of Application Errors

2017-12-01 | Lyndon F Bittle

Recognize and remedy misstatements before they turn into lawsuits, advises Lyndon Bittle.

Claims Management 03

Looking at the Tort of Bad Faith

2017-11-03 | Barry Zalma

Looking at the Tort of Bad Faith—Although around for decades, Barry Zalma argues the tort should be put down like a vampire.

Regulation and Compliance

Insurance Is Regulated by States, Right?

2017-11-03 | Aaron E Lunt

Insurance Is Regulated by States, Right?—The federal government is becoming more involved in the business of insurance, per Aaron Lunt.

Claims Management 03

Claim Investigation: Reaching Resolution

2017-10-06 | Christopher E Mandel

Chris Mandel discusses efforts necessary close a claim, from gathering evidence to litigation to setting reserve.

Claims Practices

No Insurance Policy Covers Every Possible Eventuality

2017-10-06 | Barry Zalma

No Insurance Policy Covers Every Possible Eventuality—Barry Zalma relates a case where professional liability insurance doesn't cover sexual harassment.

Regulation and Compliance

Technology and the Motor Vehicle Service Contract Industry

2017-09-08 | Aaron E Lunt

Technology and the Motor Vehicle Service Contract Industry—Aaron Lunt says it must anticipate market needs, shifting regulations, and ownership issues.

Construction Law

Are Your Goods and Services UCC Worthy?

2017-09-01 | Robert J Miletsky

Are Your Goods and Services UCC Worthy?-- It's not a question "if" the UCC Articles apply, but how often and to what extent. Robert Miletsky explains.

Defense and Settlement

The Insurer Wants Its Money Back—Can It Do That?

2017-09-01 | Lyndon F Bittle

Whether it can recover costs paid depends on many factors. Lyndon Bittle explains.

Claims Practices

Pleading Can't Change a Battery into Negligence

2017-07-21 | Barry Zalma

Pleading Can't Change a Battery into Negligence—Barry Zalma relates a recent case for coverage for a barroom assault.

Claims Management 03

Claim Reporting Best Practices

2017-06-23 | Christopher E Mandel

Chris Mandel examines the first of five major components of the claim management process, whether for insured, partially insured, or uninsured claims.

Construction Law

How To Handle "Will Serve" Letters

2017-05-12 | Robert J Miletsky

How To Handle "Will Serve" Letters -- Don't dismiss them as just another layer of paperwork, warns Robert Miletsky.

Defense and Settlement

Contract Bars Coverage? Reform the Contract!

2017-05-12 | Lyndon F Bittle

Reformation may be warranted in certain circumstances. Lyndon Bittle reviews a recent case.

Regulation and Compliance

Warranty, Service Contract, and Insurance

2017-04-28 | Aaron E Lunt

Warranty, Service Contract, and Insurance—While they have many similar components, Aaron Lunt explains that their dissimilarities are important under the law.

Claims Practices

Excess Insurer May Not Refuse Reasonable Settlement

2017-04-07 | Barry Zalma

Barry Zalma relates a case holding that the insured and primary insurer may settle when excess refuses to participate.

Claims Management 03

The Claim Function and Best Practices

2017-03-31 | Christopher E Mandel

Chris Mandel explains the fundamentals of claims management and the best ways to get to reasonable outcomes for all parties.

Courts and Coverage

Understand the CGL Policy Post-Judgment Interest Provision

2017-03-10 | R Brent Cooper

Brent Cooper continues the series on little known/understood CGL policy provisions, focusing on clause 1.g of "Supplementary Payments."

Construction Law

Beware of Unclear Language in Construction Contracts/Forms

2017-03-03 | Robert J Miletsky

Learn about contra proferentem and other problems that can arise when using imprecise wording in construction contracts.

Defense and Settlement

First Come, First Served—Must an Insurer Accept a Settlement Offer That Does Not Release All Insureds?

2017-02-24 | Lyndon F Bittle

Lyndon Bittle relates a recent Fifth Circuit case that affirmed a $2.8 million judgment against an insurer for failing to accept a Stowers demand.

Regulation and Compliance

Understanding the Consumer Financial Protection Bureau

2017-02-17 | Aaron E Lunt

Learn about the Consumer Financial Protection Bureau, which is part of the Dodd-Frank Wall Street Reform and Consumer Protection Act.

Claims Practices

Potential for Insurance Coverage Requires Defense

2017-01-27 | Barry Zalma

A recent California case -- Tidwell Ent. v. Financial Pacific Ins. -- involves pyrolysis and the insurer's duty to provide a defense.

Claims Management 03

Insurance Claim Fraud and Social Media

2017-01-13 | Christopher E Mandel

Insurance fraud is increasing, but law enforcement and social media may help slow it down.

Defense and Settlement

Does Cooperation Mean Capitulation?

2016-12-16 | Lyndon F Bittle

Lyndon Bittle relates a case regarding whether the insured's duty to cooperate required it to contribute its own assets to settle a covered claim.

Construction Law

Choose the Right Construction Dispute Resolution Method

2016-12-02 | Robert J Miletsky

When construction disputes arise, arbitration, mediation, or litigation may result. Learn the pros and cons of each method.

Claims Practices

No Bad Faith for Reasonable Dispute

2016-11-11 | Barry Zalma

Where insured fails to prove a property insurance loss, the claim ends: One-Way Investments v. Century Surety Co.

Regulation and Compliance

What Is a Contractual Liability Insurance Policy?

2016-11-04 | Aaron E Lunt

Learn what a contractual liability insurance policy (CLIP) is, why it's necessary, and how it is used in the marketplace to protect both businesses and consumers.

Courts and Coverage

Little Known/Utilized Provisions of the CGL Policy: Supplementary Payments

2016-10-28 | R Brent Cooper

CGL insureds may be paid for assisting in claims investigation under a section of the "Supplementary Payments" provision.

Courts and Coverage

Little Known/Little Utilized Provisions of the CGL Policy: Declarations Provision

2016-09-16 | R Brent Cooper

This series of articles looks at little known or utilized provisions of the commercial general liability policy, starting with the declarations provision.

Construction Law

Pay-When-Paid Clauses and Prompt Payment Acts

2016-09-02 | Robert J Miletsky

The interaction of pay-when-paid clauses and state prompt payment acts may impact your construction projects and contracts.

Regulation and Compliance

Insurance Protection on My Cell Phone

2016-09-02 | Aaron E Lunt

Cell phone insurance via portable electronic insurance (PEI) is available in all states except Wyoming.

Defense and Settlement

No Home Run If You Don't Touch All the Bases: Collecting Judgments Against Nonsettling Insurers

2016-08-26 | Lyndon F Bittle

Lyndon Bittle analyzes the obstacles of collecting judgments against nonsettling insurers in relation to a Texas case, Seger v. Yorkshire Insurance.

Claims Management 03

Opioids: a Stumbling Block to Good Claim Outcomes

2016-07-22 | Christopher E Mandel

For injured workers on opioids, claims professional vigilance can facilitate better results.

Claims Practices

Prompt Payment of Appraisal Award Defeats Bad Faith

2016-07-22 | Barry Zalma

A Texas case, Anderson v. American Risk, shows that a breach of contract is needed for a bad faith claim.

Claims Practices

Agent's Lie to Insurer Voids Policy

2016-04-08 | Barry Zalma

Lies on insurance application about material facts cancels coverage.

Claims Management 03

Managing Claims for the Benefit of Consumers

2016-03-18 | Christopher E Mandel

Whether occupational or injury or property casualty insurance claims, put consumers first.

Regulation and Compliance

What in the World Is a Motor Vehicle Service Contract?

2016-03-18 | Aaron E Lunt

Motor vehicle service contracts are defined, differ from insurance, and are regulated.

Claims Practices

Installation of Defective Product Is Not Physical Damage

2016-02-26 | Barry Zalma

Installation of Defective Product Is Not Physical Damage—Barry Zalma relates a case holding that actual physical injury is required for CGL coverage.

Courts and Coverage

Texas Recognizes Loss-of-Use Damages in Total Destruction Cases

2016-02-12 | R Brent Cooper

Resolving a split in appellate courts, Brent Cooper relates a recent Texas Supreme Court decision.

Claims Practices

Invest in Claims Training: Ignorance Can Be Cured

2016-01-15 | Barry Zalma

Barry Zalma believes the demise of formal training for claims adjusters has cost insurers dearly and advocates for its return.

Courts and Coverage

Accrual of Interest under Texas Prompt Payment of Claims Act

2015-10-30 | R Brent Cooper

Brent Cooper relates a case holding that statutory interest applies to insurer that is not in compliance with Act deadlines.

Claims Practices

Can an Insurer Obtain Insured's Tax Returns?

2015-08-28 | Barry Zalma

In relating a recent Utah case, Barry Zalma relates the court's opinion regarding how tax returns can establish a triable issue if allowed in evidence.

Claims Management 03

Next-Level Claim Strategies

2015-07-24 | Christopher E Mandel

Chris Mandel explains how such strategies can provide a clear advantage over traditional approaches and offer a competitive advantage for organizations that effectively deploy them.

Claims Management 03

Workers Compensation Options in Claims Management

2015-04-03 | Christopher E Mandel

When it comes to workers comp, many states benefit from giving employers a choice, says Chris Mandel.

Claims Practices

Is Pool Pop-Out Excluded?

2015-03-27 | Barry Zalma

Barry Zalma discusses a recent case holding that a clear and unambiguous subsurface water pressure exclusion applied.

Claims Practices

Eight-Corners Rule Defeats Right to Defense

2015-01-01 | Barry Zalma

A court rules there's no accident when a person is shot in the head at close range. Barry Zalma relates the case.

Personal Lines Claims

The Claims Professional as Problem Solver

2014-11-01 | Elise Farnham

Elise Farnham provides six tips to help resolve claim situations in an efficient and economical manner.

Claims Practices

Texas Court Rules WC Is the Exclusive Remedy in CCIP Claim

2014-10-01 | Barry Zalma

Barry Zalma relates a case involving a crane collapse and a contractor controlled insurance program.

Courts and Coverage

Burden of Proof in Coverage Litigation (Part 4)

2014-07-19 | R Brent Cooper

Brent Cooper looks at who has the burden of proof to show that a claim falls within the policy period.

Courts and Coverage

Burden of Proof in Coverage Litigation (Part 3)

2014-04-26 | R Brent Cooper

Brent Cooper discusses who has the burden of proof to prove an exception to an exclusion and to show that the person claiming coverage is insured.

Courts and Coverage

Burden of Proof in Coverage Litigation (Part 2)

2014-01-01 | R Brent Cooper

Brent Cooper continues his review of the insurer's and insured's burden of proof during the course of insurance litigation in Texas.

Claims Practices

Foreclosure Destroys Insurable Interest

2013-10-01 | Barry Zalma

Barry Zalma discusses a recent Texas case involving a homeowners insurance claim and the possibility of profiting where the policy provided no coverage.

Courts and Coverage

Burden of Proof in Coverage Litigation (Part 1)

2013-10-01 | R Brent Cooper

Brent Cooper reviews the respective burdens of proof that the insurer and insured must carry during the course of insurance litigation in Texas.

Personal Lines Claims

Evaluating Bodily Injury Claims—Back Injuries

2013-10-01 | Elise Farnham

Claims professionals need to conduct a thorough investigation, per Elise Farnham.

Courts and Coverage

Named Driver Policies

2013-07-01 | R Brent Cooper

Brent Cooper discusses "named driver" policies that limit the auto coverage afforded to only those drivers identified in the policy.

Personal Lines Claims

Evaluating Bodily Injury Claims—The Effects of Traumatic Injuries

2013-07-01 | Elise Farnham

Elise Farnham explains the importance of psychosomatic medicine and the impact of emotions on the healing process.

Personal Lines Claims

Evaluating Bodily Injury Claims: Consideration Based on the Type of Injury—Fractures

2013-06-01 | Elise Farnham

Assess the extent of injury, health of the injured party, and potential for permanent disability, per Elise Farnham.

Claims Practices

Insurer's Lawyer's Advice Not Privileged

2013-04-01 | Barry Zalma

In Washington state, it appears that all lawyers and litigants are equal except for insurers and their lawyers, who are less equal than all others are.

Courts and Coverage

Courts Address the Contractual Liability Exclusion—How Far Does It Go?

2013-04-01 | R Brent Cooper

Brent Cooper looks at Texas cases addressing the breadth of the exclusion and the resulting uncertainty.

Courts and Coverage

Taking and Defending the Adjuster's Deposition (Part 4)

2013-02-02 | R Brent Cooper

This article addresses the deposition itself. Brent Cooper covers the adjuster's appearance and objections and privileges that can be asserted.

Courts and Coverage

Taking and Defending the Adjuster's Deposition (Part 3)

2013-01-19 | R Brent Cooper

This article concludes Brent Cooper's advice on how to best prepare for a deposition.

Courts and Coverage

Taking and Defending the Adjuster's Deposition (Part 2)

2013-01-01 | R Brent Cooper

Brent Cooper deals with the most important aspect of the adjuster s deposition—preparation

Personal Lines Claims

Evaluating Bodily Injury Claims: Consideration Based on the Type of Injury—Wounds

2013-01-01 | Elise Farnham

Personal injury wounds vary. Elise Farnham discusses what should be considered when evaluating these injuries.

Claims Practices

California Allows Stacking of CGL: a Case of First Impression and Importance

2012-12-01 | Barry Zalma

Barry Zalma relates a California case holding that each insurer must pay its limits for each policy year it had a policy in effect.

Personal Lines Claims

Claims: There's an App for That, or Is There?

2012-07-07 | Elise Farnham

Elise Farnham develops ideas for mobile phone applications for insurance claims adjusters.

Courts and Coverage

Taking and Defending an Adjuster's Deposition (Part 1)

2012-06-01 | R Brent Cooper

In this new series, Brent Cooper first examines whether the deposition should be taken at all.

Claims Practices

Appraisal Only Determines Loss

2012-04-01 | Barry Zalma

In a case related by Barry Zalma, the misuse of the appraisal system and the need for competent and experienced claims people are highlighted.

Personal Lines Claims

Personal Lines Insurance Is Getting More Personal

2012-01-01 | Elise Farnham

Technological advances, says Elise Farnham, are making the claims process more personal for insureds

Courts and Coverage

Trial of the Coverage Case (Part 4)

2011-12-17 | R Brent Cooper

Insurance coverage cases involve trial demonstrative aids, themes and values, and charges. Brent Cooper explains.

Claims Practices

When an Occurrence Is Not an Occurrence: Faulty Construction Is Not an "Occurrence"

2011-12-01 | Barry Zalma

Poor construction is not considered an occurrence under a CGL policy per Kentucky court. (IRMI.com article)

Claims Management 03

The Next Level of Business Income Coverage

2011-11-01

Timothy King explains how insurance claims from off-premises events can harm business if not insured.

Personal Lines Claims

Plaintiff Duties in Personal Lines Claims

2011-11-01 | Elise Farnham

In personal lines insurance claims, plaintiffs must prove that actual damages were proximately caused by defendant's negligence (IRMI.com article)

Courts and Coverage

Trial of the Coverage Case (Part 3)

2011-10-08 | R Brent Cooper

Brent Cooper examines key elements of insurance coverage trials: opening statements and the use of expert witnesses.

Claims Practices

Claims-Made Policies—Report Potential Claims Immediately

2011-10-01 | Barry Zalma

Recent caselaw shows danger of claims-made commercial general liability insurance policies. (IRMI.com article)

Courts and Coverage

DOI Certificate Bulletins Are Not "Regulations"

2011-09-01 | Richard J Scislowski

Those in the insurance industry often react to certificate bulletins as if they have the force of law. But do they really?

Courts and Coverage

Trial of the Coverage Case (Part 2)

2011-08-20 | R Brent Cooper

Key elements of insurance coverage trials include choosing the insurer representative and voir dire. Brent Cooper explains.

Personal Lines Claims

Getting to the Bottom Line—Determination of Damages

2011-08-01 | Elise Farnham

Personal lines insurance claims can be difficult to quantify. Learn types of damages and factors to consider. (IRMI.com article)

Courts and Coverage

Additional Insured Endorsement Should Cover a Tenant's "Operations"

2011-05-01 | Richard J Scislowski

A recent Third Circuit case shows why it's preferable to specify a tenant's operations, not use, when arranging additional insured coverage for a landlord.

Claims Practices

Arson Conviction Upheld in Ohio; Texas Lets One Go Free

2011-04-01 | Barry Zalma

Barry Zalma reviews two recent arson cases with opposite results.

Courts and Coverage

Trial of the Coverage Case (Part 1)

2011-04-01 | R Brent Cooper

In this series, Brent Cooper takes a close look at insurance coverage trials, starting with jury versus nonjury pros and cons.

Personal Lines Claims

Black Swans on the Horizon: Expecting the Unexpected

2011-04-01 | Elise Farnham

To effectively manage future losses, Elise Farnham stresses that claims professionals and their organizations must ask, 'What if?'

Courts and Coverage

Distinguishing between the Exclusions

2011-02-01 | R Brent Cooper

When addressing exclusions in personal lines liability policies, Brent Cooper says the substance of the exclusion is always critical.

Claims Practices

Pleading the Fifth Can Forfeit Insurance Coverage

2011-01-01 | Barry Zalma

Where insureds invoke the Fifth Amendment, they may forfeit their insurance coverage. Barry Zalma explains.

Personal Lines Claims

The Art and Skill of Analyzing Coverage

2011-01-01 | Elise Farnham

For the personal lines claims professional, there is no substitute for a systematic and logical approach to coverage analysis. Elise Farnham explains.

Claims Management 03

Controlling Claims Leakage through Technology

2010-11-01

Proper use of claims systems, basic reporting analysis, and advanced tools such as predictive analytics can help reduce the ultimate cost of risk, per David Tweedy.

Courts and Coverage

Appraisal under the Homeowners Policy

2010-10-01 | R Brent Cooper

Brent Cooper describes the case law surrounding appraisals—their timing, objectivity, and impact.

Courts and Coverage

Sometimes, Certificate Disclaimers Help

2010-09-01 | Richard J Scislowski

Two court cases show that even though certificates are often viewed as little more than a nuisance, every so often standard certificates can save the day.

Claims Practices

Diminution in Value

2010-08-01 | Barry Zalma

When faced with a question of diminution of value, Barry Zalma says you need to determine the applicable state law.

Courts and Coverage

Duty To Cooperate

2010-08-01 | R Brent Cooper

Every liability policy contains a cooperation clause. But, as Brent Cooper shows, how it is applied and litigated differs greatly.

Personal Lines Claims

Stress-Free Claims Adjusting

2010-08-01 | Elise Farnham

While there is no single panacea for dealing with stress, Elise Farnham offers a variety of techniques that can help.

Claims Practices

Insureds and Their Public Adjuster Nephew Punished for Adding to Damage after Legitimate Loss

2010-06-01 | Barry Zalma

In New Jersey, not only does crime not pay, but if caught, you may pay three times the damages. Barry Zalma relates the case.

Courts and Coverage

Correcting Mistakes in Additional Insured Endorsements

2010-04-01 | Richard J Scislowski

A New York court holds reformation as the remedy for a scrivener's error.

Courts and Coverage

Only Defense Costs Paid by Named Insured Satisfy the Self-Insured Retention

2010-03-01 | Richard J Scislowski

Only defense costs paid by named insured satisfy the self-insured retention.

Claims Management 03

Litigation Management—Crucial but Confusing

2010-02-01

Litigation is expensive. Glenn Brown explains how to manage costs.

Claims Practices

Legitimate Loss becomes a Crime When Insured Lies

2010-02-01 | Barry Zalma

Barry Zalma relates a case proving that it doesn't pay to lie to the police and your insurer.

Personal Lines Claims

The Art of Strategic Negotiation

2010-01-01 | Elise Farnham

Becoming a skilled negotiator is vital to claims adjusters. Elise Farnham provides tips.

Claims Management 03

Reduce Claims To Improve WC Mod

2009-12-01

Manage workers compensation experience rating plans to curb expenses, per David Ackerman.

Claims Practices

Breach of Contractor's Warranty Defeats Coverage

2009-10-01 | Barry Zalma

To succeed in an insurance claim, be sure to obtain insurance certificates as required. Barry Zalma explains.

Courts and Coverage

Coverage Triggers and Duty-To-Defend Dilemmas

2009-10-01 | R Brent Cooper

The adoption of the actual injury rule in Texas creates issues with respect to the duty to defend, per Brent Cooper.

Personal Lines Claims

"Green" Building Claim Implications

2009-10-01 | Elise Farnham

Green construction has significance for loss adjusters even when their insurer does not issue green policies. Elise Farnham explains.

Claims Management 03

Workers Compensation Return-to-Work Programs: Cost Savers?

2009-08-01

Insurance savings can be achieved if done correctly. Glenn Brown explains.

Courts and Coverage

Uninsured/Underinsured Motorist Coverage and Anti-Stacking Provisions

2009-08-01 | R Brent Cooper

States are all over the board when it comes to UM/UIM anti-stacking statutes and case law. Brent Cooper reviews.

Claims Management 03

Reducing Workers Compensation Claims during a Layoff

2009-05-01

Lisa Hartman outlines the layoff issues risk managers face and suggests strategies to help guide them.

Claims Practices

Attorney Fees for Enforcement of Settlements in Florida

2009-05-01 | Barry Zalma

Barry Zalma relates cases permitting attorney fees where insureds must go to court to force claims settlement.

Courts and Coverage

Recent Cases Involving First-Party Claims

2009-05-01 | R Brent Cooper

Brent Cooper relates current homeowners, workers compensation, commercial property, and uninsured/underinsured motorist coverage cases.

Courts and Coverage

Hurricane Ike and First-Party Litigation

2009-04-01 | R Brent Cooper

Brent Cooper looks at the effect on insurance rating, underwriting, legislation, and litigation in the aftermath of Hurricane Ike.

Claims Management 03

Workers Compensation Reserves—Dollars and Sense

2009-02-01

William Quinn explains how improper loss reserving can affect insurers and employers, and should be monitored closely.

Claims Practices

Insurance Fraud

2009-01-01 | Barry Zalma

Barry Zalma explains that insurance fraud can only be defeated by a thorough investigation by claimspersons, investigators, and insurance coverage counsel.

Courts and Coverage

Underinsured Motorist Insurance: Prerequisites before Coverage Applied

2009-01-01 | R Brent Cooper

Brent Cooper relates a Texas decision showing a further entrenchment in the plain-and-ordinary meaning test.

Personal Lines Claims

Avoiding Bad Faith Allegations in Excess Loss Situations

2009-01-01 | Elise Farnham

Elise Farnham discusses steps claim professionals can take to avoid bad faith situations and minimize damage if they encounter them.

Claims Management 03

Is Self-Administration Ever the Right Answer?

2008-11-01

Glenn Brown explores the decision-making process along with the risks, possible rewards, and challenges of administering your own claims.

Claims Practices

The Examination under Oath

2008-10-01 | Barry Zalma

Barry Zalma explains why this is an important tool to help insureds prove their loss or to allow an insurer to examine the proofs of loss to avoid potential fraud.

Courts and Coverage

Injury-in-Fact Coverage Trigger—HO Policy View

2008-10-01 | R Brent Cooper

Brent Cooper looks at Don's Building Supply and its application to the Texas Homeowners Insurance Policy HO-B.

Personal Lines Claims

Personal Lines Property Loss Adjusting—Achieving Excellence

2008-10-01 | Elise Farnham

The steps involved to achieve claims closure involve knowing the policy, the contract, textbook answers, and alternatives. Elise Farnham explains.

Claims Management 03

Technology and Claims: Blessing or Curse?

2008-08-01

RMIS Review Editor David Tweedy takes a look at the advantages and disadvantages of technological progress in claims management.

Courts and Coverage

Event Data Recorders: Balancing the Benefits and Drawbacks

2008-08-01 | R Brent Cooper

EDRs are in more modes of transportation than ever. Brent Cooper looks at the legislation and case law on the issue of privacy versus public safety.

Litigation Management 02

Litigation Best Practices—Lessons from Risk Manager of the Year

2008-08-01 | Michael R Boutot

Michael Boutot interviews the Business Insurance Risk Manager of the Year who provides some yardsticks and takeaways to improve litigation management processes and outcomes.

Claims Practices

Insurers Need To Audit Their Vendors' Service

2008-07-01 | Barry Zalma

Barry Zalma explains why prudent insurers need to trust claims vendors while simultaneously verifying their performance.

Claims Management 03

Third-Party Administrators: Quality versus Price

2008-06-01

The wise consumer will analyze the quality indicators first and then compare price when selecting a TPA. Glenn Brown explains.

Claims Practices

Surprise: Insurance Is Not a Service

2008-05-01 | Barry Zalma

Barry Zalma reviews a California case concluding that insurance is neither a good nor a service, but only for the purposes of the Consumer Legal Remedies Act.

Courts and Coverage

No Insurance Coverage for "Actual Physical Contact" with "Integral Part" of Auto

2008-05-01 | R Brent Cooper

Brent Cooper describes a Texas Supreme Court ruling that collision with an axle isn't contact with a motor vehicle.

Claims Management 03

An Insurance Claims Management Retrospective

2008-04-01

William Quinn Jr. takes a look at the claims management experience, then (1950s) and now (2000s).

Claims Practices

Insurer Must Go to Trial on Allegations of a Fraudulent Settlement

2008-02-01 | Barry Zalma

Barry Zalma shows why insurers who settle with a general release may not be able to close the claim.

Litigation Management 02

The Three Pillars of Litigation Management

2008-02-01 | Michael R Boutot

Michael Boutot explains why lawyers can and should be managed, just like any other outside service vendor.

Claims Practices

Required Insurance Training and Continuing Education

2008-01-01 | Barry Zalma

With constant regulation changes, Barry Zalma says best practices mandate yearlong education.

Courts and Coverage

Trigger Theories in Homeowners Insurance

2008-01-01 | R Brent Cooper

Brent Cooper relates a case showing the difficulty of applying trigger theories in progressive or continuous property damage claims.

Courts and Coverage

The Measure of "Reasonable" Defense Costs in Independent Counsel Situations

2007-11-01 | R Brent Cooper

In independent counsel situations, who determines what costs are reasonable? Brent Cooper and Dana Harbin peruse state positions.

Claims Practices

Use Licensed Experts in Claims Litigation

2007-08-01 | Barry Zalma

An Illinois decision requiring experts to be licensed in the state before testifying could be problematic. Barry Zalma explains.

Courts and Coverage

Surface Water Exclusions in the Homeowners Policy

2007-07-01 | R Brent Cooper

Brent Cooper and Dana Harbin discuss cases in several jurisdictions where the surface water exclusion has been ruled inapplicable.

Claims Practices

The Lawyer as an Insurance Claims Expert

2007-05-01 | Barry Zalma

Contrary to popular opinion, Barry Zalma says a lawyer can make a good expert witness in an insurance claims dispute.

Courts and Coverage

Ensuing Loss Clauses in Homeowners Policies: Confusing but Not Ambiguous

2007-04-01 | R Brent Cooper

Recent court decisions make clear that ensuing loss clauses do not broaden or create coverage. Brent Cooper and Dana Harbin explain.

Claims Practices

When Agents or Applicants Lie to Insurers

2007-03-01 | Barry Zalma

Barry Zalma discusses the case for rescission when full and accurate facts about the risk are not conveyed to the insurer.

Courts and Coverage

Interpreting the "Physical Contact" Requirement of Uninsured Motorist Coverage in Indirect Contact Cases

2007-02-01 | R Brent Cooper

Brent Cooper and Dana Harbin discuss case law when indirect contact occurs.

Claims Practices

Insurance Fraud Fails in L.A. Superior Court

2007-01-01 | Barry Zalma

Barry Zalma relates the importance of insurer preparation, a thorough investigation, and use of competent counsel when facing a potentially fraudulent claim.

Claims Practices

Insurer Sues Attorney for Malicious Prosecution

2006-08-01 | Barry Zalma

In a bit of a role reversal, an insurer rightly goes after an attorney who filed an apparently malicious and unfounded lawsuit against it. Barry Zalma explains.

Claims Practices

Sharing of Information between Insurers To Fight Fraud

2006-07-01 | Barry Zalma

When insurers fail to communicate to combat fraud, no one benefits. Barry Zalma looks at legislative initiatives to stop this practice.

Courts and Coverage

Hurricanes Katrina and Rita: Coverage Disputes and Pending Litigation

2006-07-01 | R Brent Cooper

After a significant property loss, Michael Speer says all options regarding repair or replacement need to be considered.

Courts and Coverage

Hurricanes Katrina and Rita: Effect on Claims Handling Procedures

2006-06-01 | R Brent Cooper

Insurers faced unique obstacles in investigating and settling claims in 2005. Dana Harbin and Brent Cooper explain.

Courts and Coverage

Hurricanes Katrina and Rita: Effect on Rating and Underwriting

2006-05-13 | R Brent Cooper

Homeowners insurance rate increases may stabilize the market in affected states. Dana Harbin and Brent Cooper explain.

Claims Practices

New ISO ACV Definition and California Statute

2006-03-01 | Barry Zalma

ISO responds to claims handling difficulties caused by recent California statutory changes. Barry Zalma explains.

Courts and Coverage

Homeowners Policies and Acts of Self-Defense

2006-01-01 | R Brent Cooper

Brent Cooper reviews court decisions on whether homeowners are protected by their liability insurance for damages from defensive acts.

Litigation Management 02

Legal Billing—Is There a Change in the Wind? A Look at the UTBMS Task Codes and the Future of Legal E-billing

2005-12-01 | Michael R Boutot

Michael Boutot describes the history of legal billing and explains the Uniform Task-Based Management System task codes and what he sees as the future of legal e-billing.

Claims Practices

Claims in a Disaster

2005-09-01 | Barry Zalma

In light of the many natural disasters this year, insureds who have never had to deal with insurance claims adjusters are confused or intimidated by the prospect. Barry Zalma provides advice.

Claims Practices

Rescission in California

2005-08-01 | Barry Zalma

Misrepresentations or concealment of material facts - whether intentional or not 'can leave an insured without coverage, even for a legitimate claim. Barry Zalma looks at a recent case on point.

Courts and Coverage

Who Can Reject Uninsured Motorist and Personal Injury Protection Coverage?

2005-08-01 | R Brent Cooper

Brent Cooper and Dana Harbin look at the disparity among the state courts regarding who has the right to reject UM/PIP coverage, in what form, and under what circumstances.

Courts and Coverage

Unmarried Cohabitants Are Not "Members" of the Same "Household"

2005-07-01 | Richard T Valentino

What constitutes a household? Richard Valentino looks at a recent 11th Circuit case where the term was deemed ambiguous and lists rulings from other jurisdictions on the topic.

Courts and Coverage

Coverage Disputes Give Rise to "Independent" Counsel

2005-06-01 | R Brent Cooper

Brent Cooper explains how the Texas Davolos case sets out how the Independent Counsel Rule should be applied and a test as to what coverage questions give rise to independent counsel.

Claims Practices

Insurance and the Law of Unintended Consequences

2005-04-01 | Barry Zalma

Barry Zalma looks at how efforts by and for the insurance industry have resulted in far greater problems: rising costs, soaring litigation, increasing fraud, and a reputation seemingly beyond repair.

Courts and Coverage

Is Seller's Failure to Disclose Known Defects to Buyers a Covered "Occurrence"?

2005-01-01 | Richard T Valentino

Richard Valentino and Michael Resis examine cases illustrating the different approaches taken by courts on homeowners' coverage for claims arising from the sale of homes with latent defects.

Courts and Coverage

Bystander Claims—One Limit or Two?

2005-01-01 | R Brent Cooper

Whether a separate "each-person" limit applies to a bystander claim depends on whether emotional injuries are considered to be "bodily injury." Brent Cooper and Dana Harbin explain.

Litigation Management 02

Court Reporting/Deposition Services: What You Should Know

2005-01-01 | Michael R Boutot

In this quarter's Litigation Management column, Michael Boutot takes a look at the role of court reporters, their history, types, qualifications, functions, and cost factors.

Claims Practices

Fraudulent Application Can Haunt the Broker

2004-12-01 | Barry Zalma

Barry Zalma discusses a recent California case holding that if the broker knew the application contained false information, it can be held liable to the insurer for resulting damages.

Courts and Coverage

"No-Fault" Coverage Insures Injuries Arising Out of the Use of a Vehicle

2004-11-01 | R Brent Cooper

Brent Cooper and Dana Harbin look at court rulings on the issue of whether personal injury protection coverage applies when non-collision injury occurs, but the vehicle is somehow involved.

Litigation Management 02

Litigation Management—Proactive or Reactive Budgeting?

2004-11-01 | Michael R Boutot

Budgeting can be a very valuable tool if done in a proactive mindset, yet keeping past mistakes in mind. Michael Boutot explains the goals and pitfalls.

Personal Lines Claims

Adjusting Residential House Fires

2004-10-09 | George Epps

Adjusting a house fire is a difficult endeavor under the best of circumstances. George Epps looks at fire claims where the coverage is on an actual cash value basis.

Claims Practices

California Supreme Court Rules: Ordinary Negligence Involving Toxic Chemicals Not Pollution

2004-09-01 | Barry Zalma

Barry Zalma examines a recent California Supreme Court ruling which concluded that the CGL pollution exclusion does not exclude ordinary acts of negligence involving toxic chemicals.

Courts and Coverage

"Controlled Substance" Exclusion in Homeowners Policy Bars Coverage

2004-09-01 | Richard T Valentino

In this personal lines courts and coverage column, Richard Valentino examines recent cases dealing with insurance coverage for drug dealer liability.

Courts and Coverage

Diminishing Value: The Trend Against Coverage under Personal Automobile Policies

2004-09-01 | R Brent Cooper

Brent Cooper examines 2003 state supreme court rulings that personal auto policies do not obligate insurers to compensate insureds for diminished value when their vehicles are fully repaired.

Claims Practices

Mold and Fungi Insurance Claims

2004-08-01 | Barry Zalma

"Mold is gold," according to some in the claims industry. Barry Zalma looks at the growth of these claims, the science behind them, the case law, testing, and remediation.

Claims Practices

Stacking Insurance Limits

2004-07-01 | Barry Zalma

Barry Zalma explains why it is essential to examine the law of the jurisdiction relating to stacking of policy limits and self-insured retentions before making a decision on how to handle a claim.

Personal Lines Claims

Residential Water Claims

2004-07-01 | George Epps

George Epps takes a look at residential water claims - what causes them, how repairs are handled, and why restoration contractors are often necessary.

Courts and Coverage

Seventh Circuit Upholds Anti-Stacking Clauses

2004-06-01 | Richard T Valentino

In this article, Richard Valentino discusses a recent case upholding unambiguous anti-stacking clauses to prevent the doubling of an auto insurer's liability limits.

Claims Practices

The Ethical Dilemma Caused by Fighting Fraud

2004-04-10 | Barry Zalma

Barry Zalma discusses the obligation to and dangers of reporting suspected fraud.

Courts and Coverage

Subrogation Rights Against Personal Auto Uninsured Motorists Coverage

2004-03-01 | R Brent Cooper

The statutory right of a workers compensation insurer or employer to subrogate against a third party generally does not include rights to personal auto UM/UIM benefits. Brent Cooper and Dana Harbin explain.

Claims Practices

Adjusting Liability Claims

2004-01-01 | Barry Zalma

Barry Zalma details the claims adjuster's job: an investigator, an insurance contract expert, and a person of empathy who fulfills the policy promises to defend and indemnify the insured.

Claims Practices

Why Insurance Fraud Succeeds

2003-09-01 | Barry Zalma

The trend to reduce legal costs through litigation management can result in inferior service and greater indemnity payments. Barry Zalma explains.

Litigation Management 02

How To Overhaul Your Panel Counsel Network

2003-05-01 | Michael R Boutot

Michael Boutot discusses how to tune up your litigation management program by selecting a panel of law firms that will work with you to reduce and control legal costs.