Claims Adjusters

News & Analysis as of

The Wild West of Improper Joinder in North Texas

In 1998, the Texas Supreme Court recognized that an insurance claim adjuster can be held personally liable for a breach of the Texas Insurance Code. Based on this precedent, it has become commonplace for claim adjusters to be...more

Texas Legislature Reins in Public Adjuster Conduct

Obvious to anyone in the insurance industry, Texas courts are experiencing an explosion of first-party property insurance lawsuits arising from wind and hail related insurance claims. Dozens of lawsuits are filed every day in...more

How Insurance Industry Employers Can Navigate the New White-Collar Overtime Rules: Turning Legal Challenge Into Business...

As most insurance industry employers are probably aware by now, the Department of Labor has proposed revisions to its regulations that seek to further limit the instances in which certain employees may qualify as exempt from...more

District Court Rules On Discovery In Bad Faith Case

In a dispute between the excess and primary liability insurance carriers of a common insured based upon the primary insurer’s alleged breach of the duty to defend the common insured, the U.S. District Court for the Eastern...more

Don’t Mess With Texas Adjusters In Hail Damage Claims

Texas hail claim policyholder lawyers, like many plaintiffs’ lawyers, clearly prefer to be in state court rather than federal court. To accomplish this and prevent the defendant insurer from properly removing the lawsuit to...more

5th Circ. Highlights Importance Of Claim Investigation

Any insurance lawyer practicing in Texas knows that in order to show an insurance company has breached its duty of good faith and fair dealing to its insured, the insured must show “there is no reasonable basis for denial of...more

Insurance Industry Wins Temporary FLSA Exemption for Insurance Adjusters in CRomnibus

On Tuesday, we discussed Congress’s passage of the Consolidated and Further Continuing Appropriations Act, 2015, nicknamed CRomnibus in the waning days of the 2014 legislative session. The omnibus spending bill avoided...more

District of Colorado: Insureds Have No Obligation To Hire Public Adjusters To Recover Amounts Due Under A Policy

Norman v. State Farm Fire & Cas. Co., No. 13-CV-01643-PAB-CBS, 2014 WL 6478046 (D. Colo. Nov. 19, 2014). District of Colorado holds that insured has no duty to hire own adjuster in order to receive payment, and denies...more

FLSA Insurance-Adjuster Overtime Exception Buried In Appropriations Bill

Section 111 of the recently-enacted "Department of Labor Appropriations Act, 2015" directs that the federal Fair Labor Standards Act "shall be applied as if" there is an overtime exclusion for certain workers who are employed...more

And Another Texas Court Realizes What The Hail Is Going On?

Another Texas court -- this time in the Valley -- has realized What The Hail Is Going On? Nino vs. State Farm Lloyds is identical to thousands of hail damage lawsuits presently pending in the Valley. Most of these...more

With Respect to Discoverability, Indiana Federal Court Distinguishes Between Pre-Suit and Post-Suit Reserves

In May, we reported on a Third Circuit decision holding that loss reserve information was generally irrelevant and not discoverable. In October, a federal court in Indiana came to the same conclusion with respect to...more

Texas Supreme Court Denies Policyholder’s Discovery Regarding Claims Handling

It is rare to see a state’s highest court address a discovery issue. But the Supreme Court of Texas did just that recently in In re National Lloyds Insurance Co., holding that a policyholder’s demands for discovery about how...more

New York Appellate Court Dismisses Claims Against Reinsurer And Its Claims Administrator

In what began as a dispute between OneBeacon America Insurance Company and its insured, Colgate, over OneBeacon’s asserted right to control the defense of claims against Colgate in connection with numerous personal injury...more

Lawful Shmawful: Ninth Circuit Ignores Lawful Written Policy and Uses Statistical Sampling to Certify Class Based on Alleged...

On September 3, 2014, the U.S. Court of Appeals for the Ninth Circuit upheld certification of a class of approximately 800 nonexempt insurance claims adjusters who claimed they worked overtime without compensation despite the...more

Claims Handlers: It’s Time to Adjust Our Claims!

Many insurers have a longstanding practice of paying claims adjusters a set weekly salary, regardless of the number of hours they actually work. The practice has support in federal labor regulations; the regulations...more

Federal Courts Continue To Find Claims Adjusters Exempt

We have previously discussed how, over the past 10+ years, courts have increasingly recognized that insurance claims adjusters are exempt under the Fair Labor Standards Act (FLSA). The recent cases of Estrada v. Maguire Ins....more

Estimates vs. Bids: Determining Insurer Obligation

The typical property insurance claim begins with notification of a loss from the insured or its broker. Thereafter, the carrier sends out an adjuster to investigate the loss and determine whether, and to what extent, coverage...more

Dr. Dettling Talks About Shoulder/Knee Work Injuries

Orthopedic surgeon James Dettling, M.D. specializes in shoulder and knee injuries. About half his patients are injured workers treating under a Nevada workers' comp claim. He and long-time medical assistant, Patrick...more

California Court Holds An Adjuster May Be Personally Liable For Misrepresentations Made To The Insured

Earlier this month, an intermediate level California court rejected arguments that an insurance company’s adjuster owes no independent duty to the policyholders and cannot be liable even for “appalling” misconduct if he is...more

New York District Court Grants Summary Judgment Against FLSA Class of Insurance Claims Adjusters

In a number of cases, the plaintiffs’ strategy in collective active litigation under the Fair Labor Standards Act may fall into a familiar pattern: file the case, do minimal discovery, move for conditional certification under...more

The CGL “Business Risk” Exclusions

I recently came upon an interesting case from the United States Court of Appeals for the First Circuit that examined the complex and confusing Commercial General Liability (CGL) “business risk” exclusions. Oxford Aviation,...more

The Non-Response (De Facto) Denial

Injured workers have the right to file an appeal if the claims adjuster does not respond to a written request within 30 days. Attorneys are usually the only ones that know that when the adjuster fails to respond, it is...more

No Administrative Exemption Under California Law Where Worker Did Not Receive Fixed Salary

Negri v. Koning & Associates, No. H037804 (May 16, 2013): In a recent decision, a California Court of Appeal held that an insurance claims adjuster was not an exempt employee under the administrative exemption of Industrial...more

PK Law Attorney Brian S. Goodman Contributes Tips for the Proper Handling and Presenting of Property Insurance Claims After...

NAPIA Offers Tips for the Proper Handling and Presenting of Property Insurance Claims After Oklahoma Tornadoes - Potomac Falls, Virginia (May 22, 2013) – The devastating tornadoes that ripped through the suburbs of...more

The First 30 Days of Your Nevada Work Comp Claim

The first 30 days of a serious job injury claim are confusing and scary. Here are a few important tips...more

25 Results
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.