News & Analysis as of

Claims Adjusters

Washington: Third-Party Administrators and Adjusters Can Be Liable in Bad Faith Actions

by Cozen O'Connor on

On April 11, 2017, the Division III Washington Court of Appeals, on a 2 to 1 vote, held that third party administrators and adjusters can be liable in bad faith actions under multiple legal theories. Merriman v. Am. Guar. &...more

Utah 2017 Legislative Update – Employment Law Issues

by Payne & Fears on

The 2017 session of the Utah Legislature produced few bills affecting employment law; but two bills recently signed by the Governor and one bill that was not passed this year may have an impact on Utah businesses....more

What to do when insurance companies insist on their case manager

by Michigan Auto Law on

An insurance company claim adjuster cannot override a car accident victim’s right to choose his or her own case manager. But that doesn’t mean some Michigan auto insurance companies won’t try to push hard to control an...more

Adjuster Tools for Water Losses

Lois Chamberlain sat down at her desk, adjusted her reading glasses, and stared at the screen filled with columns of check requests — each supported by a claim summary. Lois was two weeks from her retirement party. She...more

Everest Indemnity Insurance Company v. Rea Rejects Implied Waiver Of The Attorney-Client Privilege

As it stands now, the majority decision in Everest is clear: No implied waiver of the attorney-client privilege occurs where adjusters themselves make the claims decisions and do not rely on the advice of counsel to form...more

JSH Reporter - Summer 2016

We are excited to announce the launch of our Summer 2016 JSH Reporter! The JSH Reporter is designed to provide information about changes in the law and how these affect a variety of industries. In this issue, you will...more

Connecticut Court Holds No Cause Of Action Against Independent Adjuster For Negligence

by Cozen O'Connor on

The states are divided over whether an independent adjuster can be sued for negligence by the insured, and no Connecticut appellate court has ever addressed that issue. Last Tuesday, however, one of the state’s federal...more

The Wild West of Improper Joinder in North Texas

by Zelle LLP on

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

by Zelle LLP on

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...

by Seyfarth Shaw LLP on

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

by Carlton Fields on

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

by Zelle LLP on

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

by Zelle LLP on

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

by Franczek Radelet P.C. on

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

by Saul Ewing LLP on

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

Checklist of Affirmative Defenses for NC Comp Claims

Although arguably the most important determination an adjuster makes when a claim is filed is whether or not the claim is compensable, before even contemplating that question, the adjuster should consider whether or not the...more

FLSA Insurance-Adjuster Overtime Exception Buried In Appropriations Bill

by Fisher Phillips on

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?

by Zelle LLP 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

by Cozen O'Connor on

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

by Carlton Fields on

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!

by Carlton Fields on

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

by BakerHostetler on

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

by Zelle LLP on

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

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