News & Analysis as of

First-Party Coverage Property Damage

Cozen O'Connor

Claims Notes: June 2024

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The Florida Supreme Court ruled that PIP (Personal Injury Protection) insurers may pay 80% of a charge submitted by a provider, even when that reimbursement amount is less than the amount that would be reimbursable under the...more

Butler Weihmuller Katz Craig LLP

Words matter: a series of leaks constitutes a single occurrence under particular policy language

In a recent decision from the United States District Court for the Middle District of Florida, Tampa Division, styled KT State & Lemon, LLP et al. v. Westchester Fire Ins. Co. et al., the Court granted summary judgment to the...more

Cozen O'Connor

New York Court Holds Coverage for Excavation Damage Precluded by Earth Movement Exclusion

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According to a recent ruling by a New York appellate court, coverage for excavation damage is precluded by the policy’s earth movement exclusion. In 3502 Partners LLC v. Great American Insurance Co. of New York, Case No....more

Lowenstein Sandler LLP

Insurance Recovery After Severe Weather

Lowenstein Sandler LLP on

While the 2021 hurricane season is not officially over yet, catastrophic weather events including Hurricanes Ida, Henri and Nicholas have already caused substantial damage, bringing record-breaking rainfall and flooding....more

White and Williams LLP

GA Federal Court Holds That Jury, Not Judge, Generally Must Decide Whether Notice Was Given “As Soon as Practicable” Under...

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Insurance policies covering first-party property damage often require insureds to notify insurers of a loss “as soon as practicable.” Where an insured may or may not have given notice “as soon as practicable,” the issue...more

Hinshaw & Culbertson LLP

[Webinar] Webinar Series: Insurance Insights – What Insurers Need to Know in 2021 - COVID-19 Claims - April 22nd, 12:00 pm - 1:00...

Join us for Hinshaw's Webinar Series: Insurance Insights – What Insurers Need to Know in 2021. This series will feature insurance thought leaders from Hinshaw and RPC, presenting on the most pressing insurance claims topics...more

Cozen O'Connor

A Consequential Ruling: Florida Supreme Court Rejects Recovery of Consequential Damages in First-Party Breach of Contract Actions

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In first-party breach of insurance contract actions, the parties oftentimes dispute whether the policyholder may seek damages that are not explicitly provided for in the policy, with the policyholder arguing such indirect...more

Rumberger | Kirk

Florida Supreme Court Rules Extra-Contractual, Consequential Damages Are Not Recoverable in a First-Party Breach of Contract...

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On January 21, 2021, the Supreme Court of Florida issued an important decision in Citizens Property Insurance Corp. v. Manor House, LLC, et. al., SC19-1394 (Fla. 2021), disallowing an insured to recover extra-contractual,...more

Butler Weihmuller Katz Craig LLP

Subro Sense - The ABC's of RCV and ACV

Oftentimes, third-party liability adjusters will refuse to pay the full amount of the “Repair Cost Value” (“RCV”) of the damages included in the subrogation demand, and contend that they only owe “Actual Cash Value” (“ACV”),...more

Butler Weihmuller Katz Craig LLP

Pretzel Logic: Cheetham V. Southern Oak And Its Ill-Begotten Progeny

The standard ISO homeowners insurance policy contains an exclusion for damage caused by water which backs up through sewers or drains.  While this appears to be an unambiguous exclusion, using twisted logic, the Third...more

Pillsbury - Policyholder Pulse blog

A Primer on Bringing First-Party Insurance Claims

The profound impact of COVID-19 leading businesses to file first-party insurance claims is now well known. Further, insurance companies are systematically pushing back on potential coverage for COVID-19, with some issuing...more

Rumberger | Kirk

Impact of Florida’s New Assignment of Benefits Law: HB 7065

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On April 26, 2019, Florida Governor Ron DeSantis signed into law Florida House Bill 7065. The law, which took effect on July 1, 2019, was designed to reduce the amount of assignment of benefits (“AOB”) agreements that could...more

Butler Weihmuller Katz Craig LLP

A Brief Refresher On Appraisal In North Carolina, South Carolina, And Georgia

Most first party property coverage policies contain an appraisal provision that allows either the insured or the insurer to make a written demand for appraisal when the parties agree that covered property was damaged by a...more

Butler Weihmuller Katz Craig LLP

"Slow and Steady" or "Fast and Furious": Repeated Seepage or Leakage Policy Exclusion Prevails

A recent ruling in a U.S. District Court in Missouri may suggest a new path for policy exclusions based on “continuous or repeated seepage or leakage of water.”  The Court rejected the argument that the continuous or repeated...more

Carlton Fields

Court Finds Animals Incapable of Vandalism or Malicious Mischief for Insurance Purposes (and all other purposes, too)

Carlton Fields on

I am willing to go out on a limb and say that if asked whether an animal, say, a raccoon, is capable of committing malicious criminal acts, most humans would agree that the issue is beyond dispute. But, alas, most humans...more

Cozen O'Connor

Failure of Insured to Provide Requested Documents Triggers Appraisal Under First Party Insurance Policy

Cozen O'Connor on

Those familiar with first party insurance policies have undoubtedly encountered a recurring issue with the interpretation of appraisal provisions – what does it mean to disagree on the amount of loss?  ...more

Butler Weihmuller Katz Craig LLP

The Evolving Limitations on Appraisers in Florida: Analyzing State Farm Florida Ins. Co. v. Sanders

Appraisers are frequently involved in Florida property claims. Accordingly, Florida courts continue to refine the roles and limitations with respect to appraisers and the appraisal process as a whole. ...more

Butler Weihmuller Katz Craig LLP

What Baseball Has Taught Me About The Insurance Appraisal Process

Anyone who has ever watched baseball knows that umpires sometimes make an incorrect call. In appraisal of a property insurance claim, sometimes the umpire can make a mistake as well....more

Butler Weihmuller Katz Craig LLP

Pennsylvania court rules insurer may still be responsible to pay RCV even if repairs never completed.

In situations where a property insurer denies coverage, the insured often complains that it is faced with a difficult dilemma – use its own money to fund repairs or avoid making repairs and risk having its recovery limited to...more

Butler Weihmuller Katz Craig LLP

Lots of Cold Feelings in Pipe Freeze Claims

A recent Pennsylvania decision highlights the difficulties and critical issues associated with identifying potentially liable parties in pipe freeze cases. ...more

K&L Gates LLP

K&L Gates Triage: Emergency Preparedness and Response in Long Term Care - Part II

K&L Gates LLP on

This is the second episode in a three-part series on emergency preparedness and response in long-term care. Since natural disasters can result in monumental expenses for rebuilding facilities, it is important to understand...more

Zelle  LLP

Insureds Cannot Shift Burden To Identify Claimed Damage

Zelle LLP on

The first-party insurance claims process has always been pretty simple for the typical insured: call the agent to report a claim, identify and quantify the claimed damage, work cooperatively with the insurance adjuster to...more

Carlton Fields

Florida Federal Court Limits First Party Bad Faith Claims

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First party bad faith actions in Florida must be pursued under §624.155 Florida Statutes because Florida does not recognize common law first party claims. The statute provides that an insured may bring a civil action against...more

Saul Ewing LLP

Bad Faith Sentinel - April 2015

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In This Issue: - En Banc Mississippi Court of Appeals Affirms Summary Judgment for Insurer, Adjuster and Employer on Bad Faith Claims Arising from Denial of Coverage and Benefits for Work-Related Injury -...more

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