Claim and Insured - Insurance Industry Brief

Examinations Under Oath in New York Property Insurance Claims

Property Insurance Coverage Law

JANUARY 23, 2025

When navigating contested property insurance claims, insured parties may receive a request from their insurer for an Examination Under Oath (EUO). It is a formal proceeding, not unlike a deposition, where an insured is required to answer questions under oath about their insurance claim.

Property Insurance

Property Insurance Insurance Claim Claim Insurer

Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

Property Insurance Coverage Law

JANUARY 22, 2025

I am snowed in after taking the deposition of a 1099 temporary claims adjuster in South Carolina. Much of his testimony has me thinking about the plight of the modern independent claims adjuster doing catastrophe work. During his deposition, the independent catastrophe adjuster said he had asked to have his claims load reduced.

Claim

Claim Property Insurance Insurer Insurance

When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

Property Insurance Coverage Law

FEBRUARY 14, 2025

The latest revelations about Allstates use of artificial intelligence (AI) in drafting insurance claims emails should serve as a wake-up call for policyholders, insurance regulators, and insurance industry claims handlers.

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Claim Policyholder Property Insurance Insurance Claim

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Property Insurance Coverage Law

APRIL 14, 2025

When handling National Flood Insurance Program (NFIP) claims, public adjusters and policyholders must be alert to critical warning signs. One of the most important phrases to recognize is: “We denied a portion of your claim.” ” Those few words, even if buried in a lengthy letter, should ring loud alarm bells.

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Take the Hassle Out of Claims Management

Advertiser: Trellis

Insurance professionals use Trellis to streamline claims management by analyzing legal trends, predicting outcomes, and strategizing effectively to serve clients better. Adjusters can evaluate claim validity, estimate settlement amounts, and identify potential litigation risks.

Claim

Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

Property Insurance Coverage Law

JANUARY 22, 2025

I am snowed in after taking the deposition of a 1099 temporary claims adjuster in South Carolina. Much of his testimony has me thinking about the plight of the modern independent claims adjuster doing catastrophe work. During his deposition, the independent catastrophe adjuster said he had asked to have his claims load reduced.

Claim

Claim Property Insurance Insurer Insurance

When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

Property Insurance Coverage Law

FEBRUARY 14, 2025

The latest revelations about Allstates use of artificial intelligence (AI) in drafting insurance claims emails should serve as a wake-up call for policyholders, insurance regulators, and insurance industry claims handlers.

Claim

Claim Policyholder Property Insurance Insurance Claim

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Property Insurance Coverage Law

APRIL 14, 2025

When handling National Flood Insurance Program (NFIP) claims, public adjusters and policyholders must be alert to critical warning signs. One of the most important phrases to recognize is: “We denied a portion of your claim.” ” Those few words, even if buried in a lengthy letter, should ring loud alarm bells.

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Claim Policyholder Property Insurance Insurer

Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Property Insurance Coverage Law

JANUARY 30, 2025

A recent federal court decision favoring Liberty Mutual Insurance Company in a pipe burst claim1 left me thinking about two lessons. First, this case strongly reminds policyholders to be aware of time limits in their insurance policies and take action as soon as they believe their claim is not being handled fairly.

Claim

Claim Policyholder Property Insurance Insurance Policy

Florida OIR Wants More Data, Warns Insurers about Concurrent Causation Denials

Insurance Journal

FEBRUARY 23, 2025

As consumer complaints have apparently mounted over unpaid hurricane losses, Florida’s top insurance regulator and some lawmakers are signaling new scrutiny on insurance carriers’ claims-handling and other practices. Florida Insurance Commissioner Michael Yaworsky late last week posted a memo, demanding …

Insurance Carrier

Insurance Carrier Insurer Insurance Insured

Florida Policyholders Are Upset with Stupid Denials of Claims

Property Insurance Coverage Law

FEBRUARY 17, 2025

The Florida House Committee on Banking and Insurance seemed to have many constituents upset with delays and denials when I was testifying in front of them a month ago. The insurance representative tried to explain that many of the denials were because most policies do not cover flood.

Policyholder

Policyholder Claim Property Insurance Policy

California FAIR Plan: Ignoring Laws and Gouging Californians on Smoke Damage Claims

Property Insurance Coverage Law

MARCH 20, 2025

Imagine a state-run insurance program so brazen that even when explicitly ordered by the Department of Insurance to remove unlawful policy language, it shrugs and continues business as usual.

Damage

Damage Claim Property Insurance Policy

Brotherhood Mutual Hit With $35 Million Punitive Award on Roof Damage Claim

Property Insurance Coverage Law

FEBRUARY 3, 2025

We have battled insurance companies, co-counseled on cases, and discussed property insurance case law at a depth most … The post Brotherhood Mutual Hit With $35 Million Punitive Award on Roof Damage Claim appeared first on Property Insurance Coverage Law Blog.

Damage

Damage Claim Property Insurance Policyholder

Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Property Insurance Coverage Law

JANUARY 30, 2025

A recent federal court decision favoring Liberty Mutual Insurance Company in a pipe burst claim1 left me thinking about two lessons. First, this case strongly reminds policyholders to be aware of time limits in their insurance policies and take action as soon as they believe their claim is not being handled fairly.

Claim

Claim Policyholder Property Insurance Insurance Policy

Canada’s Insurance Sector Faces Deluge of Climate-Related Catastrophe Claims

Insurance Journal

SEPTEMBER 3, 2024

Hotter summers in Canada that have sparked wildfires in tourist areas, intense hailstorms and thunderstorms with severe flooding in major cities, all likely linked to climate change, are leading to personnel shortages and potentially claims adjustment delays, according to insurance …

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Claim Insurer Insurance Insured

Insurers Face Business Interruption Claims After Global Tech Outage

Insurance Journal

JULY 21, 2024

Insurers could face a raft of business interruption claims after a worldwide tech outage crippled industries from travel to finance on Friday, insurance industry experts said. A software update by global cybersecurity firm CrowdStrike appeared to have triggered systems problems …

Business Interruption

Business Interruption Claim Insurance Industry Insurer

Georgia Woman Charged with Insurance Fraud After Claimed Injuries

Insurance Journal

AUGUST 5, 2024

A woman in north Georgia has been charged with insurance fraud after she claimed that a “personal care device” caused injuries that cost as much as $350,000 to treat. Kamala Anderson, 45, of Snellville, was arrested last month after the …

Injury

Injury Claim Insurer Insurance

Mistakes in setting sums insured / declared value where the Insured elects an Indemnity Period of less than 12 months.

Prof. Allan Manning

FEBRUARY 10, 2025

I recall the very first business interruption claim I did was for a risk in Toowoomba and to my horror found that the Insured had only declared 3 months insurable gross profit with a 3-month Indemnity Period. In fact, around 75% of interruption claims by number have an Indemnity Period of less than 3 months.

Business Interruption

Business Interruption Claim Insurer Insurance

Claims Analysis: Roofs Define Luxury Homes’ Insurability

Insurance Journal

NOVEMBER 17, 2024

The insurance industry is facing a significant rise in roof-related claims. The combination of increasingly severe weather events, inflation-driven repair costs and the growing issue of roofing scams has created a perfect storm — one that is straining insurer portfolios …

Home Insurance

Home Insurance Claim Insurance Industry Insurer

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

Property Insurance Coverage Law

APRIL 9, 2025

Sometimes, decisions come along that make me wonder if judges are reading the same insurance policies and insurance laws the rest of us are. The recentFloridaClark opinion 1 is one of them.

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Claim Property Insurance Insurance Policy Insurance Companies

The Regulatory Blind Spot: How Insurance Departments Fail to Detect Systemic Bad Faith Claims Practices

Property Insurance Coverage Law

OCTOBER 2, 2024

Recent investigative reporting by CBS’s 60 Minutes, noted in CBS 60 Minutes Exposes Alleged Insurance Company Fraud: Adjusters Reveal Altered Hurricane Damage Estimates by Claims Management, has exposed alleged widespread underpayments of claims and unethical claims practices in Florida’s property insurance industry.

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Claim Property Insurance Damage Insurance Industry

Claims Satisfaction Leaders Reveal Secrets to Success

Insurance Journal

DECEMBER 25, 2024

What is the secret to an insurance claims experience that satisfies customers? Power has conducted surveys and curated lists recognizing insurers that succeed at providing satisfactory claims experiences. Carrier Management recently asked claims leaders at two of … For years, J.D.

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Claim Insurance Claim Insurer Insurance

Specialist Risk Group Acquires UK Claims Specialist One Claim Ltd.

Insurance Journal

NOVEMBER 12, 2024

Specialist Risk Group (SRG), the London-based specialist insurance intermediary, announced the acquisition of One Claim Ltd. Based in Essex, England, One Claim provides broker partners and their clients with claims management support from initial notification through to settlement. The One …

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CBS 60 Minutes Exposes Alleged Insurance Company Fraud: Adjusters Reveal Altered Hurricane Damage Estimates by Claims Management

Property Insurance Coverage Law

SEPTEMBER 30, 2024

In a shocking exposé aired last night on CBS’s 60 Minutes, allegations of widespread insurance fraud by insurance companies following Hurricane Ian were exposed.

Insurance Companies

Insurance Companies Damage Claim Property Insurance

Report: Over 250,000 US Properties Have Repeated NFIP Claims

Insurance Journal

SEPTEMBER 19, 2024

properties have repeated claims for federal flood insurance, costing the National Flood Insurance Program billions of dollars in claims, according to new federal data compiled by the National Resources Defense Council. More than a quarter million U.S. Four states account …

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Claim Insurer Insurance Insured

Red Lobster Landlord Sues Insurer to ‘Clawback’ $1.2M Fire Claim Payment

Insurance Journal

SEPTEMBER 9, 2024

The landlord for a fire-damaged building leased to a Red Lobster restaurant is blaming the restaurant’s insurer for causing it to lose out on $1.2 million in fire insurance claims payments to repair the property. RL New Brunswick Owner LLC, …

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Claim Damage Insurance Claim Building

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

Property Insurance Coverage Law

APRIL 9, 2025

Sometimes, decisions come along that make me wonder if judges are reading the same insurance policies and insurance laws the rest of us are. The recentFloridaClark opinion 1 is one of them.

Claim

Claim Property Insurance Insurance Policy Insurance Companies

Most Ransomware Claims Begin With Compromised Perimeter Security: Coalition

Insurance Journal

MARCH 23, 2025

More than half of ransomware claims in 2024 started with threat actors compromising perimeter security appliances, according to a new report from Coalition. In its Cyber Threat Index 2025, the insurance provider reported that 58% of claims began with such …

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Florida Insurance Regulators Demand Fair Treatment for Policyholders

Property Insurance Coverage Law

FEBRUARY 22, 2025

How do insurance claims work when your home has already been damaged once? A recent Florida Office of Insurance Regulation (OIR) Bulletin clarifies how insurers must handle claims for multiple hurricanes. But what happens when two hurricanes strike in the same season?

Policyholder

Policyholder Property Insurance Damage Insurance Claim

How Big Was the Cat? Investigator Warns About Claims of Clogged Toilets

Insurance Journal

SEPTEMBER 12, 2024

Did you hear the one about cat poop clogging a toilet, resulting in thousands of gallons of sewage water in the home and a big insurance claim? Lin Werkheiser, an insurance fraud investigator, has heard that one and many more …

Claim

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Dellwood Insurance Says AIG’s ‘Ginned-Up Claims’ Must Be Dismissed

Insurance Journal

OCTOBER 2, 2024

The legal squabble between American International Group (AIG) and a startup-up formed by some former employees continued this week with another filing from Dellwood Insurance Group in support of its motion to dismiss AIG’s claims. Dellwood, in a U.S. District …

Claim

Claim Insurer Insurance Insured

JD Power: Customers Not Happy With Carrier Property Claims Service

Insurance Journal

APRIL 6, 2025

By Jahna Jacobson Higher premiums and longer wait times make property owners less satisfied with their insurers. Property Claims Satisfaction Studyalign with todayis climate of increasingly longer claim cycle times and higher costs … These not-very-surprising results from J.D. Poweris2025 U.S.

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Claim Premium Insurer Insurance

New York Considers Making Property Insurers Cover Taxi Claims Losses

Insurance Journal

DECEMBER 12, 2024

New York is considering asking property and casualty insurers to cover the claims of insolvent taxi insurer American Transit Insurance Co., according to people familiar with the plans. That measure is one of several options under discussion as the state’s …

Property Insurance

Property Insurance Claim Casualty Insurance Insurer

Florida’s Heritage Insurance Reports 5,400 Claims, $57M in Cat Losses From Milton

Insurance Journal

OCTOBER 23, 2024

More loss and claims estimates are trickling in from carriers after Hurricane Milton caused widespread wind and flood damage in Florida this month. Tampa-based Heritage Insurance Holdings said in a preliminary statement that about two weeks after Milton made landfall …

Claim

Claim Damage Insurer Insurance

Insurance Commissioner Orders Advance Payments on Claims for LA Wildfire Survivors

Insurance Journal

JANUARY 23, 2025

California Insurance Commissioner Ricardo Lara is asking all California insurance companies to provide advance payments on claims for Los Angeles wildfire survivors. Lara’s order is designed to help speed the recovery process for wildfire survivors affected by several fires in …

Claim

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Helene Claims in Florida Already More Than 65,700 – Far More than Idalia

Insurance Journal

OCTOBER 2, 2024

The number of property insurance claims in Florida from Hurricane Helene had topped 65,700 by Tuesday, far more than the 25,000 seen in Hurricane Idalia a year ago, the Florida Office of Insurance Regulation reported. The total estimated insured losses …

Claim

Claim Property Insurance Insurance Claim Insurer

Avoid Claim Denials: Key Policyholder Duties After a Loss

Property Insurance Coverage Law

MARCH 11, 2025

All insurance policies include a section placing specific responsibilities and obligations on policyholders to act in a certain way before entitling them to policy benefits for what should be a covered loss.

Policyholder

Policyholder Claim Property Insurance Insurance Policy

Hurricane Debby Florida Losses Top $121M; 60% of Claims Closed

Insurance Journal

SEPTEMBER 11, 2024

A month after Hurricane Debby made landfall in northern Florida, the number of property insurance claims has reached almost 20,000, and total estimated insured losses are more than $121.5 million, the Florida Office of Insurance Regulation reported this week. The …

Claim

Claim Property Insurance Insurance Claim Insurer

Milton’s 123,000 Claims So Far to Mean New Pressure on Reinsurance, Rate Hikes

Insurance Journal

OCTOBER 15, 2024

Property Insurance claims from Hurricane Milton had topped more than 123,000 by Sunday, with some $1.5 billion in estimated insured losses. That’s already more than the claims and losses reported for Helene, which made landfall in Florida two weeks earlier, …

Claim

Claim Property Insurance Insurance Claim Insurer

Claims from Hurricane Milton Continue to Rise in Florida

Insurance Journal

OCTOBER 21, 2024

Almost two weeks after Hurricane Milton made landfall near Sarasota, Florida, as a Category 3 storm, claims and loss totals continue to rise. 21, the Florida Office of Insurance Regulation said carriers had reported more than 221,582 …

Claim

Claim Insurer Insurance Insured

Ruling on Field Stands: Philadelphia Eagles Denied Covid-19 Insurance Claim

Insurance Journal

DECEMBER 16, 2024

The Philadelphia Eagles football team has lost its bid for federal court reconsideration of the dismissal of the team’s claim for insurance coverage for COVID-19 losses. The Eagles tossed a red flag in November after the federal district for Eastern …

Claim

Claim Insurance Claim Insurer Insurance

Florida Citizens’ Brass Tired of ‘Clickbait’ News on its Hurricane Claims Denials

Insurance Journal

NOVEMBER 21, 2024

Officials with Florida’s Citizens Property Insurance Corp. took issue Thursday with a number of national and Florida news reports that have suggested that the insurer has the “worst rate” on paying claims after recent hurricanes. “That’s just not accurate,” Citizens …

Claim

Claim Property Insurance Insurer Insurance

Every Claims Professional Must Read Putnam Now: Emotional Recovery After Wildfire Loss

Property Insurance Coverage Law

APRIL 17, 2025

Following the devastating 2025 Los Angeles wildfires, claims professionals across the country are once again on the media and actual frontlines of a crisis that extends far beyond burned structures and blackened landscapes. The physical damage is immense, but the emotional toll on survivors runs deeper and lasts longer than most realize.

Claim

Claim Property Insurance Damage Insurer

Fla. DFS Offers to Check Contracts With Roofers, Adjusters; Tenn. Eyes Claims Denials

Insurance Journal

OCTOBER 30, 2024

Officials in two Southeastern states have taken steps to hold insurers or recipients of insurance funds accountable after Hurricanes Helene and Milton spurred thousands of insurance claims. The Tennessee Department of Commerce and Insurance reminded insurance carriers that they must …

Claim

Claim Insurance Carrier Insurance Claim Insurer

Examinations Under Oath in New York Property Insurance Claims

Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

Trending Sources

When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Take the Hassle Out of Claims Management

Are Catastrophe Claims Adjusters Being Overworked, Provided Too Many Losses to Properly Handle, Provided Wrong Directions to Adjust Losses, or Simply Being Asked to Adjust Claims In a Manner Not Reflecting Good Faith Claims Handling?

When Artificial Intelligence Becomes Wrongful Intelligence in Claims Handling

Partial Denials Start Statute of Limitations Time Clock in National Flood Claims

Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Florida OIR Wants More Data, Warns Insurers about Concurrent Causation Denials

Florida Policyholders Are Upset with Stupid Denials of Claims

California FAIR Plan: Ignoring Laws and Gouging Californians on Smoke Damage Claims

Brotherhood Mutual Hit With $35 Million Punitive Award on Roof Damage Claim

Beware of a One-Year Deadline to File a Lawsuit—Always Hire a Public Adjuster If Your Insurer Makes You Adjust Your Own Claim

Canada’s Insurance Sector Faces Deluge of Climate-Related Catastrophe Claims

Insurers Face Business Interruption Claims After Global Tech Outage

Georgia Woman Charged with Insurance Fraud After Claimed Injuries

Mistakes in setting sums insured / declared value where the Insured elects an Indemnity Period of less than 12 months.

Claims Analysis: Roofs Define Luxury Homes’ Insurability

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

The Regulatory Blind Spot: How Insurance Departments Fail to Detect Systemic Bad Faith Claims Practices

Claims Satisfaction Leaders Reveal Secrets to Success

Specialist Risk Group Acquires UK Claims Specialist One Claim Ltd.

CBS 60 Minutes Exposes Alleged Insurance Company Fraud: Adjusters Reveal Altered Hurricane Damage Estimates by Claims Management

Report: Over 250,000 US Properties Have Repeated NFIP Claims

Red Lobster Landlord Sues Insurer to ‘Clawback’ $1.2M Fire Claim Payment

The New “Notice” Trap: Better Ring a Bell for Every Coverage You Might Claim

Most Ransomware Claims Begin With Compromised Perimeter Security: Coalition

Florida Insurance Regulators Demand Fair Treatment for Policyholders

How Big Was the Cat? Investigator Warns About Claims of Clogged Toilets

Dellwood Insurance Says AIG’s ‘Ginned-Up Claims’ Must Be Dismissed

JD Power: Customers Not Happy With Carrier Property Claims Service

New York Considers Making Property Insurers Cover Taxi Claims Losses

Florida’s Heritage Insurance Reports 5,400 Claims, $57M in Cat Losses From Milton

Insurance Commissioner Orders Advance Payments on Claims for LA Wildfire Survivors

Helene Claims in Florida Already More Than 65,700 – Far More than Idalia

Avoid Claim Denials: Key Policyholder Duties After a Loss

Hurricane Debby Florida Losses Top $121M; 60% of Claims Closed

Milton’s 123,000 Claims So Far to Mean New Pressure on Reinsurance, Rate Hikes

Claims from Hurricane Milton Continue to Rise in Florida

Ruling on Field Stands: Philadelphia Eagles Denied Covid-19 Insurance Claim

Florida Citizens’ Brass Tired of ‘Clickbait’ News on its Hurricane Claims Denials

Every Claims Professional Must Read Putnam Now: Emotional Recovery After Wildfire Loss

Fla. DFS Offers to Check Contracts With Roofers, Adjusters; Tenn. Eyes Claims Denials

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