Loss Appraisal in First-Party Claims

Appraisal presents a snare for the unwary. Most first party claims involve differing views as to the amounts owed for multiple claim elements. With little or no case law to guide parties in resolving such differences, policyholders with substantial property claims often find themselves embroiled in disputes with an insurance company that demand that the disagreement be resolved through appraisal. Almost always, this places a policyholder at a distinct disadvantage, against insurers with seasoned representatives adept at exploiting appraisals to resolve property claims in their favor. In our lead “Feature” article, “Contending with the Perils of Loss Appraisal in First-Party Claims,” the first part of a two-part article by Paul E. Breene and Richard P. Lewis, partners at Reed Smith LLP, and Arnold F. Mascali, the Founder and President of Procor Solutions + Consulting, seeks to level the playing field. This first part examines aspects of appraisal that present particular risk to policyholders, then lays out practical steps to take in advance of appraisal occurring. The second part, which will appear in an upcoming issue of the Insurance Coverage Law Report, looks at how to respond to a notice of appraisal and handling the appraisal itself.

The Occupational Disease Exclusion

In our second “Feature” article, “The Occupational Disease Exclusion: Making New Law with an Underappreciated Policy Provision,” John A. Lee and Lawrence D. Mason, attorneys at Segal McCambridge Singer & Mahoney, discuss a recent Connecticut Appellate Court precedent-setting decision in the R.T. Vanderbilt v. Hartford Accident & Indemnity Co. et al., insurance declaratory judgment action, which addresses the application of the occupational disease exclusion.

Focus On: How Lawyer's Cross-Examination Doomed Bid for Insurance Coverage

An appellate court in Louisiana has affirmed a trial court's decision that a driver of a car that rear-ended another vehicle was excluded from coverage as a “non-permissive” driver under the insurer's policy, relying in large measure on the cross-examination of the driver at his pre-trial deposition. In this issue's “Focus On” column, “How One Lawyer's Cross-Examination Doomed Bid for Insurance Coverage,” Steven A. Meyerowitz, Esq., the Editor-in-Chief of the Insurance Coverage Law Report and the Director of FC&S Legal: The Insurance Coverage Law Information Center, explains the decision.

 And More…

We also have the “best of the best” Case Law and Legislative/Regulatory Developments from FC&S Legal, as always written and analyzed by Steven A. Meyerowitz, and my Industry News column.

Enjoy the issue!

Victoria Prussen Spears

Editor, Insurance Coverage Law Report

Associate Director, FC&S Legal

Victoria Spears

Victoria Spears

Victoria Prussen Spears is senior vice president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. A graduate of Sarah Lawrence College and Brooklyn Law School, Ms. Spears was an attorney at a leading New York City law firm before joining Meyerowitz Communications. She may be contacted at [email protected].

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