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Disagreement Over the Amount of the Loss Is Needed to Invoke Appraisal

appraisal road sign
By Chip Merlin on May 5, 2022
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Can a policyholder race to a lawsuit demanding appraisal without expressing a disagreement over the amount of the loss? A Florida court says “no.”1

The holding is pretty simple:

Because the parties never engaged in an exchange of information sufficient to establish a genuine disagreement over the amount of loss, the matter was not ripe for appraisal, and the trial court erred in granting the Association’s premature motion to compel appraisal.

The vast majority of all insurance disputes come to a point where either the insurer expressly states in words that convey “the policyholder is asking for payment greater than what is determined is due,” or the policyholder conveys the message that “the insurer is paying too little.” There is usually some rancor and exchange of ideas that what is being paid or estimated is owed is something not mutually agreed to. That is an expressed disagreement.

My reading of the case suggests that the courts are looking for some expressed disagreement with the insurer’s estimated amount of loss before the policyholder can demand appraisal. Since that has been my practice, I agree with the decision. In part or in whole, there should be some disagreement about the amount of the loss before the policyholder demands appraisal.

My concern is that insurers are going to highlight this language of the decision:

Simply put, the parties did not engage in a meaningful exchange sufficient to establish a disagreement regarding the value of the property or the amount of loss. We reaffirm that “appraisal is premature when one party has not provided a meaningful exchange of information sufficient to substantiate the existence of a genuine disagreement.

Some insurance companies can never get enough “meaningful” exchanges of information when they delay and refuse to fully pay, citing that their investigation is still ongoing. They will argue the matter is not ripe for an appraisal even though there is a genuine dispute and disagreement about the loss. This happens quite often with condominium or larger dollar claims.

Thought For The Day

The people to fear are not those who disagree with you, but those who disagree with you and are too cowardly to let you know.
—Napoleon Bonaparte
____________________________________
1 Certain Underwriters at Lloyd’s v. Lago Grande 5-D Condo. Ass’n, No. 3D21-636 (Fla. 3d DCA May 4, 2022).

Photo of Chip Merlin Chip Merlin

Since 1983, Chip Merlin has served as a plaintiff’s attorney with a focus on commercial & residential property insurance claim disputes and bad faith insurance litigation. Chip is a noted national authority on insurance bad faith, lecturing to national trade groups and publishing…

Since 1983, Chip Merlin has served as a plaintiff’s attorney with a focus on commercial & residential property insurance claim disputes and bad faith insurance litigation. Chip is a noted national authority on insurance bad faith, lecturing to national trade groups and publishing a number of papers and articles on the subject for organizations such as The American Association for Justice, The Florida Justice Association, The Windstorm Insurance Network, and Trial Magazine.

As founder and president of Merlin Law Group, Chip has dedicated his practice to the representation and advocacy of insurance policyholders in disputes with insurance companies nationwide.

Chip served as Chair for the Bad Faith Insurance Litigation Group and Secretary for the Fire and Property Insurance Litigation Group for the American Association for Justice (formerly known as the Association of Trial Lawyers of America). He was also Vice-Chair for the Subcommittee on Property Insurance Law for the American Bar Association.
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  • Posted in:
    Insurance
  • Blog:
    Property Insurance Coverage Law Blog
  • Organization:
    Merlin Law Group, P.A.
  • Article: View Original Source

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