Caryn Daum

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Florida Administrative Rule Requiring Notification of Mediation Program Within Five Days Deemed Invalid

Administrative regulations enacted pursuant to a state statute often impose strict deadlines by which insurers are required to perform a variety of tasks, including the prompt issuance of a reservations of rights, notification of coverage determinations, and advising of an insured’s right to file a complaint with the state’s insurance department.  Often overlooked is the … Continue Reading

Hurricane Sandy: Consumer Group Advocates for Blocking Use of Anti-Concurrent Causation Clause

On November 6, the Consumer Federation of America sent a letter to elected officials in states affected by Hurricane Sandy in which it suggests that regulators should “block application” of anti-concurrent causation clauses: A typical anti-concurrent causation (ACC) clause might read, “[w]e will not pay for loss or damage caused directly or indirectly by any … Continue Reading

Hurricane Sandy Insurance Claims: What Insurers Should Focus On

Insurers are starting to deploy adjusters to handle claims from Hurricane Sandy. An article in yesterday’s Wall Street Journal reports that “Disaster-modeling firm AIR Worldwide estimates the industry’s share of losses at $7 billion to $15 billion. At the high end of that range, Sandy would become the third-most expensive storm for insurers in U.S. … Continue Reading

Assignment Does Not Relieve Insured’s Obligation To Submit To Examination Under Oath (EUO) According To Florida Court of Appeal

A Florida court of appeal recently held that an insured’s assignment of a claim did not relieve her of the obligation to appear for an examination under oath (EUO). This decision is significant because it makes a distinction between an assignment of proceeds of a property insurance policy and an assignment (or transfer) of the … Continue Reading

Hurricane Isaac Insurance Claims Adjustment: Insights from Katrina

As insurance companies begin the process of adjusting Hurricane Isaac insurance claims, we thought it would be helpful to highlight briefly on our blog some of the key case law from Hurricane Katrina, and some key Louisiana statutes regarding insurance claim adjustment: Water Damage Exclusions: The Louisiana Supreme Court ruled in Sher v. Lafayette Insurance … Continue Reading

Florida Federal Court Declines to Retroactively Apply 2011 Amendment to Sinkhole Insurance Statute

As state legislatures enact statutory amendments, courts are frequently tasked with deciding whether those amendments are to be applied retroactively. In one such case, the United States District Court for the Middle District of Florida was tasked with deciding whether a 2011 amendment to Florida’s sinkhole insurance statute, Fla. Stat. §627.706(2)(k)(2011) (hereinafter the “Statute”), should … Continue Reading

Collapse Additional Coverage vs. Rust/Corrosion Exclusion: New York Federal Court Finds No Evidence of Collapse and Finds The Exclusion Applies

The United States District Court for the Southern District of New York was recently tasked with deciding on summary judgment whether: (1) a rooftop water tank and its supporting steel frame structure “collapsed” due to hidden decay, which would have been a covered cause of loss, or (2) the loss was caused by rust or … Continue Reading

Florida Statute of Limitations for Breach of Insurance Policy: Under New Florida Statute, Claims Will Accrue On Date of Loss

The statute of limitations for bringing suit against a property insurer may be far shorter for policies issued after May 17, 2011, under Florida law. As a Florida federal court recently explained in West Palm Gardens Villas Condo Assn v. Aspen Specialty Ins Co., 2012 U.S. Dist. LEXIS 104861 (S.D. Fla. June 25, 2012), under … Continue Reading

Sewer Backup Exclusion Found Unambiguous by Rhode Island Supreme Court

As mentioned previously, there appears to be an influx of court cases arising from situations where heavy rainfall affects drain and sewer systems, resulting in property damage. The Rhode Island Supreme Court was recently tasked with handling such a case, reaching the same conclusion as the Massachusetts Supreme Judicial Court did in Boazova and Surabian … Continue Reading

Surface Water Exclusion Applicable to Sewer and Drain Backup Based on Anti-Concurrent Causation Clause, According to Massachusetts Supreme Judicial Court

For the second time in two months, the Massachusetts Supreme Judicial Court was called upon to decide whether or not property damage was covered when the damage resulted from a combination of a covered peril and an excluded peril. Once again, the court upheld the policy’s enforceable anti-concurrent causation language, finding that coverage was precluded. … Continue Reading

Wind vs. Water Damage Allocation Debate: Congress Passes COASTAL Act, Establishing New Wind vs. Water Allocation Formula

As reported by Arthur D. Postal on’s online news service, Congress’s recent extension of the National Flood Insurance Program includes a potentially significant provision intended to help resolve debates about allocation of damage between wind and water in hurricane losses. Recently, Congress passed the Consumer Option for an Alternative System to Allocate Losses (“COASTAL … Continue Reading

Judicial Review of Appraisal Awards: Sixth Circuit Identifies Proper Standard of Review Under Michigan Law

As previously mentioned in my blog posts on May 3, 2012 and May 17, 2012,  courts are frequently asked to determine whether an appraisal award should be overturned or vacated. Recently, the United States Court of Appeals for the Sixth Circuit held that, under Michigan law, judicial review of an appraisal award is limited to instances … Continue Reading

Massachusetts High Court Enforces Surface Water Exclusion In Light of Anti-Concurrent Causation Provision

The Massachusetts Supreme Judicial Court recently considered the interplay between “hidden seepage” coverage, and a “surface water” exclusion, holding that the policy’s enforceable anti-concurrent causation language made all the difference in the court’s conclusion that a loss caused by surface water seeping into a structure was excluded. In Boazova v. Safety Insurance Company, Docket No. SJC-10908, … Continue Reading

New York Appraisal Award Upheld by Federal Appellate Court

As mentioned in my May 3, 2012 blog post, courts are frequently asked to determine whether an appraisal award should be overturned. Recently, the Second Circuit was asked to consider the timeliness of an appraisal demand, whether the determination of the period of restoration implicates a coverage issue of the type appraisers cannot decide, and whether an … Continue Reading

Insurance Company’s Waiver of Right to Pay Actual Cash Value (ACV)

Property insurance policies typically require that the insured repair or replace the damaged property before recovering on a replacement cost value (RCV) basis.  The difference between RCV versus actual cash value (ACV) can be substantial, especially where an older building is involved.  The Indiana Court of Appeals recently held that an insurer can waive its … Continue Reading

North Carolina Insurance Appraisal Award: Federal District Court Invalidates Appraisal Award Implicating Causation Issues

Insurance appraisal awards are frequently the subject of court decisions because of difficulties appraisal panels face when tasked with determining the amount of a loss, especially when the loss implicates potential coverage issues.  In the most recent decision coming out of the United States District Court for the Western District of North Carolina, an appraisal … Continue Reading

Louisiana Insurance Bad Faith: Louisiana Appeals Court Issues New Hurricane Katrina Bad Faith Decision

While Hurricane Katrina related litigation is generally winding down, there are still some cases which are making their way through the Louisiana appellate process.  In the most recent decision coming out of the Louisiana Fourth Circuit Court of Appeal, a causation dispute led to an award in favor of an insured for consequential damages and … Continue Reading

Georgia Court Considers Cost of Repair/Diminution in Value Regarding Property Damages

The Supreme Court of Georgia recently held that a property insurer potentially was required to compensate an insured for both the cost of building repair, as well as for the diminution of value of the property resulting from the damage, even after repairs were completed. This diminution in value potentially could result, for example, from … Continue Reading