Policy Conditions

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The Second Department, Appellate Division, for the Supreme Court of New York, recently held in a matter of first impression, that an insurance company with a duty to defend may not recover defense costs after a determination that no duty to indemnify or further defend exists—even though the insurer expressly reserved its right to recoup such defense costs—unless the policy explicitly provides for such recovery. See American W. Home Ins. Co. v. Gjonaj Realty & Mgt. Co., 2018-03435, 2020 WL 7767944 (2d Dept., Dec. 30, 2020).
Continue Reading New York Court Rules Duty to Defend Policies Must Explicitly Provide for Recoupment of Defense Costs

The United States District Court for the Southern District of New York recently granted an insurer’s motion for summary judgment in a case arising from Superstorm Sandy based on unambiguous policy language providing a significantly lower limit of liability for losses resulting from flood damage. In New York University v. Factory Mutual Insurance Co., 2019 U.S. Dist. LEXIS 45105 (S.D.N.Y. March 19, 2019), the court agreed with Factory Mutual (FM) that the policy’s $250 million and $40 million sublimits for flood damages applied to New York University’s (NYU) claim, rather than the policy’s $1.85 billion overall limit.
Continue Reading The Southern District Finds Unambiguous Policy Language Controls NYU’s Superstorm Sandy Claim

A typical claim for a homeowner will involve some type of damage to the property, which, in turn, prompts the insurer to perform an inspection of the insured property, so as to assess the cause and extent of the alleged damage. Depending on the nature of the claim, insurers may be able to have a solitary claims professional perform the inspection in a rather minimal amount of time, but that is not always the case. In particular, when an insured has claimed damage to the property’s roof, the claims professional may need assistance in gaining access to the roof—perhaps requiring a ladder assist—or otherwise will need to use caution in assessing the claim, which can be time consuming.
Continue Reading Drones and Insurance: How Unmanned Aircraft Systems Can Assist Insurers in Timely and Effectively Evaluating Property Damage Claims

Back in March, our Data Privacy + Security Insider blog reported an increase in the use of commercial drones by State Departments of Transportation across the country. Now, insurance companies are also getting in the game. Using drones for underwriting, determining property values and conditions for policy issuance, inspections and risk evaluations may be more…

When Super Storm Sandy struck the Northeast on October 29, 2012, states, cities, municipalities and towns up and down the East Coast ordered hundreds of thousands of people to evacuate from their homes and businesses.  In the aftermath of those mandatory evacuations, I published an article in the April 2013 issue of DRI’s For The…

Over the last decade, policyholders and insurers have actively litigated the meaning and scope of “structural damage” under the Florida statutory sinkhole scheme. In 2011, in an effort to resolve the dispute, the Florida Legislature adopted a five-part definition of “structural damage” to be applied when interpreting insurance policies providing coverage for sinkhole losses. Fla.…

The Florida Supreme Court recently joined numerous other jurisdictions holding that general contractor overhead and profit should be included in an estimate on a property insurance claim when, based on the unique facts of the claim, it is reasonably likely that the insured will need to use a general contractor in completing the repairs.

In…

A federal court in New York recently cast light on the permissibility of property insurance policy provisions that require an insured to repair or replace damaged property within a certain period of time in order to be compensated for the full cost of the repair or replacement, instead of just the actual cash value of…

Amid a rash of recent, high-profile sinkhole losses, last week Florida’s First DCA affirmed the Florida Office of Insurance Regulation’s interpretation of a state statute as requiring property insurers to offer an endorsement covering sinkhole losses for the full amount of the coverage limit. The decision resolves some lack of clarity over whether carriers had…

Surplus lines insurance is typically provided to insureds who, for various reasons, are not able to secure insurance from an “admitted” or “authorized” carrier in a state. Legal issues surrounding surplus line coverage sometimes involve whether or not a particular statute applies to surplus lines carriers or only “admitted” or “authorized” carriers within a state.…