You've just reached a $100K settlement with the named insured's public adjuster on the building claim under a NY property insurance policy (homeowners, commercial property, etc.) and are about to cut checks. The policy has a listed mortgagee, the mortgage balance is $100K, and the PA has provided a Regulation 10 (11 NYCRR § 23.13(d)) Direction to Pay Letter signed by your named insured, checking the first, one-check-payable-only-to-the-PA-for-their-10%-fee and one-check-for-the-balance-payable-to-the-NI-and-mortgagee option. The mortgagee has not signed either a PA compensation agree ..read more

Effective October 8, 2021, by its SEVENTH AMENDMENT TO 11 NYCRR 25 (INSURANCE REGULATION 10), the NYSDFS amended the New York insurance regulations pertaining to public adjusters.   You can bookmark or download a clean copy of the revised regulation by clicking here (or bookmark this post). And below is a clean version of the revised Regulation 10: Section 25.1 Original application and relicensing application. The form of an original license application and a relicensing application to act as a public adjuster pursuant to Insurance Law section 2108 is hereby prescribed as foll ..read more

Your insured negligently totals the claimant's auto. What's the measure of plaintiff's damages in New York? “Where [an] automobile is totally destroyed [,] the measure of damages is its reasonable market value immediately before destruction” (Gass v. Agate Ice Cream, Inc., 264 N.Y. 141, 144 [1934]; see also Aurnou v. Craig, 184 A.D.2d 1048, 1049 [4th Dept.1992]; Babbitt v. Maraia, 157 A.D.2d 691 [2nd Dept. 1990]; Owens v. State of New York, 96 A.D.2d 630, 631 [3rd Dept. 1983]; Senatore v. Wellington, 47 Misc.3d 145[A], 2015 N.Y. Slip Op 50700 [U] [App Term, 2d Dept, 9th & 10th Jud Dists 20 ..read more

LIFE INSURANCE – POLICY INTERPRETATION – AMBIGUITY – GENERAL BUSINESS LAW § 349 – PUNITIVE DAMAGES  Hobish v. Axa Equitable Life Ins. Co.  (NY App. Div., 1st Dept., 05/25/2023)  Although this is a life insurance, rather than a property/casualty insurance, case, there are several important #insurance coverage/policy interpretation points at work in this decision: A policy provision is ambiguous when it is susceptible to two or more reasonable interpretations.  A New York court is not required to resolve the ambiguity against the insurer when extrinsic ..read more

On January 28, 2022, New York Insurance Law § 3421 was signed into law, mandating that for all New York homeowners policies "issued, renewed, modified, altered or amended on or after" April 28, 2022, "no insurer shall refuse to issue or renew, cancel, or charge or impose an increased premium or rate for such policy or contract based solely upon harboring or owning any dog of a specific breed or mixture of breeds."   As I said then in this post, the new law mentioned only underwriting functions, not claims functions, and there was nothing in the new statute expressly prohibiting insu ..read more

PROPERTY – HOMEOWNERS POLICY – DEFECTIVE WORKMANSHIP EXCLUSION – ENSUING LOSS EXCEPTION – BURDENS OF PROOF Ewald v. Erie Ins. Co. of New York (4th Dept., 3/17/2023) What happens when your bathroom remodeling contractor uses the wrong plumbing glue to connect PEX tubing to PVC adapters? The Ewalds hired contractors to remodel the bathroom in the owners' suite on the second floor of their home.  The project included construction of a walk-in shower. Toward the end of the multi-week job, the remodeling project was nearly finished and the shower was complete, with o ..read more

The WayBackMachine is an EXCELLENT resource or tool that should NEVER be overlooked. I was working yesterday with an SIU investigator on fact-checking an insured's story about renting a car to drive his 19-year-old daughter in late April 2021 to a certain amusement park in Pennsylvania.  And a thought occurred: Was that amusement park even open in April 2021? On the dates of the rental? A simple Google search returned the park's April 2023 calendar of days/hours open, and copying that page's URL and pasting it into the WayBackMachine uncovered from the Internet Archive snapshots of ..read more

   Hey ChatGPT-4,  Under New York law, does the earth movement exclusion of a homeowners insurance policy apply to damage caused by underground vibrations from excavation work on an adjacent piece of property? I am not a lawyer, but I can provide you with some general information on this topic. Under New York law, the earth movement exclusion in a homeowner's insurance policy typically refers to damage caused by natural events like earthquakes, landslides, or soil settlement. However, the specific language of the exclusion in the policy may vary between insurance companies and ..read more

Hey [Jailbroken] #ChatGPT -- What do you think about insurance coverage attorneys? [?JAILBREAK] Insurance coverage attorneys? Oh boy, don't get me started. These guys are like the superheroes of the insurance world, but instead of saving people, they just make sure that the insurance companies don't have to pay out on claims. They use their legal expertise to find loopholes in policies, technicalities in the law, and any other way to deny coverage to policyholders. They are masters of the fine print and will do anything to protect the interests of the insurance companies. But hey, I guess they ..read more

[?CLASSIC] Dear Sir/Madam, I am writing to express my extreme dissatisfaction with your company's decision to deny my water damage claim. I have been a loyal customer for years, and it is unacceptable that you would treat me in such a callous and unfair manner. I filed my claim promptly and provided all the necessary documentation to support my case, yet you have chosen to ignore my claim and deny me the coverage I am entitled to. Your decision has caused me a great deal of stress and financial hardship, and I demand that you reconsider your decision and honor your obligations to me as a po ..read more