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Coverage Counsel - 5 new articles
Quiz Time! Public Adjuster Compensation Question for NY Property Insurance Claims Professionals
 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 agreement or a Direction Pay Letter. How many checks do you issue, in what amounts and to whom? Answer A: Two checks. > One check for $90K to the NI and the mortgagee; and > One check for $10K to the PA. Answer B: Two checks. > One check for $90K to the NI and the mortgagee; and > One check for $10K to the PA and the mortgagee. Answer C: One check for $100K payable to the NI, mortgagee and the PA. What say you? Record your answer in the comments. I'll then wait a week or so and provide the correct answer with its explanation. ...
Public Adjusters -- The Seventh Amendment to 11 NYCRR Part 25 (NYS Insurance Regulation 10) eff. 10.08.21 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 follows: individual or business entity. An individual or business entity may apply on the department’s website or obtain an application form upon request to the department. Section 25.2 Renewal application. The form of application for a renewal license to act as a public adjuster pursuant to Insurance Law section 2108 is hereby prescribed as follows: individual or business entity. An individual or business entity may apply on the department’s website or obtain an application form upon request to the department. Section 25.3 Prohibition as to methods of doing business: (a) No individual or entity licensed to act as a...
Can I Recover the Amount My Auto Loan Balance Exceeds My Car's Fair Market Value from the Person Who Totaled My Car?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 2015]). What if the claimant's auto was overfinanced (i.e., the loan payoff exceeds its fair market value)? Can the claimant recover the difference between the loan payoff amount and the vehicle's pre-loss FMV? No. Not under New York law, even in small claims court where the standard is substantial justice between the parties according to the rules and principles of substantive law. See:
When an Ambiguous Policy Provision Does Not Necessary Mean a Loss in the Win/Loss ColumnsLIFE 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:
New York Insurance Law § 3421 Version 2.0 -- Liability Insurance for Specific Breed Dog-Owning HomeownersOn 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 insurers from including a canine exclusion in a New York homeowners policy or in denying coverage based on such an exclusion. Someone in Albany caught that, and on March 15, 2023 New York Insurance Law § 3421 2.0 was signed into law, amending subdivision 1 of that section to provide that "no insurer shall refuse to issue or renew, cancel, or charge or impose an increased premium or rate for such policy or contract, OR EXCLUDE, LIMIT, RESTRICT, OR REDUCE COVERAGE UNDER SUCH POLICY OR CONTRACT based solely upon harboring or owning any dog of a specific breed or mixture of breeds." [Added language in...
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