On February 4th, Wheeler, DiUlio & Barnabei hosted a lunch & learn webinar, The Hurdles of Modern Appraisal and What to Do About Them. Partner Anthony DiUlio discussed the current insurance appraisal process, its scope in New Jersey and Pennsylvania, as well as answered viewer’s questions live.
The webinar also specifically addressed:
- The single most important thing to do in an appraisal.
- How to push back when the opposing side isn’t doing its job.
- The new bounds of an appraisal.
Here’s a recap of some of the insurance appraisal questions discussed:
When should a claim go to appraisal vs. litigation?
The more things that are in dispute, the more likely litigation is the correct route. In other words, if you have a claim and the carrier is at $10,000 and you are at $250,000, appraisal may not be the right avenue. Similarly, if there is any secondary issue like delays in response time, unreasonable conduct, or it is an expert heavy adjustment, appraisal is risky. On the other hand, when a claim has no secondary factor to fight over, and the risk is low, appraisal could be the right choice. In other words, the adjustment has been pleasant, you simply disagree on the repairs to a roof, but everyone has been cordial, appraisal could be the better option. Always remember, once it goes to appraisal, it is out of you and the insureds hands. Through litigation, you and the insured are in the driver seat.
Is scope able to be appraised?
In PA, yes. The law reads as follows: when the parties merely disagree over the extent of damage or whether a covered peril is the cause of certain damage, that is a dispute regarding the amount of loss and is proper for appraisal. See Knop v. The Travelers Home and Marine Ins. Co., No. 10-cv-05506 (E.D. Pa. 2010) (applying Pennsylvania law); see also Cigna Ins. Co. v. Didimoi Prop. Holdings N.V., 110 F. Supp. 2d 259, 264 (D. Del. 2000) (applying Delaware law). Williamson v. Chubb Indem. Ins. Co.,
In NJ, no. where there is no dispute as to the extent of damage or the scope of work required, the parties can invoke the policy’s appraisal provision to resolve the dispute as to the amount of loss. Thus, the appraisal process is not intended to resolve disputes as to the extent of damage, the scope of work required, or the cause of the damage. German Auto. of Tinton Falls, Inc. v. Harleysville Ins. Co. of N.J., No. A-2571-13T3, 2014 N.J. Super. Unpub. LEXIS 1952, at *6 (Super. Ct. App. Div. July 29, 2014)
How does appraisal affect the ability to file a lawsuit?
Once an item is appraised, it will be a binding value for that item and there is little to do in litigation (unless there is a showing of fraud, collusion, or similar misdeeds). Any item that has not been appraised can still be fought over in litigation.
What do you do if the appraiser is not impartial, unbiased, and/or independent?
It can be difficult to truly prove this. You only have two options. 1) Contact the carrier and explain why the named appraiser is not appropriate based on the specific policy language. The carrier does have the ability to name a new appraiser. 2) Contact my office to withdraw the claim from appraisal and pursue litigation.
Does an insured have to go to appraisal? And if they do demand appraisal, are they stuck there?
While appraisal is not a requirement under the policy, either side may demand it. Once one side demands it, the other side MUST comply. This is not optional. If you were the one to make the demand for appraisal, you can always withdraw that demand and pursue other avenues if necessary (i.e. the opposing appraiser is biased, not doing their job, or something else requiring a withdraw).
Join us for our next lunch and learn webinar on Thursday, March 4th at noon, A Dive Into Policy Exclusions and Anti-Concurrent Causation. Click here to register.