On March 16, a lawsuit was filed in district court in New Orleans seeking a declaratory judgment about whether the business income coverage in a Lloyd’s property policy would cover a government-mandated shutdown or curtailment of a restaurant due to …
For a number of years, I’ve done a workshop called “The Adventures of Ace Insura, Claims Detective.” Participants assist Ace in solving a variety of coverage and claims mysteries. Each case has one or more learning points that cumulatively lay …
For much of the country, ’tis the season to beware of frozen water pipes. In this month’s column, we examine two such real-life claims from the Dakotas, one personal lines and the other commercial lines. Both are good examples of …
Last year, I wrote a 12-part series of Insurance Journal columns based on my book “When Words Collide: Resolving Insurance Coverage and Claims Disputes” where I shared the principles and practices I’ve applied over the past 30-plus years in resolving …
In the past two columns, we examined eight legal and contractual principles nonlawyers can use to resolve most claim disputes without litigation. In this month’s column, we’ll wrap up this discussion with nine other principles. Entirety of Contract By now, …
Last month’s column began a three-part series on legal and contractual principles that can be used to resolve most coverage and claim disputes without litigation. Just as you do not have to be an attorney to resolve a contract dispute, …
This article introduces a three-part series covering over a dozen largely legal and contractual principles, many of which are used by attorneys to resolve contract disputes. Most of them can also be used by agents and consultants to resolve insurance …
Step 2 of the claim resolution process involves interpreting policy provisions that are cited as the basis for a claim denial. This step (and Step 3) employs up to 12 interpretive doctrines and 17 largely legal and contractual principles for …
If you have been following this 12-part series, welcome to the home stretch. In the first six articles, we’ve examined why claims are denied and how to avoid or prevent such denials, concluding with an introduction to a four-step process …
Resolving claim disputes involves a four-step process of reading, researching, documenting, and pleading your coverage position. This process evolved from a series of seminars I introduced in the ’90s. However, when I sat down to write the book on which …
