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August 26, 2014

Better Health Care Provided to AZ Workers

Recent reports indicate Arizona is one of the best employers concerning employee health benefits to workers. Workers in Arizona pay a smaller share of their overall bill compared to the majority of state workers anywhere else in the country. According to analysts, Arizona regularly conducts surveys to compare their benefits on the national stage. The […]

 

Homeowner’s Insurance Appraisal Process

The term “appraisal” as defined in a homeowner’s insurance policy has an entirely different meaning than the one more commonly used in every day language.  Normally when we hear the term appraisal, we think of a real estate appraisal that is used to determine the value of a home.  However, in a homeowner’s insurance policy, the appraisal process is more similar to a three-member-panel arbitration proceeding which is used to determine the value of a personal property loss or home repair dispute that results from a covered homeowner’s insurance loss.

Similar to arbitration, the appraisal process is an alternative dispute resolution intended to resolve disputes without the need for litigation.  It is supposed to be less expensive to the insured and less time consuming. The majority of homeowner’s insurance policies enable appraisal when the insurance company and policy holder are unable to agree concerning the value of loss to a covered property.  Appraisal is not available when there is a coverage dispute. In an appraisal, each party generally names their own appraiser to value the loss and attempt to reach an agreement.  If the parties’ appraisers cannot agree on an amount, then it is up to a third appraiser, usually called an umpire, to resolve the dispute. Each party is responsible for the cost of their own appraiser and equally split the cost for the umpire. Attorneys’ fees and costs usually are not recoverable through the appraisal process.

Unfortunately in recent years, insurance companies have been writing complex agreements detailing the scope and procedure for the appraisal. These complex, sophisticated  appraisal agreements have led to an increase in disputes between the insurance consumer and their insurance companies. Of course, the insurance consumer has no input whatsoever into the terms contained within these appraisal agreements because the insurance company simply includes the language in the insurance policy. Because insurance contracts are generally considered contracts of adhesion, i.e., the insurer draws up the contract and the insured has little or no ability to make material changes to it, Arizona consumers best defense to unfair, unforeseen terms is Arizona’s “reasonable expectation” doctrine.

Insurance companies are also becoming more aggressive in insisting that the insurance consumer sign an appraisal agreement even though the insurance consumer may not understand that the agreement does not always cover the entire scope of the loss. The insured homeowner needs to make sure the agreement he or she signs completely encompasses the scope of the insurance loss. If it does not, the insurance company will argue that the insurance consumer should not be allowed to assert a claim for those additional damages not included in the agreement.

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  • Shane Harward Law Offices of Shane L. Harward PLC

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