Key Amendments to Insurance Claims-Handling Regulations in Puerto Rico
September 23, 2019 —
Andres Avila & Richard W. Brown - SDV InsightsPolicyholders in Puerto Rico should be aware of significant benefits provided by recent amendments to the Insurance Code. New rules establish an expedited method of property insurance dispute resolution, mandatory expedited partial payments in the event of catastrophic events, and protection against bad faith claims handling by insurers.
Appraisal Process with a Puerto Rican Twist
A key amendment is the establishment of an appraisal process, widely used for many years in the United States and now adopted in Puerto Rico. Commercial and personal property insurers in Puerto Rico shall include, in their policies, a clause for an appraisal process according to Article 11.150 of the Insurance Code of Puerto Rico, 26 L.P.R.A. § 101 et seq. (“the Code”).
The appraisal process provides both policyholders and insurers the option to submit insurance claims to an impartial umpire if a dispute arises over the value of covered damages or losses. The umpire and appraisers do not have authority to resolve coverage or legal issues. They can only resolve disputes over the quantum claimed for losses already determined to be covered by the insurer. Id. Each party is required to pay its own appraiser’s fees and split equally the fees of the umpire. Id.
Reprinted courtesy of
Andres Avila, Saxe Doernberger & Vita, P.C. and
Richard W. Brown, Saxe Doernberger & Vita, P.C.
Mr. Avila may be contacted at ara@sdvlaw.com
Mr. Brown may be contacted at rwb@sdvlaw.com
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Property Insurance Exclusion for Constant or Repeated Leakage of Water
March 14, 2018 —
David Adelstein – Florida Construction Legal UpdatesA
property insurance policy, no different than any insurance policy, contains
exclusions for events that are NOT covered under the terms of the policy. One such common exclusion in a property insurance policy is an exclusion for damages caused by "
constant or repeated seepage or leakage of water…over a period of 14 or more days."
The application of this exclusion was discussed in the recent opinion of
Hicks v. American Integrity Ins. Co. of Florida, 43 Fla. L. Weekly D446a (Fla. 5th DCA 2018). In this case, while the insured was out of town, the water line to his refrigerator started to leak. When the insured return home over a month later, the supply line was discharging almost a thousand gallons of water per day. The insured submitted a property insurance claim. The property insurer engaged a consultant that opined (likely, correctly) that the water line had been leaking for at least five weeks. Based on the above-mentioned exclusion,
i.e., that water had been constantly leaking for over a period of 14 days, the insurer
denied coverage. This denial led to the inevitable coverage dispute.
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David Adelstein, Florida Construction Legal UpdatesMr. Adelstein may be contacted at
dadelstein@gmail.com
The Montrose Language Interpreted: How Many Policies Are Implicated By A Construction Defect That Later Causes a Flood?
March 17, 2011 —
Shaun McParland BaldwinThe Court of Appeals of Indiana recently addressed the “Montrose” language added to the CGL ISO form in 2001 in the context of a construction defect claim where a fractured storm drain caused significant flooding a year after the drain was damaged. The insuring agreement requires that “bodily injury or “property damage” be caused by an occurrence and that the “bodily injury or “property damage” occur during the policy period. The Montrose language adds that the insurance applies only if, prior to the policy period, no insured knew that the “bodily injury or “property damage” had occurred in whole or in part. Significantly, it also states that any “bodily injury” or “property damage” which occurs during the policy period and was not, prior to the policy period known to have occurred, includes a continuation, change or resumption of that “bodily injury” or “property damage” after the end of the policy period.
In Grange Mutual Cas. Co. v. West Bend Mut. Ins. Co., No. 29D04-0706-PL-1112 (Ct. App. IN March 15, 2011), http://www.ai.org/judiciary/opinions/pdf/03151109ehf.pdf, Sullivan was the General Contractor for a school construction project. Its subcontractor, McCurdy, installed the storm drain pipes. One of the storm pipes was fractured in 2005 while McCurdy was doing its installation work. More than a year later, the school experienced significant water damage due to flooding. It was later discovered that the flooding was due to the fractured storm drain. Sullivanrsquo;s insurer paid $146,403 for the water damage. That insurer brought a subrogation claim against McCurdy and its two insurers: West Bend and Grange. West Bend had issued CGL coverage to McCurdy while the construction was ongoing, including the date in which the storm pipe was fractured. Grange issued CGL coverage to McCurdy at the time of the flooding. Those two carriers jointly settled the subrogation claim and then litigated which insurer actually owed coverage for the loss. Significantly, the loss that was paid included only damages from the flooding, not any damages for the cost of repairing the pipe.
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Reprinted courtesy of Shaun McParland Baldwin of Tressler LLP. Ms Baldwin can be contacted at sbaldwin@tresslerllp.com
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Hunton Insurance Team Wins Summary Judgment on Firm’s Own Hurricane Harvey Business Income Loss
March 23, 2020 —
Michael S. Levine & Michelle M. Spatz - Hunton Insurance Recovery BlogA Texas judge has ruled that Hunton Andrews Kurth is entitled to coverage from Great Northern Insurance Co., a unit of Chubb, Ltd. (“Chubb”), for losses its predecessor firm suffered when Hurricane Harvey closed its Houston office and disrupted business in 2017.
The court agreed with Hunton’s position that the policy, written specifically for a law firm, covered its business income loss until the firm’s operations were restored to their pre-loss levels. The court rejected in its entirety Chubb’s argument that coverage lasted only until the physical damage that closed the building had been repaired. Rather, siding with Hunton, the court found that the policy language affords, in addition to ordinary business income coverage during the damage period, “extended period” coverage that commences after the damaged property is repaired and after the firm’s operations resume.
From August 27 to August 31, 2017, the firm was forced to close its Houston office due to flooding and damage caused by Hurricane Harvey. While employees were permitted to return to the office on August 31, income did not return to its pre-loss level until September 14, 2017. The firm submitted a claim to Chubb for the loss sustained from August 27 to September 14, but Chubb paid only for income loss suffered during the 3-day closure period, and refused to cover the loss suffered after the building reopened.
Reprinted courtesy of
Michael S. Levine, Hunton Andrews Kurth and
Michelle M. Spatz, Hunton Andrews Kurth
Mr. Levine may be contacted at mlevine@HuntonAK.com
Ms. Spatz may be contacted at mspatz@HuntonAK.com
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No Coverage for Counterclaim Arising from Insured's Faulty Workmanship
August 03, 2020 —
Tred R. Eyerly - Insurance Law HawaiiThe Eighth Circuit found there was no coverage for the insured's faulty workmanship. Am. Family Mut. Ins. Co., S.I. v. Mid-American Grain Distributors, LLC, 958 F.3d 748 (8th Cir. 2020).
Mid-American contracted with Lehenbauer to design and construct a grain storage and distribution facility for Lehenbauer. Before the work was competed, Lehenbauer terminated Mid-American's services. Mid-American then sued Lehenbauer for breach of contract. Lehenbauer counterclaimed against Mid-American, alleged breach of "implied duties of workmanlike performance and fitness for a particular purpose" and negligence. Mid-American tendered the counterclaim to American Family. American Family accepted the tender under a reservation of rights, but sued Mid-American for a declaratory judgment.
The district court granted American Family's motion for summary judgment, concluding that the counterclaims did not allege an occurrence.
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Tred R. Eyerly, Damon Key Leong Kupchak HastertMr. Eyerly may be contacted at
te@hawaiilawyer.com
L.A.’s Modest Solution to the ‘Missing Middle’ Housing Problem
May 24, 2021 —
Kriston Capps - BloombergPractical ideas aren’t often the stuff of architecture contests. Right off the bat, that set Los Angeles’s Low-Rise design challenge apart.
A project led by the mayor’s office and the city’s chief design officer, Christopher Hawthorne, Low-Rise asked entrants to reimagine what an L.A. urban landscape with abundant housing could look like in the years to come. The organizers wanted the participating designers to think about their submissions the way they might approach a project for a local client or community. The results, which were unveiled this week, don’t look like future-forward science fiction, but rather doable local solutions to a thorny problem: the stubborn lack of affordable options across the city.
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Kriston Capps, Bloomberg
BOOK CLUB SERIES: Everything You Want to Know About Construction Arbitration But Were Afraid to Ask
October 30, 2023 —
Marissa L. Downs - The Dispute ResolverI recently had the pleasure of speaking with construction law notables John Foust and Andy Ness to discuss the release of their new book—
Construction Arbitration: The Advocate’s Practical Guide. The goal of their book: to teach attorneys what they need to know to maximize their effectiveness in the arbitration context. To that end, the book covers every aspect of the arbitration process including motion practice, conduct as an advocate, presentation of the case, and post-hearing submissions. Read on for Andy and John’s candid, behind-the-scenes take on how this book came to be and why you should get your copy now, while supplies last!
Q: Who is the target audience for this book?
Andy: In the editing process (and in writing my own chapter on Navigating an International Construction Arbitration) I pretended that I was speaking with a construction lawyer who was a few years out of law school, with some litigation experience, who was getting ready to take on a significant and complex construction arbitration for the first time. The book presupposes knowledge of the basics and tries to anticipate the questions that would be asked when you are trying to think through the whole arbitration process from start to finish. What should my pleadings look like? How much discovery am I likely to be able to obtain? How should my demeanor be different from what I would do in a courtroom? How much should I object during the hearing? In a nutshell, it’s “What do I need to know to maximize my chances of success in the arbitration setting?”
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Marissa L. Downs, Laurie & Brennan, LLPMs. Downs may be contacted at
mdowns@lauriebrennan.com
Homeowners Not Compelled to Arbitration in Construction Defect Lawsuit
January 06, 2012 —
CDJ STAFFA California appeals court has ruled that developers cannot enforce CC&Rs in a case where a developer cited an arbitration clause it had inserted into the CC&R. The homeowners are alleging construction defect and wished to sue the developer who claimed a right to this under the CC&Rs.
The Marina del Rey Argonaut reports that particular appeal dealt only with whether the developer could compel arbitration. The underlying construction defect issues will subsequently have to be determined at trial.
The attorney for the homeowners’ association, Dan Clifford, noted that “arbitration has to be agreed to by both parties.” The covenant was drafted by the developer and in addition to requiring arbitration, it had a clause that it could not be amended without the consent of the developers. The court ruled that CC&Rs “can be enforced only by the homeowners association, the owner of a condominium or both.”
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