Question. I have a homeowners' claim in Maryland with Allstate insurance. It is Allstate's AP2 policy, which is all-risk and a replacement cost policy. The Building Structure Reimbursement section reads (in the Our Settlement Options section for coverages A &B)

“Under Coverage A — Dwelling Protection and Coverage B — Other Structures Protection, we will make additional payment to reimburse you for cost in excess of actual cash value (ACV) if you repair, rebuild or replace damaged, destroyed or stolen covered property within 180 days of the actual cash value payment. This additional payment includes the reasonable and necessary expense for treatment or removal and disposal of contaminants, toxins or pollutants as required to complete repair or replacement of that part of a building structure damaged by a covered loss.”

Several years ago, an attached sunroom collapsed due to the weight of ice and snow. That loss was covered by the insurer.

In the process of replacing the collapsed sunroom, the homeowners association in the neighborhood of the risk dwelling attempted to prevent the policyholder from rebuilding the sunroom. The issue became a protracted legal battle, which the policyholder eventually won.

The policyholder subsequently rebuilt the sunroom.

Even though the policy states that the rebuilding of the structure has to be done within 180 days of the ACV payment, are there any exceptions to the 180-day rule that would allow the policyholder to be paid the depreciation?

— Kentucky Subscriber

Answer. Most policies do not have any language listing extenuating circumstances as reasons not to adhere to the policy conditions. A carrier may have internal procedures, but that is not in the policy language.

Unless the policy language specifically states something to the contrary, the carrier can stick to the stated language. If the insured notified the carrier of the situation and kept them posted throughout that could give the insured some standing, but if the insured didn't mention anything to the carrier and comes back years later I can't see why the carrier would provide the difference between ACV and replacement cost.

Question. We have a major homeowner loss where the owner was out of the country when the fire rendered the home a total loss.

Her agent (who also happened to be out of the country on his own vacation) was made aware of the loss two days later and notified the homeowner. He did not, however, notify the carrier. The carrier was not aware of the claim until our office was involved 14 days later.

The carrier has sent letters alluding to the verbiage regarding the “Duties after Loss” — which of course involves notifying the carrier in a timely fashion. Doesn't that fall on the direct writer agent and his E & O [errors and omissions] policy?

How could the carrier deny the claim when its own agent didn't report it?

— Kentucky Subscriber

Answer. If both the agent and the homeowner are out of the country, I hardly see how the carrier can say that 14 days after the loss isn't prompt notice. The ISO HO 00 03 requires prompt notice to the carrier or the agent; as the agent represents the carrier, in most cases that is going to be considered notice to the carrier, even though the carrier wasn't directly notified for two weeks.

As long as reasonable attempts to protect the property were made, I see no reason why the carrier would hesitate in paying this claim. People are allowed to take vacations, even insurance agents, and depending on what countries they were in internet access may not have been as readily available as it is in the United States.

Merriam Webster online defines prompt as “being ready and quick to act as occasion demands; performed readily or immediately.” Although 14 days isn't immediate, the loss certainly was reported readily. Should this go to court, I can't see a court finding for the carrier unless serious, extensive subsequent damage occurred within those 14 days.

Analysis brought to you by the experts at FC&S Online, the unquestioned authority on insurance coverage interpretation and analysis for the P&C industry. To find out more — or to have YOUR coverage question answered —visit www.nationalunderwriter.com/FCS.

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