We have been having trouble resolving a fire loss claim under a homeowners policy. There is no dispute as to the cause of the fire loss and we have prepared a building estimate. The dispute is over the extent and valuation of the loss.
As the insured's representative, we instituted our right of appraisal. We submitted the name of our disinterested builder and asked the insurer to do likewise, but they refused to pick a disinterested builder. Instead, they went to their original builder, the one with whom we could not agree about the amount of damages.
We feel that this is a violation of the policy intent. Our interpretation of the appraisal clause, which states that "each party will choose a competent appraiser," is that both parties should choose a disinterested builder. If these two cannot reach an agreement, they select an umpire. Having one of the original parties to the dispute chosen as an appraiser does not make much sense to us.
New York Subscriber
The policy requires only that the appraiser must be competent; it does not require that each party select a disinterested appraiser.
The hope is that because the appraisers are competent professionals who are one step removed from the dispute, they will reach an agreement despite a certain natural bias in favor of their employer. If they cannot, the policy offers a mechanism for them to choose an umpire who decides which of the appraisers is right.
Finally, if they cannot agree on an umpire, the policy provides for a court to select the umpire. These contingencies for involving an umpire are based in part on the recognition that the appraisers chosen by the parties might not be completely unbiased.
This premium content is locked for FC&S Coverage Interpretation Subscribers
Enjoy unlimited access to the trusted solution for successful interpretation and analyses of complex insurance policies.
- Quality content from industry experts with over 60 years insurance experience, combined
- Customizable alerts of changes in relevant policies and trends
- Search and navigate Q&As to find answers to your specific questions
- Filter by article, discussion, analysis and more to find the exact information you’re looking for
- Continually updated to bring you the latest reports, trending topics, and coverage analysis
Already have an account? Sign In Now
For enterprise-wide or corporate access, please contact our Sales Department at 1-800-543-0874 or email [email protected]