Many of us appreciate incorrect direction, deception and technical play on words in the brain and riddles. The same is usually not the case when an insurer declares your legal rights after a devastating loss. While this blog lists California requirements, laws and regulations, the principle applies to policyholders and policyholders' advocates across the country – it pays to know your insurance rights.
During a total loss report after a fire in California 2020 is considered a "state" in an emergency ", an insured received a brief damage update with language that, although technically true, can easily mislead an unsuspecting policyholder. The first example below refers to the time for collection of amounts held or written off for personal property:
The policy states: If you receive a settlement under this policy for damaged personal property on a real cash value, you can make a further claim for payment:
in. Repair or replacement will be completed within one year after the first payment for damage to your personal property. If you are unable to complete the repair or replacement of your damaged personal property within one year of the first payment due to circumstances beyond your control, you may request an extension of time. Additional extensions of six months should be given to you for good reasons.
The key words here are "the policy says". While the policy stated this, it was what the adjuster did not mention in the letter that legislation was adopted almost two years earlier, A.B. 1
(b) (1) (B) In the event of a loss relating to a "state of emergency", as defined in section 8558 of the Government Code, a time limit for less than 36 months from the date on which the first payment against the actual cash value is made may not be imposed on the insured to recover the full cost of compensation for the loss, subject to the insurance limit.
After a total loss from a catastrophic event, policyholders often remain displaced from a permanent residence one year after the first payment to their personal property has been made. It is not difficult to imagine skewed spending habits and policyholders giving up their withheld dollar amounts after reading the language quoted in the letter above.
Although the letter quoted above is short — just a few pages — the adjuster manages to include a second potentially misleading paragraph. This section addresses the "lawsuit against us" provisions:
The California Fair Claims Practices Regulations state that you must be notified of any time limits that may apply to your claim. Your policy contains the following provision regarding lawsuits against the California Fair Plan:
12. Suit against us. No action can be brought unless the policy provisions have been complied with and the action is commenced within one year of the expiry date.
This time the introductory language is "your policy contains the following provision." However, the letter does not include language from A.B. 2594, which extended a consumer's right to sue from 12 to 24 months if it is related to a state of emergency. Applicable language in cal. Ins. Code § 2071 reads: 1
No lawsuit or action against this policy for recovery of any claim shall be sustainable in any court or justice unless all claims in this policy have been complied with, and if not commence within 12 months of the next commencement of the loss. If the loss is related to a state of emergency, as defined in section b of section 8558 of the Government Code, the time limit for bringing an action is extended to 24 months after the beginning of the loss.
While the first sentence of California Code of Regulations § 2695.4 (a) states, “[e] many insurers shall notify a beneficiary or beneficiary of the first party any benefits, coverage, time limits or other provisions of insurance companies that may be issued by that insurer. to the claim of the applicant  ”your adjuster may not be up to date with recently adopted laws or regulations that may affect your claim. Also keep in mind that the language of your policy may not meet the minimum coverage required. We recommend that you become familiar with the legal claims rights in your country or consult someone who is.
For more blogs related to forest fires, including updates to legislation and tips for dealing with damage, check out some of Merlin Law Group's previous blogs here. United policyholders are also a premium resource for free insurance information and training. Check out their disaster recovery library and instructions for guidance.
1 Proud tolling.