{"id":6,"date":"2010-02-17T02:44:56","date_gmt":"2010-02-17T04:44:56","guid":{"rendered":"http:\/\/insuranceclaimsgroup.com\/blog\/?p=6"},"modified":"2014-03-19T13:03:01","modified_gmt":"2014-03-19T17:03:01","slug":"independent-appraiser-uses-policy-to-protect-policyholders","status":"publish","type":"post","link":"https:\/\/insuranceclaimsgroup.com\/blog\/independent-appraiser-uses-policy-to-protect-policyholders\/","title":{"rendered":"Independent Appraiser Uses Policy To Protect Policyholders"},"content":{"rendered":"

\"independent-appraisers-and-umpire\"<\/a>Independent Appraiser Uses Policy To Protect Policyholders<\/h2>\n

Almost all insurance policies have an appraisal clause that allows the parties of the insurance contract to resolve disputes that may arise during a claim.\u00a0 Appraisal is for the “amount of loss,” only.\u00a0 This is the amount of monies it will cost to fully complete the repairs caused by the claim damages.\u00a0 For instance; policyholders could be forced to use an independent appraiser<\/a> to settle their differences with the insurance company, using the appraisal process to protect their interests.<\/p>\n

In a recent Texas case, JM Walker, LLC v. Acadia Insurance Company, reveals how an\u00a0independent appraiser and the appraisal process protected a policyholder from mistakes made by the insurance company.\u00a0 Mistakes that could have cost the policyholder “hundreds of thousands of dollars!”\u00a0 Each situation can be a bit different simply by how the appraisal clause is worded in the policy, by the type of damage that occurred, and by all the facts pertaining to the loss.<\/p>\n

In this situation, JM Walker owned five buildings in North Richland Hills, Texas.\u00a0 A hailstorm caused damages to the roofs of the five buildings. Walker submitted a claim to his insurance company, Acadia.\u00a0 However, at first Acadia denied the claim after their adjuster determined that the roofs did not need to be fully replaced, and that the damage that was caused by the hail, did not reach the $5,000 deductible that applied to the policy.<\/p>\n

Mr. Walker disagreed with that assessment from the insurance company’s adjuster.\u00a0 The two parties could not agree, so Acadia executed its contractual right to appraisal.\u00a0 At first, Mr. Walker tried to litigate the matter in court by filing a lawsuit.\u00a0 However, the Judge advised that the parties should continue with the appraisal process.\u00a0 It is not uncommon for judicial courts to suggest this process, as most policies require that all policy provisions be exhausted before entering the courtroom.<\/p>\n

Independent Appraiser Were Used<\/h1>\n

The appraisal process includes two independent appraiser<\/a>s (one hired by each party) and an appraisal umpire.\u00a0 If the independent appraisers cannot agree on an amount of loss they can submit their differences to the umpire.\u00a0 The umpire in this appraisal process found on behalf of JM Walker and produced an award for the amount of loss at $423,053.96.\u00a0 Appraisal awards are binding, therefore, Acadia paid the amount.\u00a0 (You may recall that their first offer was $0, because they determined the loss to be below the $5,000 deductible.)<\/p>\n

JM Walker tried filing an appeal to the United States Fifth Circuit. It was Walker’s belief that he was entitled to more hail damage proceeds and was also seeking additional money for what he believed was “bad faith” actions by Acadia with their miss handling of the claim.<\/p>\n

The Court ruled that under Texas law, “appraisal awards made pursuant to the provisions of an insurance contract are binding and enforceable, and every reasonable presumption will be indulged to sustain an appraisal award<\/a>.”\u00a0 The Court also ruled that an otherwise binding appraisal may only be overturned in only three situations:<\/p>\n

(1) when the award was made without authority;
\n(2) when the award was made as a result of fraud, accident, or mistake; or
\n(3) when the award was not in compliance with the requirements of the policy.”<\/p>\n

Mr. Walker diligently tried to argue on all three points.\u00a0 However, the court dismissed his rebuttal on all three.\u00a0 This appraisal and case is a good resource showing the respect the Texas courts have for the appraisal process. It is my opinion that the Independent Appraiser and the insurance appraisal process protected the policyholder in this situation.\u00a0 Mr. Walker should be happy the policy had such a clause.\u00a0 The work that the Independent Appraiser did during this Appraisal was responsible for Walker receiving $418,053.96 over what the insurance carrier said they owe on the claim.<\/p>\n

Independent Appraiser Assistance<\/h3>\n

If you should ever find yourself in an insurance claim dispute with your insurance company, you should truly consider calling an Independent Appraiser<\/a> to explore your options with the insurance appraisal process.\u00a0 Independent Insurance Appraisal Services<\/a> is all we do.\u00a0 Feel free to call Insurance Claims Group, Inc. at 919-669-9111 to have all your independent appraiser questions answered at NO COST.<\/p>\n

Related:
\nInsurance Appraisal Process – http:\/\/www.insuranceappraisalprocess.com<\/a>
\nHow The Insurance Appraisal Process Works<\/a><\/p>\n