Most property insurance coverage insurance policies have a one or two 12 months go well with limitation interval. Some states will lengthen this time-frame to carry a lawsuit for varied causes. Nonetheless, I generally run throughout situations the place a public adjuster or policyholder thinks that the go well with limitation interval has no impression on the time to demand appraisal. This isn’t appropriate, and a requirement for appraisal ought to all the time be made earlier than the go well with limitation interval runs.
A just lately determined case in Pennsylvania demonstrated this level. 1 The info of the case are as follows:
On July 18, 2021, a fireplace broken the Houtzes’ property…On the time, the Houtzes had an lively insurance coverage coverage issued by State Farm…After the Houtzes submitted discover of the loss, State Farm accepted the loss was coated beneath the Houtzes’ coverage. From July 2021 to March 2023, the Houtzes and State Farm negotiated the insurance coverage declare, and State Farm issued funds beneath the coverage. On July 13, 2023, after a dispute arose concerning the loss quantity, the Houtzes demanded an appraisal of the loss quantity pursuant to the coverage’s appraisal provision. The following day, State Farm denied the appraisal request as premature as a result of it was not made inside one 12 months after the date of the loss, in violation of the coverage’s go well with limitation provision. The go well with limitation provision, titled ‘Swimsuit In opposition to Us,’ states: ‘No motion shall be introduced in opposition to [State Farm] except there was full compliance with the entire coverage provisions. Any motion by any occasion should be began inside one 12 months after the date of loss or injury.’
A lawsuit was filed, and the courtroom ultimately sided with State Farm on the breach of contract motion:
The Houtzes haven’t alleged any info suggesting State Farm waived the go well with limitation protection. As a substitute, the Amended Criticism suggests the other. In its July 2023 letter denying the Houtzes’ appraisal request, State Farm explicitly said it was not waiving any limitations or provisions, and in addition claimed it had reminded the Houtzes of the go well with limitation provision in ‘correspondence all through this declare and [as] early as [its] letter dated August 12, 2021.’ State Farm’s express reliance on the go well with limitation provision for nearly two years doesn’t represent waiver, and the Amended Criticism contains no allegations on the contrary.
There are additionally no info pled to recommend State Farm induced the Houtzes to delay bringing this motion. The Houtzes declare had they identified State Farm ‘would take an unreasonable and unjustified place to refuse appraisal just because they had been past the go well with limitation, go well with would have been beforehand filed.’ As a result of the appraisal denial occurred lengthy after the one-year limitation interval expired, the implication is State Farm induced them to delay their appraisal request till after the one-year limitation. However the Criticism comprises no factual allegations to this impact. Certainly, the Houtzes allege virtually no info concerning State Farm’s conduct previous to its appraisal denial, and no info suggesting any inducement. The Houtzes solely allege they ‘continued to barter the declare’ and State Farm ‘was complying with its tasks.’ These info don’t plausibly recommend State Farm induced the Houtzes to delay this motion.
Of their response in opposition, the Houtzes argue State Farm ‘purposefully, and even inadvertently, wait[ed] till one 12 months ha[d] handed from the date’ of the hearth to disclaim appraisal, as soon as State Farm ‘believed it was immune from go well with.’ The Courtroom is unpersuaded given the Houtzes’ personal allegations display the other. The Houtzes allege ‘[a] dispute rose as to the quantity of the loss.’ Am. Compl. As soon as the Houtzes demanded appraisal, State Farm acknowledged receipt of their demand and explicitly denied the demand beneath the go well with limitation provision at some point later. The Courtroom can not discover estoppel to use when the Houtzes haven’t offered any info—past their very own conclusory allegations—on how State Farm allegedly delayed this motion. As a result of the Houtzes haven’t alleged info plausibly suggesting waiver or estoppel, the go well with limitation provision is enforceable. Houtzes’ breach of contract declare is thus time-barred by the supply. Accordingly, Depend I shall be dismissed.
The primary lesson is to demand the appraisal well timed and earlier than the go well with limitation interval runs. The second lesson to recollect is that many states require a lawsuit to be filed throughout the go well with limitation interval, even when the matter is in appraisal. I famous this second lesson in When Does the Statute of Limitations Run After a Texas Appraisal:
Value determinations are a standard various methodology to litigation for resolving property insurance coverage disputes. Nonetheless, the time to file go well with varies from state to state, even when an appraisal is invoked. Policyholders must be cautious that although an appraisal is invoked, some states nonetheless enable the time to carry go well with to run regardless of the continuing appraisal. Statutes of limitation when an appraisal is concerned is usually a advanced and sometimes missed facet of a declare with disastrous outcomes if the problem shouldn’t be legally analyzed.
Swimsuit limitation intervals and statutes of limitations may be troublesome to establish. In case you are not clear when the deadline to file go well with will happen, all the time search an opinion from a professional legal professional.
Thought For The Day
Targets aren’t sufficient. You want objectives plus deadlines: objectives sufficiently big to get enthusiastic about and deadline to make you run. One isn’t a lot good with out the opposite, however collectively they are often large.
—Joe Griffith
1 Houtz v. State Farm fireplace & Cas. Co., No. 23-3579, 2024 WL 2392982 (E.D. Penn. Might 23, 2024).