Insurance coverage Contract Interpretation—Test For State Exceptions and Coverage Language Variations


One warning I present to audiences when discussing insurance coverage contract interpretation is that common guidelines could have state exceptions and that coverage language could impression these state exceptions. An instance is that appraisers can’t be retained on a contingent price. I recite this rule whereas talking about appraisal and all the time warn that a number of states permit the alternative.

In Hozlock v.Donegal Firms/Donegal Mut. Ins. Co., 1 a Pennsylvania courtroom dominated in a case of first impression that appraisers may very well be retained and paid on a contingent foundation. Nevertheless, the courtroom made this additional notice, warning that coverage language may lead to a special end result:

We notice that if Appellant so desired, it may have explicitly contracted for fully impartial appraisers. It didn’t. In actual fact…which mandates sure provisions in hearth insurance coverage insurance policies, requires that such insurance policies embrace a clause offering for third occasion appraisal when the events disagree on the worth of a loss. The statute units out a inventory paragraph offering for such appraisal, which insurance coverage corporations are required to make use of of their insurance policies. This inventory paragraph accommodates the particular language that events’ appointed appraisers be ‘competent and disinterested.’ … The appraisal clause in Appellant’s coverage merely requires the appraisers to be competent. Appellant was required by statute to make use of the code’s inventory language. It selected not to take action.

Saying that Pennsylvania is a state that permits appraisers to be retained on a contingent price is simply partially right. Based mostly on the case holding, it could be extra correct to say that Pennsylvania is a state the place, relying on particular coverage language, an appraiser may very well be employed on a contingent foundation as an exception to the overall rule adopted in almost each jurisdiction that prohibits the follow.

Thought For The Day

Stand up, rise up, Rise up on your rights. Stand up, rise up, Don’t hand over the combat.
—Bob Marley


1 Hozlock v. Donegal Firms/Donegal Mut. Ins. Co., 745 A.2nd 1261 (Penn. Superior Ct. 2000).



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