Ohio Supreme Court Rejects Challenge to Appraisal Award

Appraisal, Property in 60 Seconds

Allegations of additional damage are insufficient to challenge an insurance appraisal award, according to the Ohio Supreme Court. In One Church v. Brotherhood Mut. Ins. Co., the Court examined a windstorm insurance coverage dispute that resulted in an appraisal award. The policyholder brought a lawsuit following the award, contending that, after appraisal, additional hidden damage was discovered …

Ohio Supreme Court Rejects Challenge to Appraisal Award Read More »

Property in 60 Seconds: Supreme Court Holds: Investigate!

Fraud, General, Property in 60 Seconds, SIU

It’s not everyday that the United States Supreme Court issues a decision directly on point for insurance investigators. But that’s exactly what happened in Keathley v. Buddy Ayers Construction, Inc.  First, the Court advised that a discrepancy in a past bankruptcy proceeding will not automatically amount to judicial estoppel. Importantly though, the court didn’t stop there. In …

Property in 60 Seconds: Supreme Court Holds: Investigate! Read More »

brain, artificial, intelligence, learning, machine, chip, technology, concept, ai generated-8530786.jpg

The Insurer’s Use of AI as a Tool

Artificial Intelligence

The first wave of litigation challenging insurers’ use of artificial intelligence (“AI”) in coverage determinations has arrived.  These early decisions suggest that courts willingly scrutinize AI’s role in claim handling and are willing to conclude that the reasonable use of an AI platform mustn’t be criticized. We’ve briefly addressed three (3) recent federal decisions – …

The Insurer’s Use of AI as a Tool Read More »

New Jersey Supreme Court Limits Recovery of Future Medical Expenses

Medical Expenses

The New Jersey Supreme Court, last week, held that future medical expenses cannot be recovered against a tortfeasor when those expenses remain payable through available Personal Injury Protection (“PIP”) benefits. In Murray v. Punina, plaintiff sought damages for anticipated future surgeries and treatment, but the Court found those expenses were still “collectible” under the remaining …

New Jersey Supreme Court Limits Recovery of Future Medical Expenses Read More »

Third Circuit Affirms Plain Meaning of “Surface Water”

Surface Water

In Shemen v. Cincinnati Insurance Company, the United States Court of Appeals for the Third Circuit, applying New Jersey law, affirmed summary judgment in favor of The Cincinnati Insurance Company, reinforcing a straightforward principle: clear policy language will be enforced as written. The case arose from property damage caused by heavy rainfall during Hurricane Ida. Cincinnati denied coverage under …

Third Circuit Affirms Plain Meaning of “Surface Water” Read More »

Late Notice in Property Insurance: One Issue, Three Different Rules

Duties After Loss

Late notice has quietly reemerged as one of the most consequential, and unsettled, issues in first-party property insurance claims. While the policy language often appears straightforward, courts across the country are taking sharply different approaches to a fundamental question: Does late notice automatically bar coverage, or must the insurer prove prejudice? The answer increasingly depends …

Late Notice in Property Insurance: One Issue, Three Different Rules Read More »

Property in 60 Seconds: Minnesota Federal Court Orders Discovery Into Insurer’s Use of AI

Artificial Intelligence, Emerging Issues, Property in 60 Seconds

A recent decision in Estate of Lokken v. UnitedHealth Group, Inc. highlights emerging litigation risks associated with insurers’ use of artificial intelligence tools to guide coverage decisions. The case involves allegations that UnitedHealth Group relied on an AI-driven predictive model developed by its subsidiary naviHealth to determine the appropriate duration of post-acute medical care for insureds. The court’s …

Property in 60 Seconds: Minnesota Federal Court Orders Discovery Into Insurer’s Use of AI Read More »

hammer, dish, judge-471884.jpg

Sixth Circuit Rejects Attempt to Expand Code-Upgrade Coverage Beyond Policy Sublimit

Ordinance/Law

Property insurance policies often contain ordinance or law sublimits that cap what an insurer will pay for the increased cost of construction necessary to comply with current building codes. A recent Sixth Circuit decision underscores the enforceability of those provisions and rejects attempts to expand them through generalized statements about “full coverage.” In Piatt Lake …

Sixth Circuit Rejects Attempt to Expand Code-Upgrade Coverage Beyond Policy Sublimit Read More »

When to Cry Over Spilled Milk: A Cautionary Tale for Insurers on Payment Handling

Bad Faith, Claim Payments, Public Adjusters

When an insurer issues claim payments, the job isn’t always finished once the check clears. The recent Pennsylvania Superior Court decision in Spilled Milk, Inc. v. Nautilus Insurance Co. (Oct. 28, 2025), serves as a reminder that even well-intentioned payment handling can expose a carrier to breach of contract and bad faith allegations when the …

When to Cry Over Spilled Milk: A Cautionary Tale for Insurers on Payment Handling Read More »