{"id":898926,"date":"2021-07-13T15:46:26","date_gmt":"2021-07-13T21:46:26","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=898926"},"modified":"2021-07-13T15:46:32","modified_gmt":"2021-07-13T21:46:32","slug":"appraisal-before-insurance-coverag","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/appraisal-before-insurance-coverag\/","title":{"rendered":"New Jersey Federal Court Holds That Insurance Coverage Issues Do Not Need To Be Decided Before Appraisal"},"content":{"rendered":"\n<p>Paul Fertland and Vincent Passarelli | <a href=\"https:\/\/www.propertyinsurancelawobserver.com\/2021\/07\/06\/new-jersey-federal-court-holds-that-insurance-coverage-issues-do-not-need-to-be-decided-before-appraisal\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Property Insurance Law Observer<\/a><\/p>\n\n\n\n<p>A federal court recently held that ongoing insurance coverage issues should not prevent an <a href=\"https:\/\/www.myconstructionexpert.com\/blog\/appraisal-process-non-covered-claims\/\" target=\"_blank\" rel=\"noreferrer noopener\">appraisal<\/a> from going forward as per an appraisal clause in the insurance policy. In\u00a0<em>DC Plastic Products Corp. v. Westchester Surplus Lines Insurance Co.<\/em>\u00a0Case No. 17-13092 (D.N.J. May 19, 2021), the District Court of New Jersey directed the parties to proceed with the <a href=\"http:\/\/adviseandconsult.net\/experts.php\" target=\"_blank\" rel=\"noreferrer noopener\">appraisal<\/a> process as set forth in the relevant policy, despite the defendant-insurer\u2019s argument that appraisal is improper under New Jersey law where unresolved coverage issues exist.<\/p>\n\n\n\n<p>Plaintiff DC Plastics Products Corporation (\u201cDC Plastics\u201d) made an insurance claim to its insurance carrier Westchester Surplus Lines Insurance Co. (\u201cWestchester\u201d) after DC Plastics\u2019 premises in Bayonne, New Jersey was damaged as a result of Superstorm Sandy in 2012. Since that time, the parties have disagreed over whether certain additional payments were required under the terms of the policy.&nbsp; The policy at issue contained an appraisal provision that allowed either party to make a written demand for an appraisal if the parties disagreed on the amount of loss. This provision also specified that if the separate appraisers selected by both sides cannot agree on an umpire, \u201ceither may request that selection be made by a judge of a court having jurisdiction.\u201d DC Plastics filed a motion for the court to appoint an umpire.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/www.propertyinsurancelawobserver.com\/wp-content\/uploads\/sites\/11\/2021\/07\/shutterstock_266367755.jpg\"><img decoding=\"async\" src=\"https:\/\/www.propertyinsurancelawobserver.com\/wp-content\/uploads\/sites\/11\/2021\/07\/shutterstock_266367755.jpg\" alt=\"\" class=\"wp-image-1813\"\/><\/a><\/figure>\n\n\n\n<p>Westchester argued that that the court should refrain from selecting an umpire because, under New Jersey law, appraisal is improper where unresolved coverage issues exist. The court disagreed and pointed out that the case law cited by Westchester did not support its argument and only \u201cmakes it clear that appraisers (and umpires) cannot make legal determinations and may only determine a disputed amount of loss, not a party\u2019s liability.\u201d More specifically, the court found that Westchester\u2019s reliance on&nbsp;<em>Rastelli Bros., Inc. v. Netherlands Ins. Co.<\/em>, 68 F. Supp. 2d 448 (D.N.J. 1999) was misplaced because the&nbsp;<em>Rastelli&nbsp;<\/em>court specifically based its decision to deny the insured\u2019s request for appraisal on the fact that the parties only disputed whether the loss was covered and did not dispute the amount of loss, so there was nothing for the appraiser to determine.&nbsp; Here, in contrast, Westchester and DC Plastics disagreed on the amount of loss.&nbsp; Thus, the court held there was no reason to delay an appraisal simply to determine the amount of loss.&nbsp; Further, the court noted that the applicable appraisal provision allowed Westchester to retain its right to contest liability regardless of the outcome of the appraisal.&nbsp;<\/p>\n\n\n\n<p>The District Court of New Jersey\u2019s decision in this case is another example of a court holding that ongoing coverage issues during an insurance claim should not delay a properly requested appraisal from determining the value of a disputed loss. For example, in&nbsp;<em>State Farm Lloyds v. Johnson<\/em>, 290 S.W.3d 866 (Tex. Sup. Ct. 2009), the insurer argued that the homeowner plaintiff\u2019s request for an appraisal under the terms of the policy was improper because the parties disagreed as to causation of damage to plaintiff\u2019s home. The Texas Supreme Court ordered the appraisal to be conducted despite this disagreement holding that the appraiser\u2019s job is to determine the amount of loss and not to decide who must pay for the damages. Thus, the court reasoned, the amount of loss can be determined by an appraiser, and any issues as to causation can be determined later by the court.<\/p>\n\n\n\n<p>In light of decisions like&nbsp;<em>DC Plastics&nbsp;<\/em>and&nbsp;<em>Johnson<\/em>, insurers should be fully prepared for an appraisal to take place even if there are disagreements as to who will pay for the loss.&nbsp; To that end, insurers should focus on selecting the best appraiser for a particular claim even if there are ongoing coverage or causation disputes. Further, and perhaps most importantly, insurers should use clear and unambiguous language to reserve their rights with regard to the ongoing disputes.&nbsp; This will be critical to guard against any argument that the insurer has fully accepted coverage, or waived its right to deny coverage.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Paul Fertland and Vincent Passarelli | Property Insurance Law Observer A federal court recently held that ongoing insurance coverage issues should not prevent an appraisal from going forward as per an appraisal clause in the insurance policy. In\u00a0DC Plastic Products Corp. v. Westchester Surplus Lines Insurance Co.\u00a0Case No. 17-13092 (D.N.J. May 19, 2021), the District&hellip; <a class=\"more-link\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/appraisal-before-insurance-coverag\/\">Continue reading <span class=\"screen-reader-text\">New Jersey Federal Court Holds That Insurance Coverage Issues Do Not Need To Be Decided Before Appraisal<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[10235],"tags":[9895,351,10904],"class_list":["post-898926","post","type-post","status-publish","format-standard","hentry","category-insurance-appraisal","tag-advise-consult","tag-insurance-appraisals","tag-insurance-coverage-claims","entry"],"jetpack_publicize_connections":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>New Jersey Federal Court Holds That Insurance Coverage Issues Do Not Need To Be Decided Before Appraisal - Advise &amp; 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