{"id":905952,"date":"2026-07-30T15:34:59","date_gmt":"2026-07-30T21:34:59","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=905952"},"modified":"2026-07-30T15:35:02","modified_gmt":"2026-07-30T21:35:02","slug":"insurance-appraisal-wear-and-tear-scope","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/insurance-appraisal-wear-and-tear-scope\/","title":{"rendered":"Executive Summary: &#8220;Wear and Tear&#8221; Disclaimers and the Scope of Insurance Appraisal"},"content":{"rendered":"\n<p><a href=\"http:\/\/www.adviseandconsult.net\/experts.php\">Advise &amp; Consult, Inc.<\/a><\/p>\n\n\n\n<p><strong>Overview<\/strong><\/p>\n\n\n\n<p>In property insurance claims, insurers frequently attempt to reject policyholder demands for appraisal by framing causation disputes\u2014specifically, distinguishing between covered storm damage and excluded wear and tear\u2014as unappraisable &#8220;coverage questions.&#8221;<\/p>\n\n\n\n<p>In the majority of U.S. jurisdictions, once an insurer admits there is a covered loss, determining whether specific damage was caused by a covered event or by &#8220;<a href=\"https:\/\/www.myconstructionexpert.com\/blog\/wear-and-tear-exclusions-of-homeowners-policy\/\">wear and tear<\/a>&#8221; falls directly within the <a href=\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-appraisal-as-an-insurance-claim-dispute-resolution-tool\/\">appraisal<\/a> panel&#8217;s authority to evaluate the scope and amount of loss.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\">Key Legal Findings &amp; Jurisdictional Split<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\">1. Majority Rule: Causation Is an Amount-of-Loss Issue<\/h4>\n\n\n\n<p>When an insurer concedes coverage for part of a loss, deciding which specific damages stem from a covered peril (e.g., wind or hail) versus excluded maintenance issues is considered a factual determination for the appraisal panel.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Colorado (10th Circuit):<\/strong> Held that an insurer breaches its policy by refusing appraisal when acknowledging some storm damage while attributing the remainder to wear and tear (<em><a href=\"https:\/\/www.propertyinsurancecoveragelaw.com\/blog\/wear-and-tear-insurance-appraisal\/?utm_campaign=Blog%20Subscription%20-%20Daily%20Roundup&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_J7KS-2N-ehzhEjxmIRN0Nm672eGW2TKvl7EPMOnyNU4fZ5zBTH7rSFdvzvqive_XeCnIFVfuonZfeypqcY3m30u04vE8UMiz4vS7Y5XGGch1CvxI&amp;_hsmi=429373937&amp;utm_content=429373937&amp;utm_source=hs_email#15\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">BonBeck Parker, LLC v. Travelers Indem. Co.<\/a><\/em>).<\/li>\n\n\n\n<li><strong>Florida:<\/strong> Established that causation is a coverage issue for the court only when an insurer <em>wholly denies<\/em> a claim. Once partial coverage is admitted, causation becomes an amount-of-loss determination for appraisers (<em><a href=\"https:\/\/www.propertyinsurancecoveragelaw.com\/blog\/wear-and-tear-insurance-appraisal\/?utm_campaign=Blog%20Subscription%20-%20Daily%20Roundup&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_J7KS-2N-ehzhEjxmIRN0Nm672eGW2TKvl7EPMOnyNU4fZ5zBTH7rSFdvzvqive_XeCnIFVfuonZfeypqcY3m30u04vE8UMiz4vS7Y5XGGch1CvxI&amp;_hsmi=429373937&amp;utm_content=429373937&amp;utm_source=hs_email#17\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">State Farm Fla. Ins. Co. v. Gonzalez<\/a><\/em>).<\/li>\n\n\n\n<li><strong>Texas, Iowa, &amp; Illinois:<\/strong> Courts routinely require appraisal even when panels must differentiate hail impact from deterioration or improper installation (<em><a href=\"https:\/\/www.propertyinsurancecoveragelaw.com\/blog\/wear-and-tear-insurance-appraisal\/?utm_campaign=Blog%20Subscription%20-%20Daily%20Roundup&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_J7KS-2N-ehzhEjxmIRN0Nm672eGW2TKvl7EPMOnyNU4fZ5zBTH7rSFdvzvqive_XeCnIFVfuonZfeypqcY3m30u04vE8UMiz4vS7Y5XGGch1CvxI&amp;_hsmi=429373937&amp;utm_content=429373937&amp;utm_source=hs_email#18\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Hart Chesnutt, LLC v. Covington Specialty Ins. Co.<\/a><\/em>; <em><a href=\"https:\/\/www.propertyinsurancecoveragelaw.com\/blog\/wear-and-tear-insurance-appraisal\/?utm_campaign=Blog%20Subscription%20-%20Daily%20Roundup&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_J7KS-2N-ehzhEjxmIRN0Nm672eGW2TKvl7EPMOnyNU4fZ5zBTH7rSFdvzvqive_XeCnIFVfuonZfeypqcY3m30u04vE8UMiz4vS7Y5XGGch1CvxI&amp;_hsmi=429373937&amp;utm_content=429373937&amp;utm_source=hs_email#19\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">N. Glenn Homeowners Assn. v. State Farm<\/a><\/em>; <em><a href=\"https:\/\/www.propertyinsurancecoveragelaw.com\/blog\/wear-and-tear-insurance-appraisal\/?utm_campaign=Blog%20Subscription%20-%20Daily%20Roundup&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_J7KS-2N-ehzhEjxmIRN0Nm672eGW2TKvl7EPMOnyNU4fZ5zBTH7rSFdvzvqive_XeCnIFVfuonZfeypqcY3m30u04vE8UMiz4vS7Y5XGGch1CvxI&amp;_hsmi=429373937&amp;utm_content=429373937&amp;utm_source=hs_email#20\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Mouw v. Shelter Mut. Ins. Co.<\/a><\/em>).<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\">2. Minority Rule: Causation Is Strictly Judicial<\/h5>\n\n\n\n<p>A few states restrict appraisal exclusively to monetary valuation, reserving all causation assessments for judicial review unless contractually specified otherwise (e.g., Alabama in <em><a href=\"https:\/\/www.propertyinsurancecoveragelaw.com\/blog\/wear-and-tear-insurance-appraisal\/?utm_campaign=Blog%20Subscription%20-%20Daily%20Roundup&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_J7KS-2N-ehzhEjxmIRN0Nm672eGW2TKvl7EPMOnyNU4fZ5zBTH7rSFdvzvqive_XeCnIFVfuonZfeypqcY3m30u04vE8UMiz4vS7Y5XGGch1CvxI&amp;_hsmi=429373937&amp;utm_content=429373937&amp;utm_source=hs_email#22\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Rogers v. State Farm Fire &amp; Cas. Co.<\/a><\/em>).<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\">Practical Takeaways for Policyholders &amp; Practitioners<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Enforce Demands in Majority States:<\/strong> Where coverage is acknowledged in part, insurance carriers should be held to appraisal requirements even if wear and tear is cited.<\/li>\n\n\n\n<li><strong>Narrow the Dispute First:<\/strong> Utilizing appraisal to resolve factual disagreements over scope and causation simplifies the process, leaving pure legal and policy interpretations for court resolution if necessary.<\/li>\n\n\n\n<li><strong>Jurisdictional Review:<\/strong> Always confirm whether the subject jurisdiction follows the majority or minority rule before initiating formal appraisal demands or litigation.<\/li>\n<\/ul>\n\n\n\n<p>Written with the assistance of AI.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>When one of your cases is in need of a construction expert, estimates, insurance appraisal or umpire services in defect or insurance disputes &#8211; please call Advise &amp; Consult, Inc. at 801.641.8304, or email <a href=\"mailto:experts@adviseandconsult.net\">experts@adviseandconsult.net<\/a>.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Advise &amp; Consult, Inc. Overview In property insurance claims, insurers frequently attempt to reject policyholder demands for appraisal by framing causation disputes\u2014specifically, distinguishing between covered storm damage and excluded wear and tear\u2014as unappraisable &#8220;coverage questions.&#8221; In the majority of U.S. jurisdictions, once an insurer admits there is a covered loss, determining whether specific damage was&hellip; <a class=\"more-link\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-appraisal-wear-and-tear-scope\/\">Continue reading <span class=\"screen-reader-text\">Executive Summary: &#8220;Wear and Tear&#8221; Disclaimers and the Scope of Insurance 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":[10721,10235],"tags":[9895,22,131,9240],"class_list":["post-905952","post","type-post","status-publish","format-standard","hentry","category-insurance","category-insurance-appraisal","tag-advise-consult","tag-insurance","tag-insurance-appraisal","tag-wear-and-tear","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>Executive Summary: &quot;Wear and Tear&quot; 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