Insurers do not Have Carte Blanche to Finish Claims Investigation

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3χλμ.

Still Adjusting is Not Grounds to Dismiss Lawsuit


Read the full article at https://www.linkedin.com/pulse/insurers-do-have-carte-blanche-take-forever-resolving-barry and at https://zalma.com/blog plus more than 3700 posts. 


Three insurers moved to dismiss the suit brought by their insureds because, they say, they are still “adjusting” the claim. In the alternative, they sought a stay of the litigation pending the completion of their own investigation.


In Dewey Beach Enterprises,Inc. v. Drass Insurance Agency, Inc.;  C.A. No. N20C-08-018 CEB, Superior Court Of The State Of Delaware (May 13, 2021) the Delaware court considered available court dates when faced with the motion to dismiss.


Zalma Opinion


Professional claims investigators and adjusters should never take more than a year to make a coverage determination on a fire caused by arson. A professional claims person understands that arson is nothing more than a fire and is an insured against peril. An arson is only an arson-for-profit if there is evidence that the insured caused the fire for the purpose of defrauding the insurer. If they have a basis for a claim of arson-for-profit they should immediately deny the claim and if not, they should immediately work with the insured to pay the claim.

 

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