Matching issues in an insurance claim.

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Matching issues in an insurance claim
Matching is one of the more difficult topics in
insurance. When only part of the property is
damaged such as siding or a roof on the outside
or a living room set where just the sofa is
damaged, and if these items cannot match the
existing property, should the entire property be
replaced in order to properly indemnify the
insured, this is a battle we constantly
fight. When replacement cost coverage is
available, logic would dictate that new for
old would apply and the entire item should be
replaced with mismatched siding, shingles, or
other property, the value of the property is
diminished. However, various courts have found
for both options some state the entire thing
should be replaced, while others have found that
repairs, even if they do not match, are
acceptable. The following chart shows which
states have gone so far as to pass statutes
related to this issue. Not all states are listed,
just those are listed that are areas in which we
prominently serve and, as you can see, some
states have statutes directly addressing the
issue, while others do not. However, other
statutes may address things indirectly.
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Arizona The reasonable expectations doctrine for insurance claims states that when insurance terms cannot be understood by the reasonably intelligent consumer, the court will interpret them in light of reasonable expectations of the average insured. Thus, matching can be enforced when the contract allows for it or when the consumer reasonably believes the contract allows for it, even when it does not. Hanks v. Am. Family Mut. Ins. Co., No. CV-12- 00880-PHX-DGC, 2013 WL 2286966, at 2 (D. Ariz. May 23, 2013) Gordinier v. Aetna Casualty Surety Co., 742 P.2d 277, 28384 (1987)
Colorado In deciding whether a contract is ambiguous, a court may consider extrinsic evidence bearing on the meaning of the written terms such as evidence of local usage and of the circumstances surrounding the making of the contract. However, the court may not consider the parties own extrinsic expressions of intent. Fire Ins. Exch. v. Rael by Rael, 895 P.2d 1139, 1143 (Colo. App. 1995) KN Energy, Inc. v. Great Western Sugar Co., 698 P.2d 769 (Colo.1985).
Oklahoma If the terms of a promise are in any respect ambiguous or uncertain, it must be interpreted in the sense in which the promisor Okla. Stat. Ann. tit. 15, 165
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believed, at the time of making it, that the promise understood it.
Utah When a loss requires replacement or repair of items and the repaired or replaced items do not match in color, texture, or size, the insurer shall repair or replace items so as to conform to a reasonably uniform appearance. This applies to interior and exterior losses. (fire and extended coverage) Utah Admin. Code r. R590-190-13
Texas Parol evidence rule. If a contract is ambiguous, extrinsic evidence may be relied upon to construe it. Natl Union Fire Ins. Co. of Pittsburgh, PA v. CBI Indus., Inc., 907 S.W.2d 517 (Tex. 1995) Southland Lloyds Ins. Co. v. Cantu, 399 S.W.3d 558, 580 (Tex. App. 2011).
Nevada Any ambiguity . . . should be construed against the drafter. Anvui, LLC v. G.L. Dragon, LLC, 163 P.3d 405, 407 (Nev. 2007).
We wish all States were like Nevada but that
doesnt mean we cant present a claim for
matching in your claim. We may be able to get the
damages covered and if not we are usually able
to find other coverages to help recover funds.
One way or the other you will know Brown OHaver
tried every option to get you paid a fair claim.