Jonathan Wheeler, P.C. has been dedicated to representing homeowners, business owners, and other property owners for over 25 years. The past year has been an exciting one: we added two additional partners – Anthony DiUlio and Mario Barnabei – who have assisted in successfully representing 100’s of clients last year alone. Most importantly, the firm has made some major strides to helping the industry as a whole, and that includes you.
Beyond resolving six and seven figure claims, we have worked on four major cases which we wanted to bring to your attention:
1. State Farm admitted its “over a period of time” provision is ambiguous.
First, and (in this writer’s opinion) most importantly, State Farm admitted, through the testimony of its representative and adjuster, Ed Toussaint, that the State Farm Policy language regarding long term and repeated leakage or seepage “over a period of time” is ambiguous.
This is a major fact for State Farm to admit because, as you may or may not be aware, any policy language that is ambiguous MUST be read in a way most favorable to the insured. This means if a “period of time” could mean a week, a month, a year, or a decade, it MUST be read in whatever way is most favorable to the insured.
Any claim which State Farm denied for being a leak which occurred “over a period of time” can be fought in the Courts. So if you have ANY claim denied for a leak which occurred over a period of time by State Farm, call my office and we will do what we can to help.
2. You can adjust and get coverage for 1st Party Property Coverage under the Liability Portion of the Policy.
One of the most surprising wins for us came in NJ, but it could effect PA as well. We successfully argued a claim for damage as the result of a leaking oil tank that was discovered in the back yard.
The reason this case was so critical is that the Court found that although the damage was not covered under Section I property coverage because of the laundry list of exclusions (including pollution and damage to land), the Court did find coverage because the state required clean-up of the oil triggering Liability Coverage.
There are three important takeaways for this claim:
- The exclusions which apply to Section I do not necessarily apply to Liability Coverage.
- Whenever a 3rd party (City, State, Governmental agency) forces work to be completed on the property as the result of a loss, there may be liability coverage under the policy even if not covered under Section I.
- When you feel there is coverage and see no other options, give us a call and we will do all we can to help.
3. We were successful in Stage One of Class Action over Overhead and Profit against Farmers/Truck Insurance.
One of our current cases – Kurach v. Truck Insurance – regards Truck’s unjust withholding of Overhead and Profit in ACV payments.
As you are likely aware, Farmers, through Truck Insurance, has been withholding Overhead & Profit in actual cash value payments for claims. The policy says that unless state law indicates otherwise, they reserve the right to withhold the O & P until incurred.
The problem is, our office already won this issue in the Courts against State Farm, so the law does indicate otherwise. We have successfully argued in State Court that PA Law does require the payment of O & P and that the policy was ambiguous as to O & P because ACV is calculated as RCV – Depreciation, not RCV – Depreciation – O &P.
Not surprisingly, Truck Insurance has appealed the issue, and we just argued the case in the Court of Appeals. We anticipate hearing a ruling in the coming months.
This would be a big win for property owners and adjusters alike. Once we get a favorable ruling, we will be seeking class certification so that we can make this change as far-reaching as possible.
If you would like more information regarding this case, please email me at [email protected].
4. We have first win against State Farm regarding its attempt to limit access in plumbing leaks.
Last but not least, we have had a successful battle with State Farm regarding its access provision. In the case of Aguiar v. State Farm, we won coverage after arguing that the State Farm access provision which is billed as “additional coverage” is actually a reduction of coverage, and that this creates an obvious confusion and ambiguity in the policy.
Just as discussed above, any ambiguity must be resolved in favor of the insured. This was a big win because it helps show that State Farm can’t hide behind confusing policy language anymore. As you can imagine, State Farm appealed this award, and we will continue to fight them on this access issue.
If you have had any claim denied by State Farm citing the “tear out” provision, contact us right away and we can discuss further options.
This is just a sampling of the successes we had in 2017. We will continue to fight for you and your clients against the insurance carriers whenever a claim isn’t paid for fairly. If you have any claims which have been denied or underpaid, or if your clients are owed for money or we unjustly denied, give us a call. We can discuss the claim, discuss hiring you as our expert, and discuss all the options to make sure the claim is paid in full.