Policyholder v. First Party Carrier
First party property claims create a trap for the unwary. The policyholder wants payment of the claim; the carrier must have the opportunity to conduct its investigation and the time to determine whether the claim should be paid. Each claim must be scrutinized to assure the loss is covered and, if so, the amount of policy benefits actually due.
Hardiman & Carroll has been advising carriers for many years on the interpretation of commercial and homeowner property policies, the investigation of property claims, the proper amount of benefits (if due) and the available options if coverage issues are present. Our experience spans personal lines single family homeowner losses to commercial earthquake and 9/11 claims.
For example, a recent claim was submitted to a personal lines carrier client, involving vandalism damage to a newly constructed house in Modesto and its contents. After investigation, the carrier denied the claim. The insured sued, seeking the usual damages implicated in the denial of first party benefit claims: policy benefits, compensation for economic losses and emotional distress, punitive damages and attorneys fees.
Hardiman & Carroll took the case to trial on behalf of the client. Michael Hardiman established that the claim was either entirely fabricated or exaggerated. Additionally, under the circumstances the carrier acted properly and no benefits were due. Defense verdict.