Making the Policyholder Whole

Adjusting Today Basis for Institutes CE Courses The Institutes, the leader in providing knowledge solutions for risk management and the property/casualty insurance industry, offers continuing education courses based on technical information compiled from issues of Adjusting Today. The courses — “Valuing a Property Insurance Claim” and “Natural Disasters: Coverage Issues”— include seven modules each and are approved for credit by insurance departments in most states. They are offered to property insurance producers, adjusters or both, depending on the state, for up to three continuing education credit hours per course. More information is available at CEU.com. Gary Thompson is a partner in the Policyholder Group at Weisbrod Matteis & Copley PLLC in its Washington, D.C. office. The opinions set forth in this article are not necessarily those of the firm, its attorneys, or its clients. Gary Thompson ABOUT THE AUTHOR CORPORATE OFFICE 126 Business Park Drive Utica, New York 13502 800.382.2468 Outside U.S. (315) 797.3035 FAX: (315) 272.2054 Editor@AdjustingToday.com Copyright © 2018 Rising Phoenix Holdings Corporation. All Rights Reserved. Adjusters International and the AI logo are registered trademarks of Rising Phoenix Holdings Corporation. Follow Adjusting Today on Facebook & Twitter: Facebook.com/AdjustersInternational Twitter.com/AdjustingToday ADJUSTING TODAY is published as a public service by Adjusters International, Inc. It is provided for general information and is not intended to replace professional insurance, legal or financial advice for specific cases. ADJUSTINGTODAY Adjust ingToday. com View our entire catalog of back issues, download PDF versions, subscribe and contact the editor. WEB ADDRESSES AdjustersInternational.com AdjustingToday.com PUBLISHER Ronald A. Cuccaro, SPPA EDITOR Sheila E. Salvatore AT18 3049 set issues. For example, in the options presented by the pair and set clause, one might add: “In the event that more than 50 percent of a set is damaged, the insurer will pay the full replacement value of the entire set” or “in the event more than 50 percent of hotel furnishings are damaged, the insurer will pay the full replacement of all similar hotel furnishings to allow the hotel to maintain a uniform décor.” More often than not, however, the policyholder and insurer may struggle to apply standard-form pair and set language to a context where there is no definitive guidance from the policy. Such cases become fair game for reasonable dispute — and the policyholder may invoke the pair and set clause as well as the concept generally inherent in RCV coverage in order to make up for the policyholder’s overall loss. The goal that all should accept is to make the policyholder whole. … the cardinal rule of insurance contract interpretation is that where language is ambiguous, as written or as applied in context, any ambiguity is interpreted in favor of coverage for the insured …

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