Articles by Jim Sams

Sams is editor of ClaimsJournal.com, the online resource and daily newsletter for property/casualty insurance claims professionals. ClaimsJournal is a member of the Wells Media Group. Sams can be reached at jsams@wellsmedia.com

Courts Allow COVID-19 Claims by Insureds With Policy Endorsements for Diseases

While insurers continue to win four out of five cases in early rounds, in the past month two property owners with policies that contained endorsements specifically providing coverage for diseases survived motions to dismiss their COVID-19 business interruption claims. On …

Social Inflation Lesson: Not Settling Cost Insurer Millions in Suit by Excess Insurer

The defense team for Chubb Group’s Ace American Insurance Co. was confident that no jury would award more than $2 million in a wrongful death lawsuit filed by the family of Mark Braswell, who died on May 16, 2014, when …

COVID-19 Business Interruption Rulings, Most Favoring Insurers, Moving to Appeals

A wave of litigation over business-interruption losses caused by COVID-19 shutdown orders has started splashing into the appellate courts. Appeals of trial court decisions in at least 11 lawsuits have been filed so far, all but one of them by …

Florida Court Upholds Policyholder Right to Assign Benefits

An appellate court in Florida has upheld the right of policyholders to assign their right to collect benefits from an insurance claim to contractors, reversing trial court rulings in favor of insurers. The Florida 3rd District Court of Appeals ruled …

8th Circuit: Late Notice Bars Coverage Under Arkansas District’s ‘Claims-Made’ Policy

Ace American Insurance Co. is not liable for the approximately $250,000 that an Arkansas school district paid to settle a sexual harassment lawsuit because the district did not notify the insurer about a complaint against it until more than six …

Social Inflation Lesson: Not Settling Cost Insurer Millions in Suit by Excess Insurer

The defense team for Chubb Group’s Ace American Insurance Co. was confident that no jury would award more than $2 million in a wrongful death lawsuit filed by the family of Mark Braswell, who died on May 16, 2014 when …

Tennnessee High Court: Presumption Law Protects Agents, Carriers

Under Tennessee law, policyholders who pay their premiums create a legal presumption that they have accepted the terms of coverage. The statute limits lawsuits by underinsured policyholders who thought they had enough coverage but found after a loss that they …

Expansion of Workers’ Comp for COVID-19 Created Narrow Benefit in 6 States

While at least 17 states have passed laws or issued orders that expanded access to workers’ compensation benefits for employees who contract COVID-19, many of those directives are creating new exposure for only a sliver of the workforce, new research …

Hospital Charges Rise Despite Fewer Visits to Emergency Rooms

Auto casualty claimants are avoiding hospital emergency rooms during the COVID-19 pandemic but are generating increased hospital charges anyway, according to a new report by Mitchell, a San Diego-based claims administrator. “Anecdotally, we have heard that some people have been …

Analysts Say Cat Models Would Encourage Wildfire Mitigation Measures

Predictive modelers told California regulators on Thursday that the state’s antiquated rules for calculating wildfire risk when setting property insurance rates discourage innovative mitigation measures that could ultimately reduce losses. Nancy P. Watkins, a principal and consulting actuary for Milliman, …