Appraisal Exists to Establish Quantum of Loss

Published: Aug. 31, 2023, 2:20 p.m.

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Appraisal Required to Establish Amount of Loss\\n\\nThe plaintiff, Shelter Mutual Insurance Company (Shelter), appealed the \\ncircuit court of Coles County\'s March 28, 2023, oral pronouncement \\ndenying its motion for judgment on the pleadings and ordering the \\nparties to proceed forward with the appraisal process as outlined in the\\n at-issue insurance policy, and the circuit court\'s written March 30, \\n2023, order memorializing the same. In Shelter Mutual Insurance Company \\nv. Tim Morrow and Jodie Morrow, 2023 IL App (5th) 230249-U, No. \\n5-23-0249, Court of Appeals of Illinois, Fifth District (August 24, \\n2023) was asked to determine if appraisal could be compelled.\\n\\nBACKGROUND\\n\\nShelter issued a homeowners insurance policy to the Morrows (the \\nPolicy). The Policy was in effect from April 7, 2021, to April 7, 2022. \\nThe policy provided:\\n\\nAppraisal\\n\\nIf you and we fail to agree on the market value, total restoration cost,\\n actual cash value, or amount of loss, as may be required in the \\napplicable policy provision, either party may make written demand for an\\n appraisal. ...\\n\\nThe appraisers shall then appraise the loss, stating separately the \\nmarket value, total restoration cost, actual cash value, or loss to each\\n item as may be required in the applicable policy provision....\\xa0\\n\\nOn December 10, 2021, a hail and windstorm occurred affecting the \\nMorrows\' property. The Morrows submitted a claim to Shelter for damage \\nallegedly sustained because of the storm. Shelter inspected the claimed \\nproperty damage and determined that the damage added up to less than the\\n Morrows\' deductible of $1000. In response, the Morrows obtained their \\nown report and estimate from a public adjuster, the Accuval Group LLC, \\ndated December 21, 2021. That report indicated that a complete tear-off \\nand replacement of the residence roof and garage roof, as well as \\nremoval and replacement of the fencing would be necessary at a total \\ncost of $38,198.15, less the $1000 deductible.\\n\\nFollowing this report, Shelter obtained a second assessment, this time \\nfrom Donan Engineering, dated February 2, 2022. That report concluded \\nthat some of the damage claimed was attributed to the storm, but other \\ndamage claimed was not. That report found that much of the damage was \\nattributable to installation errors, inadvertent man-made damage, and \\nsealant strip failure. On February 8, 2022, Shelter sent a letter \\ninforming the Morrows that it continued to view the loss as not \\nexceeding their deductible. \\n\\nThe Morrows answered the complaint and filed counterclaims asserting \\nbreach of contract and bad faith, specifically alleging bad faith for \\nShelter\'s refusal to submit to the appraisal process as outlined in the \\nPolicy and as previously invoked by the Morrows on May 5, 2022.\\n\\nThe circuit court denied the motion for judgment on the pleadings and \\nordered the parties to proceed with the appraisal process as previously \\ninvoked by the Morrows and as outlined in the Policy.\\n\\nANALYSIS\\n\\nAn appraisal clause is analogous to an arbitration clause. The Court of \\nAppeals held that an order denying a motion to dismiss was tantamount to\\n an order denying arbitration.\\n\\nShelter\'s assessment acknowledged that a tornado touched down \\napproximately 1.8 miles northwest of the Morrows\' property on the date \\nof the storm. The report acknowledged\\xa0 that "higher wind speeds affected\\n [the Morrows\'] property." Based upon these facts alone, it is evident \\nthat the question at issue is not whether a covered loss occurred \\nbecause a covered loss was found by Shelter\'s own adjuster in its \\nreport. Therefore, the true dispute of the parties is the amount of that\\n covered loss.\\n\\nThis case involves a determination of the "amount of loss," which is \\nexpressly stated within the appraisal clause as an appropriate issue for\\n determination under that process\\n\\nThe Court of Appeals affirmed the circuit court\\u2019s oral pronouncement.

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