BLOGS: All Risks Covered

10.18.2016, 11:07:00 AM

Hurricane Matthew flood claims may not be entirely preempted by federal law

In the wake of Hurricane Matthew and its associated flooding (particularly in North Carolina and South Carolina), a recent case of first impression in the Sixth Circuit may be cited by both damaged businesses and insurers and insurance brokers in the Carolinas. Harris v. Nationwide Mutual Fire Insurance Company, __ F.3d __, 2016 WL 4174381 (6th Cir. Aug. 8, 2016).

Writing for a unanimous panel, Judge Ralph B. Guy, Jr. held that the National Flood Insurance Act (established in the wake of flooding in Florida and Louisiana after Hurricane Betsy in 1965) did not preempt claims based on state law for negligence in the procurement of an insurance policy for a home situated in a flood-prone area. Although this case was decided on principles of federal abstention, it has major ramifications for those practicing insurance law. While it is not binding on any courts in the area affected by Hurricane Matthew, policyholder counsel will likely cite to it as persuasive authority in support of negligence claims against insurance brokers and other professionals involved in the purchase of homes or insurance.  

The case arose when a married couple suffered a flood loss during a 2010 flood of the Cumberland River. They brought a claim against their mortgage bank (Regions), a flood-zone certifier, their insurance company (Nationwide) and their insurance broker (David Vandenbergh). On appeal, the issue was whether the homeowers’ state law claims for negligence during the procurement of their Standard Flood Insurance Policy were preempted by Congress when it passed the National Flood Insurance Act (NFIA) The panel unanimouslyheld that while the NFIA preempted coverage claims against the insurer, it did not preempt negligence claims regarding procurement of the policy.
The case was remanded to the district court for further proceedings and, presumably, for trial.

The Court explained that:
“The NFIA indisputably preempts state-law causes of action based on “the handling and disposition of SFIP claims.” Gibson [v. American Bankers Ins. Co.], 289 F.3d at 949. . . . . The Fifth Circuit has distinguished claims-handling causes of action from policy-procurement causes of action, and held that the NFIA does not preempt state-law claims “to the extent that they implicate [insurers'] acts or omissions regarding issuance of the policy because those claims are procurement-based, not claims-handling-based.” Spong v. Fid. Nat'l Prop. and Cas. Ins. Co., 787 F.3d 296, 306 (5th Cir. 2015). In determining whether a plaintiff's cause of action arises from claim handling or policy procurement, the Fifth Circuit looks to whether the plaintiff was “already covered” by a SFIP, or instead was a “potential future policyholder.” Id.  We agree with the Fifth Circuit's approach and hold that the NFIA does not preempt policy-procurement claims such as plaintiffs'.”


In adopting the same distinction as the Fifth Circuit, the Court noted that:
“Damages stemming from policy-procurement claims, unlike those arising from policy-coverage claims, are not “flood policy claim payments.” 44 C.F.R. § 62 App. A, Art. I. . . . . Policy-procurement damages, therefore, pose no danger to the federal interests prompting preemption in the claims-handling context, i.e., “reduc[ing] fiscal pressure on federal flood relief efforts.” C.E.R. 1988, Inc., 386 F.3d at 270.”
Addressing questions of federal abstention:
“[G]eneral conflict-preemption principles do not compel barring state-law policy-procurement claims. It is possible to comply with both state tort laws and FEMA regulations, and state laws regarding misrepresentation and breach of fiduciary duty in the policy-procurement process do not “stand[ ] as an obstacle to the accomplishment and execution of the full purposes and objectives of Congress” in enacting the NFIA. Id. at 269Id. at 269 (quoting Green v. Fund Asset Mgmt., L.P., 245 F.3d 214, 222 (3d Cir. 2001)).”


As Hurricane Matthew's floodwaters recede from the Carolinas, Harris and Spong are likely to be cited as the parties duel over whether claims for negligent procurement in the purchase of insurance can proceed to trial. 

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2.04.2016, 11:25:00 AM

Finance Fox: The Future of Insurance?

By Gemma Saluta and Jonathan Reich

It is common for North American insurance companies to take inspiration from international markets.  One new product of interest is Switzerland based, FinanceFox.  From an app that you download on your phone, you can compare insurance companies and receive personal advice.  Finance Fox advertises that you can compare insurance policies from different insurers and across multiple lines of insurance from their app.  The customer pays nothing, and Finance Fox receives payments from the insurance companies “for reducing administrative tasks and managing insurance contracts on their behalf.”  This is typically a broker’s fee that is anywhere from 8% to 15% of the premium.  The user appoints Finance Fox to be its personal broker, so that the company can represent the user in any insurance matter.  As with many benefits that get renewed every year, the company likely has the opportunity to realize a larger profit margin as customers renew policies. 

So the question then becomes, is this viable for the US market?  We certainly see current insurance companies putting out their own apps, but we rarely see on that tries to compare products from multiple companies, let alone act as a broker.  In order for this product to take hold in the US, we have identified several issue areas that would have to be addressed:
  •  Multiple state licensing requirements
  •  Licensing requirements across different lines of insurance
  • The practicality by the user of reviewing insurance documents over a small screen
  • Clarification regarding issues of procurement
  • Multiple state laws regarding agency 
  • Ensuring adequate communication so that the customer receives the policy he or she requests
  • Data Security
Our economy is pushed by innovation.  This online marketplace for multiple policies across multiple insurers is a novel concept.  Hopefully, we can learn from the European market response whether this concept is worth pursuing in the United States.

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12.10.2015, 9:01:00 AM

Comment period open on N.C. insurance regulations for insurance agents, premium finance companies, and bail bondsmen

The North Carolina Department of Insurance is accepting comments regarding Chapters 6 and 13 of its administrative rules.  The comment period opened on December 1, 2015 and lasts until February 1, 2016. Under North Carolina law, as adopted in 2013, state agencies must initially review all of their administrative rules within five (5) years, and then re-review all rules once every 10 years. These administrative rules are codified in Title 11 of the North Carolina Administrative Code.

Chapter 6 governs the Agent Services division.  This includes licensing of individuals who receive an insurance license from the Department of Insurance (includes resident and non-resident agents) as well as pre-licensing education (requirements, courses, schools, instructors, etc.), insurance continuing education requirements, certain courses or course providers, and public adjusters. 

Chapter 13 governs the Agent Services division with regard to non-insurance entities such as premium finance companies, motor clubs, and bail bondsmen.

After the comment period, the Department will be required to evaluate each rule and determine whether that rule is: (1) necessary with substantive public interest, (2) necessary without substantive public interest, or (3) unnecessary.  Each of these three categories have sub-definitions. 

You can comment on rules in Chapter 6 or 13 here on the Department of Insurance's website.  We are also available to assist you in making comments to rules.

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