There’s an previous saying that matches squarely with how the current Ohio case of Leonard v. State Farm resolution 1 got here down: “The satan is within the particulars.” In insurance coverage disputes, these particulars begin with the coverage language. The Ohio Court docket of Appeals’ current opinion exhibits what occurs when a policyholder’s counsel fails to make the coverage a part of the document. With out it, the court docket merely had nothing to interpret and nothing to implement.
However the opinion additionally raises deeper questions in regards to the nature of the appraisal course of and the ever-contentious subject of matching. The court docket accepted State Farm’s place that this was a protection dispute quite than a query of the quantity of loss. I basically disagree. Matching disputes are valuation points. They go to the scope and value of needed repairs, not whether or not protection exists.
As I defined in my United Policyholders amicus transient earlier than the Connecticut Supreme Court docket in Karl Klass v. Liberty Mutual Insurance coverage Firmpublic coverage favors appraisal as a result of appraisal is usually a “easy, speedy, cheap, and honest methodology of figuring out the quantity of loss.” That is precisely the type of disagreement that matching represents. When one a part of a roof or wall can’t get replaced with out rendering the construction mismatched, the appraisers’ process is to determine how a lot it can price to revive the property to its pre-loss uniform look. They’ll even take depreciation on that quantity to return to an precise money worth quantity, as mentioned in The Stupidity of Taking Matching Out of Precise Money Worth.
That’s squarely throughout the appraisal clause’s operate. Readers considering that case and the way Connecticut views matching throughout the appraisal panel’s authority ought to learn Matching is a Factual Dedication and Can Be Resolved by Appraisal. I additionally recommend studying Does Colorado Require Matching? Is Matching a Protection Difficulty or a Factual Difficulty For an Appraisal Panel.
In Leonardthe policyholder’s roofer argued that the substitute shingles couldn’t be matched and that the prevailing decking didn’t meet code. These are traditional development and valuation questions. These will not be summary authorized interpretations of coverage protection, however one thing that property insurance coverage adjusters research and debate each day of their line of labor. However the trial court docket, and later the appellate court docket, framed the dispute as one among protection quite than scope. As soon as the policyholder’s counsel didn’t introduce the coverage itself into proof, the battle was successfully misplaced.
The result’s unlucky not just for Mr. Leonard but additionally for policyholders normally. When courts categorize matching disputes as “protection” points, they rework widespread factual questions of restore price into authorized questions that bar appraisal. This erodes the very objective of the appraisal clause, which I at all times hear good ole’ Steve Badger saying is ‘the honest and environment friendly decision of disagreements about worth.’
After all, Steve Badger was by no means round a number of hundred years in the past to know why the appraisal clause was positioned in a coverage, and the individuals who wrote it into the coverage didn’t go away something for us to find out why they included it. However, as we emphasised within the Klass amicus transient, “(o)n an on a regular basis foundation, insurance coverage appraisers and adjusters cope with scope of injury points akin to matching, precise money worth, put on and tear, depreciation, and different mundane adjustment points.” Why can’t additionally they do it in an appraisal to place the dispute to relaxation?
The lesson right here isn’t merely that policyholders want competent counsel as a result of they actually do to prevail towards the insurance coverage trade’s very competent counsel. As a substitute, it’s that everybody within the insurance coverage claims enterprise should keep in mind that all the pieces begins with the coverage language and with the understanding that appraisal is supposed to resolve factual disagreements over the extent and worth of a loss. Matching isn’t about increasing protection, however about quantifying what it takes to make the insured entire, according to the coverage’s promise of indemnity.
As legal professionals, adjusters, and claims professionals, we must always resist the creeping development of labeling factual valuation disputes as “protection” questions. Courts ought to implement appraisal clauses as supposed and as a method of resolving precisely these kind of conflicts earlier than they spiral into pointless litigation.
I need to give a shout-out to a tremendous insurance coverage policyholder legal professional, Robert Rutter, for bringing this case to my consideration to share on this weblog.
Thought for the Day
“Info are cussed issues.”
—John Adams
1 Leonard v. State Farm Hearth & Cas. Ins. Co.2025-Ohio-5089, 2025 WL 3140754 (Ohio App. Nov. 10, 2025).
