Appraisal and umpire FAQs

Appraisal and Umpire Process: Resolving Claim Disputes

The appraisal process provides a structured way to resolve disputes over insurance claim values by appointing impartial appraisers, with an umpire stepping in as a neutral third party if agreement can't be reached. This method aims for fair, efficient outcomes and often serves as a cost-effective alternative to litigation for policyholders and insurers alike, though its binding effect may vary based on policy language and jurisdiction.

What is the insurance appraisal process?

The appraisal process is a dispute resolution method in many insurance policies where each party (policyholder and insurer) appoints an appraiser to evaluate the loss amount. If they disagree, an umpire decides.

When should I invoke the appraisal clause?

Invoke appraisal when there's a disagreement over the value of the loss or repair costs, but not over coverage issues. It's a voluntary option that can be requested by either party in writing, per policy provisions.

What are the pros and cons of appraisal?

Pros: Faster and less costly than litigation; often binding on amount of loss. Cons: Limited to value disputes, not coverage; potential for biased appraisers; costs for your appraiser; may not be fully binding in all policies or if challenged for reasons like fraud or improper process.

What is an insurance umpire?

An umpire is a neutral third party selected when appraisers cannot agree on the loss value. They review both appraisals and make a final decision, which is typically binding if agreed upon by at least one appraiser.

Who pays for the appraisal?

Each party pays for their own appraiser, and the umpire's fees are typically split equally.

What qualifications should an umpire have?

Umpires must be impartial, have no financial interest in the outcome, disclose conflicts, and be experts in valuation and the relevant damage types.

How does the appraisal process work?

Each side selects a competent appraiser. They assess the damage and try to agree on the loss amount. If no agreement, they submit differences to an umpire, whose decision is typically binding on the amount of loss if agreed upon by at least two parties (appraisers and umpire). However, the binding nature can vary; some policies may lack explicit binding language, and awards may be challengeable in court under certain conditions like fraud, misconduct, or improper invocation.

When is an umpire needed?

An umpire is a neutral third party selected when appraisers cannot agree on the loss value. They review both appraisals and make a final, binding decision.

How is an umpire selected?

The two appraisers typically agree on an umpire. If they can't, a court may appoint one. It's important to vet umpires for experience and neutrality.

Is the umpire's decision binding?

Typically yes, if the umpire's award is signed by at least one appraiser, it becomes binding on the amount of loss. However, this can vary by policy language, and decisions may be set aside in cases of fraud, mistake, or lack of authority.

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