There’s an previous saying that matches squarely with how the latest 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’ latest opinion exhibits what occurs when a policyholder’s counsel fails to make the coverage a part of the document. With out it, the courtroom merely had nothing to interpret and nothing to implement.
However the opinion additionally raises deeper questions concerning the nature of the appraisal course of and the ever-contentious difficulty of matching. The courtroom accepted State Farm’s place that this was a protection dispute fairly than a query of the quantity of loss. I essentially disagree. Matching disputes are valuation points. They go to the scope and value of obligatory repairs, not whether or not protection exists.
As I defined in my United Policyholders amicus temporary earlier than the Connecticut Supreme Court docket in Karl Klass v. Liberty Mutual Insurance coverage Firm, public coverage favors appraisal as a result of appraisal generally is 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 is going to value to revive the property to its pre-loss uniform look. They will even take depreciation on that quantity to come back 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 perform. Readers taken with that case and the way Connecticut views matching throughout the appraisal panel’s authority ought to learn Matching is a Factual Willpower 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 Leonard, the policyholder’s roofer argued that the alternative shingles couldn’t be matched and that the present decking didn’t meet code. These are basic building and valuation questions. These aren’t summary authorized interpretations of coverage protection, however one thing that property insurance coverage adjusters examine and debate day by day of their line of labor. However the trial courtroom, and later the appellate courtroom, framed the dispute as certainly one of protection fairly than scope. As soon as the policyholder’s counsel did not introduce the coverage itself into proof, the struggle was successfully misplaced.
The result’s unlucky not just for Mr. Leonard but additionally for policyholders on the whole. When courts categorize matching disputes as “protection” points, they rework frequent factual questions of restore value 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.’
In fact, 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 temporary, “[o]n an on a regular basis foundation, insurance coverage appraisers and adjusters take care of scope of harm points reminiscent of matching, precise money worth, put on and tear, depreciation, and different mundane adjustment points.” Why can’t in addition 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 business’s very competent counsel. As an alternative, it’s that everybody within the insurance coverage claims enterprise should do not forget that every thing 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 attorneys, adjusters, and claims professionals, we should always resist the creeping development of labeling factual valuation disputes as “protection” questions. Courts ought to implement appraisal clauses as supposed and as a way of resolving precisely some of these conflicts earlier than they spiral into pointless litigation.
I need to give a shout-out to a nice insurance coverage policyholder lawyer, Robert Rutter, for bringing this case to my consideration to share on this weblog.
Thought for the Day
“Details are cussed issues.”
—John Adams
1 Leonard v. State Farm Fireplace & Cas. Ins. Co., 2025-Ohio-5089, 2025 WL 3140754 (Ohio App. Nov. 10, 2025).
