Insurance claims can be complex, and the recent case of Brellenthin v. Am. Fam. Mut. Ins. Co. highlights the importance of navigating them with care. In Brellenthin, the policyholder’s use of a public adjuster unfamiliar with Wisconsin law led to a series of mistakes that ultimately cost them their claim against American Family Mutual Insurance. This blog post explores the case’s facts, lessons learned, and legal arguments presented by the policyholders.
An Overview of Brellenthin v. American Family
The Brellenthin case began on July 9, 2018, when a leaking appliance caused damage to a house. The homeowners filed an insurance claim with their insurance company American Family Mutual Insurance Company, which then investigated, adjusted the loss, and paid the homeowners about $17,000. The insureds were dissatisfied with this amount so they then hired a Minnesota-based public adjuster because they were dissatisfied with their claim payment.*
- September 19, 2018: The public adjuster informs American Family of its involvement and requests a copy of the policy.
- Fall of 2018: The public adjuster prepares a higher estimate, prompting American Family to re-investigate the claim.
- December 10, 2018: American Family denies coverage for certain damages based on an engineer’s findings.
- February 8, 2019: The policyholder’s public adjuster requests an appraisal, but American Family denies it, citing a coverage issue.
- March 17, 2019: American Family maintains its coverage position, denies appraisal, and asserts the statute of limitations tolling.
- January 16, 2020: The policyholders filed a lawsuit, but American Family argues the statute of limitations bars the lawsuit.
No Coverage, No Appraisal, and a Lawsuit Loss
American Family argued that the lawsuit was filed outside the one-year statute of limitations. The Court agreed. Consequently, the policyholders lost their case and received no compensation for their claims.
Legal Arguments in Brellenthin
The Brellenthin case provides valuable lessons for policyholders dealing with insurance disputes:
The policyholders argued that their appraisal demand tolled the statute of limitations under Wisconsin Statute § 631.83(5), which states:
“Tolling of period of limitation. The period of limitation is tolled during the period in which the parties conducted an appraisal or arbitration procedure prescribed by the insurance policy or by law or agreed to by the parties.”Wis. Stat. § 631.83(5)
The court rejected the insured’s argument that this section applied. The Court stressed that for the tolling provision to apply, both parties must actively participate in conducting the appraisal. The parties are not conducting an appraisal where the insured demanded an appraisal but the insurer rejected the demand. The court didn’t conclusively decide if a demand for an appraisal could toll the statute of limitations in various scenarios. The Court clarified that the tolling effect of the initial demand would persist only until the insurer rejected the appraisal. Given the case’s circumstances, that period was only a few weeks and did not justify exceeding the statute of limitations by six months.
- Understanding Nuances: Claim professionals must understand the nuances of state laws, statutes of limitations, and other regulations.
- Importance of Legal Counsel: Retaining a Wisconsin insurance claim lawyer who is knowledgeable about Wisconsin law is crucial when dealing with Wisconsin insurance regulations and statutes.
- Timely Action: Filing a lawsuit promptly after a denial can be essential, as waiting may result in losing valuable legal ground.
The Brellenthin case serves as a cautionary tale, highlighting the consequences and pitfalls of relying on a public adjuster who may not fully understand the legal intricacies of an insurance claim. Policyholders should be vigilant, seek legal counsel when needed, and take timely action to protect their rights.
Murdock Law, S.C. helps people and businesses with their insurance claims. Contact the attorneys at Murdock Law if you feel like you’ve been treated unfairly by your insurance company, or you’re just not sure where to start. We’ll double-check your insurance policy and work with you to make sure you’re getting what you deserve on your claim.
* While the decision names the public adjuster, we withhold their identity in this article due to the severity of the error. It’s unclear if a malpractice claim was filed.