There’s an outdated saying that matches squarely with how the current Ohio case of Leonard v. State Farm determination 1 got here down: “The satan is within the particulars.” In insurance coverage disputes, these particulars begin with the coverage language. The Ohio Courtroom of Appeals’ current opinion exhibits what occurs when a policyholder’s counsel fails to make the coverage a part of the file. With out it, the court docket 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 subject of matching. The court docket accepted State Farm’s place that this was a protection dispute reasonably than a query of the quantity of loss. I essentially disagree. Matching disputes are valuation points. They go to the scope and price of mandatory repairs, not whether or not protection exists.
As I defined in my United Policyholders amicus transient earlier than the Connecticut Supreme Courtroom 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 sort 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’ activity is to determine how a lot it would price to revive the property to its pre-loss uniform look. They’ll 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 inside the appraisal clause’s operate. Readers concerned with that case and the way Connecticut views matching inside 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 Challenge or a Factual Challenge 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 traditional building and valuation questions. These are usually not summary authorized interpretations of coverage protection, however one thing that property insurance coverage adjusters research and debate day by day of their line of labor. However the trial court docket, and later the appellate court docket, framed the dispute as one in all protection reasonably than scope. As soon as the policyholder’s counsel didn’t introduce the coverage itself into proof, the struggle was successfully misplaced.
The result’s unlucky not just for Mr. Leonard but in addition for policyholders usually. 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 goal 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 take care of scope of injury points reminiscent of 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 do not forget that every part 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, in step with the coverage’s promise of indemnity.
As attorneys, adjusters, and claims professionals, we must always resist the creeping pattern of labeling factual valuation disputes as “protection” questions. Courts ought to implement appraisal clauses as meant 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 high quality 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 Hearth & Cas. Ins. Co., 2025-Ohio-5089, 2025 WL 3140754 (Ohio App. Nov. 10, 2025).