There’s an outdated saying that matches squarely with how the current Ohio case of Leonard v. State Farm determination 1 got here down: “The satan is within the particulars.”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 reveals 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 concern of matching. The court docket accepted State Farm’s place that this was a protection dispute somewhat than a query of the quantity of loss. I basically disagree. Matching disputes are valuation points. They go to the scope and price of vital repairs, not whether or not protection exists.
As I defined in my United Policyholders amicus temporary 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 truthful methodology of figuring out the quantity of loss.” That is precisely the form 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 resolve how a lot it should 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 inside the appraisal clause’s perform. Readers taken with that case and the way Connecticut views matching inside 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 Problem or a Factual Problem For an Appraisal Panel.
In Leonard, the policyholder’s roofer argued that the alternative shingles couldn’t be matched and that the prevailing decking didn’t meet code. These are traditional development and valuation questions. These usually are not summary authorized interpretations of coverage protection, however one thing that property insurance coverage adjusters examine and debate daily of their line of labor. However the trial court docket, and later the appellate court docket, framed the dispute as considered one of protection somewhat than scope. As soon as the policyholder’s counsel did not introduce the coverage itself into proof, the combat was successfully misplaced.
The result’s unlucky not just for Mr. Leonard but in addition for policyholders typically. When courts categorize matching disputes as “protection” points, they rework frequent 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 truthful 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 depart 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 similar 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 definitely 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 keep in mind 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 complete, in line 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 way of resolving precisely all these conflicts earlier than they spiral into pointless litigation.
I wish to give a shout-out to a effective insurance coverage policyholder lawyer, 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).