In New York, an appraisal process is an alternative dispute resolution method for insurance claims that allows the policyholder and the insurer to resolve disputes regarding the amount of loss. The appraisal panel, made up of two appraisers, determines the amount of loss, the actual cash value (ACV), and the amount of loss each item sustains in the claim.
However, what happens if the appraisers cannot agree on the amount of loss, and it has been 5+ months, and the carrier’s appraiser has not yet submitted their itemized amount of loss to the policyholder’s appraiser? Can the policyholder’s appraiser invoke the umpire’s involvement?
Under New York law, if one of the party’s appraisers has “failed or refused to participate in the appraisal or perform their duty under the appraisal provision,” either party has the option to apply for an umpire’s appointment to break the impasse. However, invoking the umpire’s involvement should be done with caution and after thoughtful consideration of the evidence, documentation, and applicable policies, to avoid undermining the impartiality of the process.
Whether or not the carrier’s appraiser can submit their itemized appraisal of loss at this stage depends on the specific language of the appraisal clause in the policy. Invoking an umpire’s appointment may be necessary to seek guidance from the court or an arbitrator to determine whether the carrier’s appraiser can submit an itemized appraisal of loss during the umpiring process.
In any case, it would be prudent for the policyholder to consult with an experienced insurance claims attorney who can review the policy language and appraisal clause, assess the procedural and substantive fairness of the appraisal process, and take appropriate action to protect the policyholder’s rights under the policy.
In conclusion, the appraisal process in New York is an impartial, unbiased mechanism to resolve insurance claim disputes. If appraisers cannot agree on the amount of loss, invoking an umpire’s appointment may be necessary, along with consulting with an experienced insurance claims attorney to ensure the policyholder’s rights under the policy are protected.