Appraisal Umpires
The appraisal clause, which permits a policyholder to employ an independent appraiser to evaluate the number of their damages, is closely related to the umpire clause. As a result, the insurance company will employ its appraiser. After that, the two appraisers will meet to choose an umpire. The umpire serves as a sort of arbitrator. 1
The appraisal panel is made up of these three people. The assessment panel's job is to set or determine the level of loss or the total dollar amount required to repair or replace the damaged property to its original state.
TAKEAWAYS IMPORTANT
- The umpire clause, similar to an arbitration provision, is used to resolve disputes between insurers and insureds.
- Each party hires an independent appraiser who collaborates with the umpire to resolve claim disagreements.
- To determine the matter, only two of the three-panel members must agree.
- The policyholder's chosen appraiser and the insurance company's appraiser will analyze the papers, estimates, and disparities between them once an appraiser panel is in place. Then they'll try to work out their differences. In this scenario, the three will discuss the concerns and try to agree on how to resolve the disagreements. If the two appraisers cannot reach an agreement, the umpire makes the final decision.
- You may want to consider speaking with a highly skilled attorney.
Surprisingly, not all members of the appraiser panel must agree. Only two of the three people, the umpire and one of the appraisers, or the two appraisers themselves, must agree. The argument is over once two of the three members of the assessment panel sign the award. The policyholder receives the amount of the award.
Appraisal Umpire Bias?
In most appraisal awards, the umpire usually sides with either the insurer's appraiser or the insured's appraiser. As a result, both parties to the appraisal are looking for an umpire who will be fair and impartial (or at least only partial to their side).
A prospective umpire should reveal material suggesting a bias for both parties to be fully informed. But what exactly is this data?
The general rules requiring disclosure were recently reviewed in Dickey v. Alterra America Insurance Company, 2017 WL 3013405 (C.D. Cal.):
To prove partiality, the party seeking to vacate must present specific facts demonstrating that the umpire was genuinely prejudiced against the moving party or that the umpire neglected to disclose material that gives rise to a reasonable suspicion of bias.
Previous work for a side by an umpire may create the impression of bias necessary to vacate an award.
Only if the preceding effort was substantial and ongoing can a court overturn an award based on a perception of prejudice.
In Dickey, the umpire — McCarthy — told the parties that he had worked on a claim with the insured's named appraiser, Twarowski, five years before. Twarowski was a public adjuster in the previous claim, and McCarthy was Allstate's appraiser.
On the other hand, McCarthy failed to disclose that the law firm that represented Allstate in the preceding claim was the same firm that represented Alterra American Insurance Company in the assessment in question. Twarowski had no idea that this law firm was working for Allstate in the previous appraisal.
The court determined that this single past engagement, five years ago, was inadequate to generate an impression of prejudice sufficient to warrant the appraisal award being vacated. According to the court, the relationship was "too distant, too tenuous, and too insubstantial," to establish the required impression of prejudice.
Takeaway
Suppose one of the appraisers, one of the parties, or one of the lawyers representing the parties has an unreported relationship with one of the appraisers, one of the parties, or one of the lawyers representing the parties. In that case, the appraisal award may be in jeopardy. Attempting to go past the insurer using an umpire who is an old high school friend of the insured's appraiser, for example, may result in a request to vacate and the same litigation that an appraisal is supposed to avoid.
Each appraiser should make a comprehensive written disclosure of all relationships they have to any party or lawyer engaged in the claim and the potential umpire. Because this is not uncommon, the parties are likely to agree that their respective appraisers have some link to the party nominating them. On the other hand, Umpires are a different story because they are usually the ones who make the final decision. Prospective umpires should be scrutinized more closely, as should each side's relationship with the prospective umpire, to ensure that the final award is not the consequence of secret gamesmanship or personal "behind the scenes" interactions.
Complaints of Umpire Bias
 Allegations made that Patrick Sharkey of Jackson Walker is a bias umpire and is not competent to give a fair and impartial decision. Is AAA the best resource of appointing umpires? Does it produce bias umpires? Should consumer beware of insurance with clauses requiring an umpire be appointed by adr.org?
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