The Massachusetts Appraisal Clause: A Wholly Unworkable Solution

by Sean Preston, Coverall Law

Introduction

Navigating through the intricacies of insurance claims in Massachusetts reveals a perplexing maze, especially when one encounters the Appraisal Clause as outlined in the state’s insurance law.

This provision, intended to offer a streamlined process for resolving disputes over property damage claims, instead can serve as a battleground where insurers’ interests seemingly overshadow those of vehicle owners and auto body shops. This article delves into the Appraisal Clause’s complexities, uncovering the subtle ways insurers may leverage policy provisions to their advantage, leaving claimants navigating a path fraught with procedural uncertainties and legal ambiguities.

Legal Framework and Process

In Massachusetts, if there’s a disagreement over how much a car repair should cost after an accident, both the car owner and the insurance company have a right to start a special process to sort it out, according to state law (M.G.L. c.175, s.191A). This process involves each side choosing an appraiser to estimate the damage. If these experts can’t agree, they’ll pick a third “disinterested” person, an umpire, to make the final decision. This is meant to ensure fairness, but getting there might be complicated.

Choosing an Umpire

The two experts perform the appraisal, and each separately state two things: the amount of loss and the actual cash value (ACV) of the vehicle prior to loss. If these experts fail to agree, they need to rely on a third person which they’ve already chosen, called an “umpire,” to make the final decision. There’s a catch, though; if they can’t choose an umpire within 15 days, one of the parties then needs to petition a court to step in and choose an umpire for them. This step can add more time and possible complexity to resolving the claim, showing how even a system designed for fairness can get tricky.

Competence and Impartiality of Appraisers and Umpire

For the appraisal process to be fair, it’s crucial that the experts and the umpire chosen are both qualified and unbiased. This means they should have the right skills to accurately assess car repair costs and favor neither the car owner nor the insurance company; however, making sure that these experts are truly impartial and competent can be challenging. There’s no straightforward method to prove they meet these standards, which can make the process feel less reliable for everyone involved.

Unresolved Issues and Operational Challenges

The process starts with submitting a “Proof of Loss” to claim damages, but the specifics can confuse many. There’s also uncertainty about whether the umpire needs to be a licensed motor vehicle damage appraiser, which can affect the final decision. Choosing between the initial appraisals or finding a middle ground adds another layer of complexity. Lastly, figuring out the car’s ACV versus the claimed loss amount can lead to significant disagreements, especially in recent times, highlighting the system’s operational challenges and the need for clearer guidelines.

Case Law and Precedents

In Massachusetts, when it comes to disagreements over car insurance claims, there’s a lack of specific court cases to guide us. This means that both car owners and insurance companies lack clear examples to follow. Instead, they often agree on their own how to solve these disputes. This situation can make things a bit uncertain, showing how important it is to understand the rules or possibly get advice from a legal expert when facing these issues.

Practical Implications for Claimants

Car owners and auto body shops often face hurdles with insurance claims, especially when insurers use tactics to slow down or complicate the appraisal process. This can make it tough for shops to get fair compensation for repairs and for owners to have their cars fixed in a timely manner. Understanding the rules, and sometimes getting legal advice, can help navigate these challenges.

Seeking Legal Remedy

Once the appraisal process begins in Massachusetts, it must continue unless both the car owner and the insurance company mutually agree to stop it. This means both parties need to be on the same page to abandon the process, highlighting the importance of careful consideration before starting it.

Conclusion

The Appraisal Clause in Massachusetts presents significant challenges for vehicle owners and auto body shops, marked by a maze of procedural uncertainties and insurer tactics. The lack of specific state precedents further complicates the landscape, underscoring the urgent need for clearer guidelines and stronger protections for claimants. This situation calls for legislative or judicial intervention to refine the process, making it more transparent and equitable for all parties involved.

Recommendations

Vehicle owners and auto body shops should approach appraisal disputes with caution, understanding the commitment once the process begins. It’s crucial to document all communications and assessments thoroughly. Seeking legal counsel early can provide strategic advantages, especially in navigating the complex terrain of insurance claims and ensuring fair treatment throughout the appraisal process.

Want more? Check out the March 2024 issue of New England Automotive Report!