In the realm of insurance policies, one crucial provision often found in the Loss Settlement section is Appraisal. This unique policy feature serves as an effective Alternative Dispute Resolution (ADR) mechanism, designed to facilitate resolution when disputes arise between the Carrier and Policyholder regarding the amount of loss.
Appraisal comes into play when there is a deadlock between the insurance carrier and policyholder in agreeing on the amount of loss. Instead of opting for a traditional lawsuit, Appraisal offers an alternative route for resolution. It serves as a structured process for determining the appropriate compensation for a covered loss, providing a more expedient and cost-effective solution.
It’s crucial to note that Appraisal, while effective in resolving disputes related to loss amounts, does not extend its purview to coverage issues. The focus is primarily on quantifying the financial impact of the loss rather than delving into broader policy coverage intricacies. This makes Appraisal a specialized tool for a specific aspect of the claims process.
One intriguing feature of Appraisal is its ability to include or exclude specific items from the loss amount calculation based on causation. Depending on the state and its legal framework, Appraisal may consider causation as a determining factor, influencing what is included or excluded from the final assessment. This adds a layer of nuance to the Appraisal process, making it adaptable to regional legal nuances.