Insurance · Claims and Loss Settlement

What is the role of an 'appraisal' clause when the insured and insurer disagree about the amount of a loss?

Correct answer

It provides a dispute-resolution process in which each party selects an appraiser, the appraisers select an umpire, and an agreement by any two of the three sets the amount of loss

  1. A It cancels the claim
  2. B It provides a dispute-resolution process in which each party selects an appraiser, the appraisers select an umpire, and an agreement by any two of the three sets the amount of loss
  3. C It lets the insurer decide alone
  4. D It applies only to liability claims

Why this is the answer

The appraisal clause in many property policies provides a method to resolve disputes specifically about the amount (value) of a covered loss — not about whether coverage applies. Typically, each party (insured and insurer) selects a competent, independent appraiser; the two appraisers then choose an umpire; and an agreement between any two of these three parties establishes the amount of loss. This process avoids litigation over valuation disagreements. It addresses the loss amount only; coverage disputes are handled differently. Understanding the appraisal clause as a structured valuation dispute-resolution mechanism is standard claims content on the property insurance exam.
Source: NAIC Model Outline, Appraisal Clause

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