Legal Question in Insurance Law in North Carolina

Re: House Burns - Insurer Refuses to pay

Holy Smokes. What a complicated question. You definitely need to provide more facts for a reliable answer, and you probably need to consult a lawyer. It is not clear to me the extent to which the Insurer relied on your information and/or your request for a given amount of coverage, and the extent to which the Insurer knew that the Appraisal was not appropriate. Putting aside several factual questions, there are a lot of very complicated doctrines at issue. In particular, there are instances in which the insurer is said to have "waived" a policy provision (or is "estopped" to assert a policy provision), that may help you here. Some cases recognize that the Insurer can be liable for failing to advise the Insured as to the type of policy (or limits) he needs, and some cases indicate that the Insurer has a duty to advise the Insured of the terms of the policy (where the insured mis-understands them). Short of litigation, you could approach your agent and inform him or her that you were relying on them to provide you with adequate coverage, or that they used an improper figure for setting the limits (or the appraisal amount). They may or may not want to offer you anything. They probably have some insurance (probably an E&O policy). My suspicion is that their initial reaction will be that they provided you with the insurance you requested. This is really a complex question, that involves very esoteric issues of insurance law. If you want to pursue your claim beyond that request of the agent, you should consult a lawyer.