Don’t Let Insurers Play the Mismatched Game: NAIC Standards Require Matching and Uniform Appearance
Jonathan Wilkofsky is a panelist presenting appraisals at the First Party Claims Conference. He just mentioned that the issue of matching replacement materials during property insurance claims has been settled in model laws. The National Association of Insurance Commissioners (NAIC) has addressed this issue directly in their Unfair Property/Casualty Claims Settlement Practices Model Regulation, providing important guidance that favors uniform appearance over patchwork repairs.
Uniform Appearance Requirements
The NAIC’s position on matching is straightforward and policyholder-protective. Section 9.A(2) of the model regulation establishes clear requirements when replacement materials don’t match existing materials in quality, color, or size. The regulation mandates that insurers must replace all items in the affected area to achieve a “reasonably uniform appearance.”
The regulation provides substantial protection against partial replacements that would leave property with a mismatched appearance. Coverage extends to both interior and exterior losses, and insurers must address any consequential physical damage during repairs. Importantly, policyholders cannot be charged for costs beyond their deductible, and the regulation explicitly prohibits charges for betterment.
Real-World Applications
These requirements become particularly significant in common claim scenarios involving roof replacements, siding repairs, flooring installations, and cabinet replacements. When insurers propose partial replacements that would result in mismatched appearances, policyholders can point to these established standards as support for complete replacement. Cosmetic issues are significant in all repairs or replacements and cannot be overlooked.
While the NAIC model regulation provides an excellent framework, implementation of these laws varies by jurisdiction. Some states, such as Tennessee, have incorporated similar provisions into their regulatory framework. Other states may rely on their own statutes or case law to address matching issues. The rule is to check each state law for matching.
Moving Forward
Understanding these regulatory requirements strengthens a policyholder’s position during claim negotiations. For those facing matching disputes in their claims, consulting with experienced policyholder counsel can help ensure these protections are properly applied. The goal remains consistent: restoration of the property to its pre-loss condition with a uniform appearance.
We’ll continue monitoring developments in this area and providing updates as states adopt or modify these important consumer protections. For those facing matching issues, please use our search function, as noted in Coverage Issue of “Matching” Roof Tiles or Shingles Shows How to Use the Search Function of this Blog.
Thought For The Day
“Architecture is a visual art, and the buildings speak for themselves”
—Julia Morgan
