保单结构与条款第 520 / 531 题
The insured and the insurer agree the fire loss is covered but cannot agree on what it is worth. Under the appraisal condition:
a.The insurer's adjuster sets the binding amount
b.Each picks an appraiser and they pick an umpire
c.The claim is denied until the parties agree
d.A court decides the amount before any payment
解析
Appraisal is a valuation mechanism, not a coverage mechanism: each side names a competent independent appraiser, the two of them select an umpire, and agreement between any two of the three sets the amount of loss. It is available only where coverage itself is not in dispute. Nothing in it lets the adjuster fix the figure alone or forces the insured into court, and the claim is not denied merely for want of agreement.
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