The Ultimate Guide to Insurance Appraisal in Massachusetts

Massachusetts Uses Statutory Reference, Not Ordinary Appraisal

Massachusetts starts from a different place than most state appraisal guides. The standard fire-policy language in M.G.L. c. 175, § 99 sends a disagreement about the amount of loss to three referees. It does not tell each party to appoint its own appraiser and have those appraisers choose an umpire. Instead, each party supplies three eligible nominees and the other party chooses one person from that list. Those two referees select the third. The statute calls the proceeding a reference, and that name matters because the selection rules and the Commissioner's role are distinctly Massachusetts.

Section 99 prints the Massachusetts standard form for insurance against fire or fire and lightning. Its reference clause makes a written majority award conclusive and final as to the amount of loss or damage. It also makes reference a condition precedent to an action to recover the loss unless the parties waive it. The same section restricts policy additions or modifications that would change the standard form's three-referee reference or suit-limitation provisions. Those rules provide a strong statutory foundation, but they still must be read in the setting of the insurance product and the complete policy actually issued.

The policy remains part of the legal analysis

Section 99B allows the Commissioner to approve property policies for business, professional, or governmental operations that do not correspond word for word to the standard fire form, provided the statutory protection is no less favorable. It also addresses approved homeowners multi-peril forms for specified condominium units and smaller dwelling structures and permits several loss-settlement designs. That statutory flexibility is one reason not to treat a quotation from an old form as the reader's current contract.

The practical research order is simple. Read the current declarations, all policy forms, and every endorsement first. Then identify the peril, property, and damage category the insurer has accepted or denied. After that, compare the operative language with sections 99 through 101E. The statute establishes the reference architecture. The issued contract and written coverage position show what this particular dispute asks that architecture to do.

Valuation terminology also depends on the policy. Section 101H says that sound value is synonymous with actual cash value when the policy provides for payment on an actual-cash-value basis. That defined equivalence does not convert an actual-cash-value reference into a replacement-cost award or eliminate the policy's separate replacement conditions.

This guide does not announce a universal rule for every non-fire peril or every Massachusetts property product. A multi-peril policy may carry the statutory protections in a broader contract, but the exact approved wording and endorsements control the claim-level analysis. The safe statement is that Massachusetts has a mandatory statutory reference system within the law's defined scope, not that every property-related contract uses identical language.

What the Massachusetts Division of Insurance Can Do

The Division of Insurance has specific jobs in the reference process. Under section 100, if the first two referees do not choose the third within ten days after selection of the second referee, either referee or either party may apply under oath to the Commissioner. The Commissioner may make a summary inquiry or hold a hearing and appoint the third referee. Section 100A supplies a related appointment route when a referee dies, resigns, becomes incapacitated, leaves the Commonwealth, refuses to serve, or otherwise cannot continue before the award.

Those appointment proceedings can require the Commissioner to examine whether the proposed person satisfies the statutory qualifications and whether the application follows the nomination rules. Section 100B requires every nominee or appointee to be disinterested, a Massachusetts resident, and willing to act. It also imposes the recent-service restriction and bars an application from specifying a person who was previously nominated by either side in that reference. The Commissioner's appointment authority is therefore more than a name-drawing exercise, but it is still tied to the appointment assigned by statute.

Charge review is not award review

Section 101B gives the company or insured ten days to petition the Commissioner for review of the third referee's detailed charges. After notice and a hearing, the Commissioner may approve or disapprove those charges in whole or in part. That is a fee-review function. It is not a statutory appeal asking DOI to recalculate the loss or reverse the majority's valuation.

DOI's Consumer Services Unit performs a different function. It can review an insurer's response for compliance with the policy and Massachusetts insurance law, help the parties communicate, and require corrective action when an insurer or insurance professional has not met a legal obligation. DOI also states clear limits. Consumer Services cannot give legal advice, decide disputed claim facts, determine the value of a claim, decide the amount owed, or tell an insurer to pay when the insurer followed the law and policy.

A useful complaint identifies the exact policy, claim number, disputed conduct, relevant dates, and supporting documents. It should not ask the regulator to decide a coverage lawsuit or an ordinary reference-award challenge. Those questions have different procedures, and the verified sources do not establish a DOI merits-review route for the award itself.

MPIUA Is a Separate Residual-Market System

The Massachusetts Property Insurance Underwriting Association, commonly called MPIUA or the Massachusetts FAIR Plan, provides basic property insurance for eligible applicants who have been unable to obtain insurance through the voluntary market. MPIUA's current site identifies Homeowners, Dwelling Fire, and Commercial Property programs approved by the Massachusetts Division of Insurance. That makes MPIUA an important part of the state's insurance market, but not a substitute name for an ordinary voluntary-market homeowners insurer.

An MPIUA claim still begins with the current issued documents. Obtain the declarations, policy form, endorsements, notices, and any edition information that identifies the contract in force on the date of loss. Confirm the covered peril, valuation basis, proof requirements, reference terms, and suit condition from that set. The name FAIR Plan does not establish those details by itself.

The distinction has practical consequences. A residual-market policy can differ from a voluntary-market form in covered perils, settlement terms, limits, and endorsements. A party preparing for reference should cite the actual MPIUA clause and the applicable Massachusetts statute, not a generic national appraisal clause or an unverified historical form. If the issued documents cannot be located, that is a document problem to solve before framing the reference submission.

Reference Fixes Amount; Courts Retain Legal Coverage Questions

Massachusetts reference and litigation can address the same claimed damage while deciding different issues. Reference determines the amount of loss sustained or, where section 101D applies, the sound value of the property. Litigation can decide policy construction, exclusions, legal defenses, and ultimate liability. Calling the panel an arbitration panel on a DOI webpage does not erase that boundary.

Section 101E states the boundary directly. An insurer does not waive a legal defense by joining a statutory reference, and the proceeding fixes only amount of loss or sound value. The exception requires both parties to agree in writing that the reference will proceed under Chapter 251. Without that mutual writing, the ordinary statutory reference should not be described as a Chapter 251 arbitration that conclusively adjudicates all contract rights.

The Appeals Court applied this separation in Audubon Hill South Condominium Association v. Community Association Underwriters of America, Inc. The panel fixed the amount of repair, but the insurer had consistently reserved coverage and liability. The court held that the award did not bind the coverage question and affirmed judgment based on the policy's terms. The amount finding was not meaningless. It simply did not answer the separate legal question.

This is why a reference submission should identify the disputed valuation and any reserved legal issues in plain language. A party can provide evidence needed to value the loss without asking referees to issue a legal judgment on coverage. If both sides intentionally want broader Chapter 251 arbitration, section 101E requires their agreement in writing. That choice should never be inferred from participation in ordinary reference.

Augenstein Allows Necessary Fact Finding Without Making Coverage Final

A statement that Massachusetts referees never consider causation would be wrong. The Supreme Judicial Court's decision in Augenstein v. Insurance Company of North America explains why. The authority to determine amount of loss includes the authority to decide that no factual loss existed. It can also require referees to distinguish damage attributed to different physical causes when that factual work is necessary to measure loss under the policy.

Augenstein discussed earlier Massachusetts decisions in which referees separated loss attributed to lightning from loss attributed to windstorm. The court rejected a fragmented procedure that would force referees to value all damage without deciding which physical loss belonged in their amount determination. Referees necessarily reach working conclusions about the claimed loss and the policy while performing that task.

The limit is equally important. A referee's interpretation of policy language is not conclusive on legal coverage or ultimate liability. Augenstein explains that a policy-construction question can remain open for reexamination in an action on the policy. Section 101E reinforces that result by preserving legal defenses. A factual determination about whether damage exists and what caused it is not the same thing as a final legal ruling that an exclusion applies or that the insurer must pay.

Three questions keep the boundary clear

1. What physical fact must be found? Identify whether the dispute concerns the existence, location, extent, or attribution of observed damage.
2. What policy term must be interpreted? Separate the factual estimate from any dispute about the legal meaning of an exclusion, condition, limit, or grant of coverage.
3. What did the parties submit or reserve? Preserve the written demand, response, coverage letters, and any scope or reservation communication.

Audubon Hill shows the other side of this framework. There, the insurer reserved the policy and liability questions while the referees valued the claimed repair. The amount award did not decide coverage. By contrast, Augenstein involved a factual loss-occurrence issue placed before the referees without a preserved policy-construction defense. The cases should be read together rather than reduced to competing slogans.

No universal Massachusetts rule should be stated for every mixed-cause scenario. Nor should a partial payment automatically be described as conceding every cause, item, or damage category. Map each disputed category to the coverage position and the proposed amount submission. That method respects the referees' factual role without turning their necessary valuation judgments into conclusive legal coverage decisions.

Residence, Disinterest, Willingness, and the Four-Month Rule

Massachusetts does not leave referee eligibility to a generic professional-title test. Section 100B applies to every person nominated, specified in an application, or appointed under sections 100 and 100A. The person must be disinterested, must reside in Massachusetts, and must be willing to act. The DOI confirms that there is no special referee license merely to be identified as a potential referee.

The four-month restriction requires a separate check. Prior service as a referee for either party during the relevant four-month period disqualifies the person unless the statute's written consent is obtained. The insured provides the written consent for a referee nominated by the company. The company provides it for a referee nominated by the insured. Both provide written consent for a third referee. The statutory dates used to measure the period vary with the kind of nomination or appointment, so the service history and consent should be documented before selection.

• Confirm Massachusetts residence and current willingness to accept the assignment.
• Obtain a written disclosure of relationships, prior claim work, and financial interests.
• Check service for either party during the statutory four-month period.
• Obtain the correct party's written consent if the statute permits the recent service.
• Do not specify in a Commissioner application anyone previously nominated in that reference.
• Match the person's practical experience to the property and valuation issues presented.

No referee license does not mean no licensing question

The role actually performed can create a separate public insurance adjuster issue. Section 162 defines the regulated insured-representation activity, including work connected with assessing damages, negotiating, settling, appraising, or referring a property loss. Section 172 separately requires an approved written contract for a public insurance adjuster representing an insured. DOI's licensing materials likewise treat property-loss adjusting and claim appraisal experience as part of that regulated field.

It would be too broad to say that every person who serves as a referee needs a public insurance adjuster license. DOI expressly says no special referee license is required. It would also be too broad to assume that calling compensated insured-side work reference removes it from public-adjuster regulation. If the engagement includes representing the insured, assessing the claim, negotiating, settling, appraising, or handling reference beyond the neutral statutory role, review sections 162 and 172 and current DOI licensing requirements before work begins.

The Massachusetts Reference Process, Step by Step

Reference begins after a claim is presented and the insurer and insured fail to agree on amount of loss within the statutory setting. The insured makes a written demand for reference to three referees. From there, section 100 uses reciprocal lists and several ten-day periods. The sequence should be followed literally and documented by delivery date.

1. Confirm the amount disagreement and the operative authority.Gather the current policy and endorsements, coverage letters, estimates, proof submissions, payment history, and suit deadline. Identify what amount question will be referred and what legal issue, if any, remains reserved.
2. The insured sends a written demand. The demand should identify the claim and invoke the Massachusetts reference procedure. It should not assume that a generic appraisal demand or unilateral appraiser appointment satisfies section 100's nominee exchange.
3. The insurer supplies three nominees. Within ten days after receiving the written demand, the insurer submits in writing the names and addresses of three people to the insured.
4. The insured chooses from the insurer's list. Within ten days after receiving those names, the insured gives written notice selecting one of the three to serve as a referee.
5. The insured supplies three nominees. The insured also submits in writing three names and addresses to the insurer. The insurer then has ten days after receiving that list to notify the insured in writing of its choice of one of those people.
6. The first two select the third. They have ten days after selection of the second referee to agree upon and select the third referee.
7. A statutory impasse goes to the Commissioner. If the first two do not select the third in that period, either referee or either party may apply in writing under oath to the Commissioner in the prescribed form. After any inquiry or hearing the Commissioner considers appropriate, the Commissioner appoints the third and gives written notice.
8. The panel holds its first hearing. Section 101 requires the three referees to meet to hear evidence within ten days after the third is selected or appointed. The hearing may be adjourned, but no more than one week may pass between hearings unless all referees agree.
9. The majority produces a written award. Section 101A requires the award to be reduced to writing and executed in duplicate. The third referee publishes it by delivering one duplicate to the insurer and one to the insured, unless another lawful publication method is used.

Vacancies return to the statutory appointment system

If a referee cannot continue before the award because of death, resignation, incapacity, removal from Massachusetts, refusal, or another reason, section 100A provides a sworn application procedure for a replacement. Depending on who chose the departed referee, the other side or specified participants may apply. Except for a successor to a Commissioner-appointed third referee, the application lists three names and the Commissioner selects from them. The insurer and insured may also fill a vacancy by mutual agreement.

Third-referee charges follow a conditional rule

Massachusetts does not support the shortcut that every panel cost is always split equally. Section 101B addresses the third referee's compensation and expenses. If the award is in favor of the insured, the insured and company are each liable for one half. If the award is in favor of the company or no award is rendered, the company is liable for the full charge, although it may deduct half if it later makes a settlement payment to the insured. Section 101C requires the insurer to make the payment to the third referee and permits the insured's share to be deducted from an award.

The third referee must provide the detailed charge statement required by section 101B. An aggrieved insured or insurer has ten days to petition the Commissioner for review of those charges. That ten-day fee-review period should not be confused with a deadline to challenge the amount award itself.

For a general explanation of property-insurance appraisal mechanics, see the insurance appraisal process guide. Its ordinary two-appraiser and umpire model is background only. Massachusetts's cross-nomination sequence, three-referee terminology, and Commissioner appointment route control here.

The Two-Year Suit Condition and Its Narrow Reference Window

Section 99 states that an action on the policy must be commenced within two years from the time the loss occurred. It also makes reference a condition precedent to an action to recover the loss unless the parties waive reference. Those provisions create a timing problem that generic advice to demand appraisal early does not solve. The reference schedule and the lawsuit schedule must be tracked together.

The statute supplies a limited protection when the amount of loss has been referred within those two years after the parties failed to agree. In that setting, the time to sue may not be less than ninety days after a valid reference award or after the reference or award is expressly waived by the parties. This is a minimum post-reference window tied to the statutory conditions. It is not an automatic additional ninety days attached to every demand letter.

Hawley: a demand is not the same as a reference underway

In Hawley v. Preferred Mutual Insurance Company, the insureds requested reference five days before the two-year period expired. The Appeals Court held that the mere request did not toll the period because the reference procedure had not begun. The statutory response sequence itself could carry the parties beyond the deadline. Hawley therefore rejects the idea that sending a last-minute demand automatically preserves the policy action.

This guide does not state a universal separate deadline for making the original reference demand, a universal waiver rule, or a universal tolling rule for adjustment, negotiation, a DOI complaint, or payment. The verified authority supports the two-year condition, the narrow post-reference minimum, and Hawley's demand distinction. Other timing and waiver questions depend on the issued policy, procedural posture, documented conduct, and current law.

The current statutes contain a 30-day and 60-day mismatch

The live text cannot responsibly be reduced to one universal payment deadline. Section 99's standard-form payment clause currently says the company, within thirty days after the insured submits the required statement, shall take one of the listed payment, replacement, or repair paths. Section 101C, addressing payment of the third referee's charges and an award during the fee-review period, still refers to a sixty-day period prescribed in the standard form or section 102.

The guide does not reconcile that statutory mismatch and does not announce that every Massachusetts property award is payable in either thirty or sixty days. Review the current issued policy, the complete statutory context, proof-of-loss history, charge-review status, and any other applicable payment law. The conflict is a reason for policy-specific analysis, not permission to pick the number that best fits one side's preferred deadline.

What a Majority Award Decides, and What It Does Not

A Massachusetts reference award is written and made by a majority of the three referees. Section 99 makes it conclusive and final as to the amount of loss or damage. Section 101A requires duplicate execution and publication to both sides. Those are strong words about amount. They do not convert the award into a final adjudication of every policy issue or an unconditional command to pay the face amount immediately.

Section 101E preserves legal defenses and confines ordinary reference to amount of loss or sound value. Limits, deductibles, prior payments, exclusions, property interests, replacement conditions, and other unresolved contract questions may affect payment after the amount is fixed. Whether any particular issue remains is a claim-specific policy and legal question. The point is not that payment never follows an award. The point is that amount finality and payment liability are not identical legal conclusions.

Section 101C adds another narrow distinction. Payment of referee compensation or expenses does not by itself prevent the insured or company from contesting the award's validity. The statute says that much. It does not, in the cited authorities, establish one simple list of grounds, one universal filing procedure, or one universal deadline for challenging every ordinary reference award.

Read the award against the submission

• Confirm that the writing reflects a majority of the three statutory referees.
• Identify the amount categories the demand and hearing actually submitted.
• Separate factual findings used to measure loss from legal policy conclusions.
• Locate every reservation of coverage or liability made before or during reference.
• Check the third referee's detailed charge statement and the ten-day DOI fee-review period.
• Calendar the section 99 suit condition and any review issue immediately.

Augenstein and Audubon Hill show why the record matters. A factual loss-occurrence question actually submitted to referees can become conclusive in measuring loss. A preserved legal policy-construction issue can remain for court decision even after the panel fixes a number. The award should therefore be read with the demand, nominee correspondence, hearing record, coverage letters, and reservations, not as a number detached from the proceeding that produced it.

Three Massachusetts Cases Define the Practical Boundary

Massachusetts's statutory text does most of the procedural work, but three appellate decisions answer recurring questions about factual loss, legal coverage, and timing. Each decision should be used for the point it actually decided. None creates a universal rule for every cause dispute, waiver argument, or policy form.

Augenstein: factual loss and attribution can belong to the referees

In 1977, the Supreme Judicial Court explained that authority to determine amount carries authority to decide that no factual loss existed. Drawing on earlier lightning and windstorm authority, the court also recognized that referees may need to attribute damage between causes to determine loss under a policy. Their policy interpretation is a working step in valuation, not a conclusive ruling on legal coverage or ultimate liability. That construction question can remain for judicial reexamination.

Audubon Hill: a reserved coverage issue remains legal

The Massachusetts Appeals Court considered a panel amount award where the insurer had repeatedly reserved coverage and liability. The court held that the referees' amount determination did not bind the coverage question and affirmed judgment for the insurer under the policy terms. The case applies section 101E's separation between amount and preserved legal defenses and explains why Augenstein does not make every factual or legal dispute final in reference.

Hawley: a request alone does not toll the suit condition

In 2015, the Appeals Court addressed a reference request sent five days before the section 99 two-year period expired. It held that the request did not toll the period because the reference procedure had not begun. Hawley is a direct warning against reading the ninety-day minimum as an automatic extension triggered by a letter. It does not establish a universal rule for every waiver or estoppel theory, and this guide does not extend it that far.

The cases fit the statutes rather than replacing them. Section 99 establishes the three-referee amount process and timing condition. Section 101E preserves legal defenses. Sections 100 through 101C supply nomination, hearing, award, and charge mechanics. Start with that text, then use each case to answer the specific question in front of it.

Prepare the Submission, the Referees, and the Calendar Together

Massachusetts reference preparation has three simultaneous tracks. The first is substantive: define the amount disagreement and preserve any policy-construction issue. The second is procedural: complete the reciprocal nomination and selection steps with eligible referees. The third is temporal: protect the two-year suit condition while the statutory ten-day periods run. Neglecting any one track can undermine the usefulness of the other two.

Build a claim record the panel can use

Collect the declarations, complete policy, endorsements, notice of loss, proof submissions, inventories, photographs, videos, estimates, invoices, engineering or consultant reports, payment letters, reservations, denials, and written extensions. Organize estimates by the same rooms, elevations, systems, or property categories. Mark differences in dimensions, quantities, unit pricing, repair method, depreciation, actual cash value, replacement cost, and prior payments.

The record should also show the boundary of the submission. State which physical damage and amount categories are being referred. Identify any factual attribution the referees must make. Then list policy construction, exclusions, or other legal defenses that remain reserved. That written map helps the panel perform the factual work Augenstein permits without assuming that it has final authority over legal coverage.

Vet six nominees, not one appraiser

Because each side supplies three names, eligibility should be checked before the list is served. Confirm residence, disinterest, willingness, and recent referee service. Obtain disclosures and identify any written consent needed under section 100B. A list containing an ineligible or unwilling person can create avoidable appointment disputes within an already compressed statutory schedule.

• Record the delivery date of the insured's written demand.
• Calendar each ten-day nomination, choice, and third-referee period separately.
• Prepare for the first evidentiary hearing within ten days after the third selection.
• Preserve evidence that may disappear during mitigation, demolition, or repair.
• Request the written duplicate award and detailed third-referee charge statement promptly.
• Do not confuse the ten-day fee petition with award-validity procedure.
• Protect the two-year suit condition without assuming the demand tolls it.

After the award, compare the writing with the submission and coverage record. Confirm the majority, delivery, amount categories, fee statement, and any reserved legal question. If there is concern about validity, policy construction, payment, or the suit deadline, obtain claim-specific legal review immediately. The sources cited authorities do not support a universal ordinary-reference challenge deadline that can safely be calendared from a general article.

Massachusetts Primary Resources

Start with sections 99 and 99B for the standard policy, reference clause, suit condition, and approved form variation. Sections 100, 100A, and 100B govern reciprocal selection, Commissioner appointments, replacements, residence, disinterest, willingness, and the four-month restriction. Sections 101 through 101C govern the first hearing, written award, third-referee charges, and charge review. Sections 101D and 101H address sound value and actual cash value, while section 101E preserves the legal-defense boundary.

DOI's Arbitration Panel Information page translates those mechanics into a useful consumer sequence and confirms that no special referee license is required. Section 172 and DOI licensing materials address the separate public insurance adjuster lane. DOI's complaint page explains both the assistance Consumer Services can provide and the disputed facts, valuation, payment, and legal questions it cannot decide.

Read Augenstein for factual loss and damage-attribution nuance, Audubon Hill for preserved coverage and liability, and Hawley for the difference between demanding reference and having the loss referred within the section 99 timing framework. Use MPIUA's current site to identify the residual-market program, then use the actual issued MPIUA documents rather than an archive to establish policy wording.

A reliable order of review

1. The declarations, current policy forms, and every endorsement.
2. The proof-of-loss history, coverage position, estimates, and payment record.
3. M.G.L. c. 175, §§ 99 through 101E, using the live statutory text.
4. Augenstein, Audubon Hill, and Hawley for the exact appellate questions they decided.
5. DOI appointment, licensing, charge-review, and complaint materials.
6. Current MPIUA information and the policy actually issued for a FAIR Plan claim.

That order keeps Massachusetts reference recognizable on its own terms. Exchange the statutory nominee lists, verify every referee, define the amount question, preserve legal coverage issues, and calendar section 99 before waiting for the panel to finish. Those are the decisions the current primary sources support.

Frequently Asked Questions