Hail Claims

Correctly Suing The Adjuster

February 27, 2016 | Mark S. Humphreys

Attorney’s who handle hail claims need to know the proper way to sue an insurance adjuster unless they want to litigate the case in Federal Court. A U.S. Western District, Waco Division opinion is worth reading. It is styled, Polansky’s Wrecker Service v. Universal Underwriters Insurance Company and William Gillis.

Polansky’s sued Universal and Giliis for violations of the Texas Insurance Code resulting after a claim for wind and hail damage was not sufficiently reimbursed. The case was filed in State Court and removed to Federal Court by Universal and Gillis on allegations of diversity and their assertion that Gillis was improperly joined in the lawsuit. Polansky’s is asking the court to remand the case stating that Gillis was not improperly joined. The Court’s job in this case is to examine whether or not Gillis was properly sued.

Polansky’s , makes the following factual allegations in regard to his claims against Gillis:

Anti-Concurrent-Causation Exclusions

February 9, 2016 | Mark S. Humphreys

Hail claims lawyers need to read the Texas Supreme Court opinion styled, JAW The Point, L.L.C. v. Lexington Insurance Company. This is a 2015, opinion that is relevant to most hail damage claims, as well as lots of other claims. The case is written about in the State Bar of Texas Insurance Journal It is hard to believe that this case is the Texas Supreme Court’s first occasion to address the proper application of the so-called “anti-concurrent-causation” (the “ACC”) exclusion, which in this case bars coverage for:

loss or damage caused directly or indirectlyby any [excluded cause or event], regardless

of any other cause or event that contributes concurrently or in any sequence to the loss.

Complying With The Policy

January 21, 2016 | Mark S. Humphreys

Fort Worth lawyers will tell you to comply with the policy provisions when making a claim. In this regard, a case from the U.S. District Court McAllen Division is a good read. It is styled, Belinda Santa Maria v. State Farm Lloyds, et al.

This a summary judgment ruling and there were other motions pending but due to the ruing in favor of State Farm, the Court deemed the other motions of no consequence.

Plaintiff’s claims arise from damage sustained to their property as a result of a storm event on March 29, 2012. Plaintiffs reported the claim on April 11, 2012, and State Farm inspected the property on May 2, 2012, estimating the loss at $7,028.04. On the same day, State Farm issued a check for $2,177.16, after adjusting for depreciation and deductible.

Hail Damage Claims

January 17, 2016 | Mark S. Humphreys

Dallas area attorneys who handle hail damage claims need to read this opinion from the 5th Circuit Court of Appeals. The style of the case is, Vincent Stagliano v. The Cincinnati Insurance Company.

This is a first-party insurance dispute over coverage for damage to commercial property allegedly caused by a hailstorm. The District Court granted summary judgment in favor of Cincinnati.

The facts in this case are straightforward. Plaintiffs own a number of properties in and around Dallas, and Cincinnati provided loss protection from August 14, 2010, to August 14, 2011. On June 21, 2011, a claim was submitted for damage to one of the properties that occurred as a result of a hail storm on May 24, 2011. The claim was paid. A year and eight months later, claims for several other properties alleged to have been damaged in the same storm were submitted and Cincinnati denied these claims.

Allegations Of Fraud Against Adjusters – Insurance Lawsuits

January 12, 2016 | Mark S. Humphreys

When suing an adjuster, the requirements are very specific to keep a case out of Federal Court. This is illustrated in a U.S. Northern District, Fort Worth Division, opinion. The case is styled Southlake Campus, Inc. v. Allstate Insurance Company, et al.

This action arises from a dispute over insurance coverage of a property damaged during a storm. Southlake alleges various causes of action which are specifically asserted against Allstate only. The only part of the petition that includes allegations against the adjuster is the section requesting a declaratory judgment.

This case was removed to Federal Court by Allstate under 28 U.S.C. 1332, for reason of diversity of citizenship and the amount in controversy exceeding $75,000.00. Allstate contends the adjuster was not properly joined as a defendant.

Insurance – Breach Of Contract – Hail Damage

January 10, 2016 | Mark S. Humphreys

Hail damage claims are a big source of litigation for insurance attorneys in the Dallas and Fort Worth areas. An opinion from the Federal Court , Southern District of Texas, McAllen Division is worth reading. It is styled, Armando Martinez, et al v. State Farm Lloyd’s, et al.

This is a granting of summary judgement in favor of State Farm.

Martinez’s claims arise from damage sustained to their property as the result of hail storms in April 2012. On May 7, 2012, Martinez reported an insurance claim for property loss and State Farm inspected the property of May 14, 2012, estimating the loss to the dwelling at $10,802.78. The adjuster found damage to the dwelling roof, shed roof, gutters, and a metal carport. On the same day, State Farm issued a check for $8,325.08, after applying depreciation and deductible.

Cedar Hill, Texas Insurance Lawyer

January 7, 2016 | Mark S. Humphreys

This 2014, Texas Supreme Court opinion should be of local interest. The case is styled, In re National Lloyd’s Insurance Company.

In this narrow holding, the Texas Supreme Court held that the trial court abused its discretion by ordering the defendant insurance company to produce evidence related to insurance claims of third parties.

After her Cedar Hill home was damaged by storms, Mary Erving filed claims with her homeowners insurance company, National Lloyds Insurance Company. Although National Lloyds paid the claims, Erving became concerned that her claims had been undervalued. As a result, Erving sued National Lloyds for breach of contract, breach of duty of good faith and fair dealing, fraud, conspiracy to commit fraud, and violations of the Texas Deceptive Trade Practices Act, and Chapters 541 and 542 of the Texas Insurance Code.

Concurrent Causation Clauses

January 5, 2016 | Mark S. Humphreys

Attorneys handling hail damage claims need to read this case. It is a 2015, Texas Supreme Court opinion styled, JAW The Point, L.L.C. v. Lexington Insurance Co.

In this case, the “anti-concurrent causation” (ACC) exclusion reads:

loss or damage caused directly or indirectly by any [excluded cause or event], regardless of any other cause or event that contributes concurrently or in any sequence to the loss.

Insurance Company Must Conduct A Reasonable Investigation

January 2, 2016 | Mark S. Humphreys

Grand Prairie insurance lawyers must know what it takes for an insurance company to be found liable for bad-faith. A 5th Circuit Court of Appeals opinion is educational in this respect. It is a 2014 opinion styled, Santacruz v. Allstate Texas Lloyd’s, Inc.

The 5th Circuit reversed a summary judgment in favor of Allstate because the reviewing panel found that Allstate had failed to make a reasonable investigation before denying the claim. The result is unusual not only because Allstate’s bad-faith summary judgment was reversed, but also the reason for reversal was not that Allstate had no reasonable basis for the denial but rather, it failed to conduct a reasonable investigation before denial. Under Texas’ bad-faith standard, the insurer must demonstrate both.

In this case, a rainstorm blew several shingles off Santacruz’s roof, causing leaks and exgensive damage to personal property. The insured promptly reported the incident to Allstate who informed the insured that it could not send an adjuster for several days. However, because more storms were forecast, Santacruz, upon the advice of his contractor, informed Allstate that he had to repair the roof immediately to prevent further damage. Allstate repeated that it needed to inspect the roof before it could be repaired. Santacruz proceeded with repairs that day. A few days later, an Allstate adjuster came and took pictures of the roof and interior but did not further investigation. Allstate denied the Santacruz’s claim, who then sued Allstate for breach of the duty of good faith and fair dealing and intentional infliction of emotional distress.

Interpreting Appraisal Clause

December 22, 2015 | Mark S. Humphreys

Mineral Wells insurance lawyers are aware of appraisal clauses in insurance contracts. Interpreting them is not always easy. The Amarillo Court of Appeals issued an opinion in a 2015 case that needs to be read. It is styled, In Re Century Surety Company.

This is a mandamus proceeding that arises from a lawsuit by an insured, Jefferson, against Century.

The lawsuit filed on December 16, 2013, arises out of a claim submitted for hail damage which occurred on May 28, 2013, alleging breach of contract and extra-contractual claims. A lawsuit was filed suing Century, an adjusting company, and two individuals.