Hail Claims

Hail Damage Claims In Texas

March 19, 2015 | Mark S. Humphreys

Dallas lawyers handling hail damage claims need to be aware of the actions taking place in Austin. A recent article from the Insurance Journal needs to be read. The title of the article is, Attorneys, Insurers Facing Off Over Hail Litigation In Texas. Here is what it tells us about the battle between hail claims attorneys and insurance companies.

The vestiges of twin hailstorms that ravaged the south Texas coast in 2012 are now blowing through the halls of the Capitol in Austin.

Two of the state’s most-powerful lobbies, the insurance industry and trial lawyers, are gearing up for a fight over a push to ease penalties against companies that deny homeowners their hail-damage claims.

Hail Claims – Removal To Federal Court

March 7, 2015 | Mark S. Humphreys

Mansfield attorneys handling hail damage claims can tell you that the insurance companies are always trying to have lawsuits in Federal Court rather than State Court. Here is another opinion on that issue from the US Court, Northern District, Dallas Division. The style of this case is Ocotillo Real Estate Investments I, LLC, v. Lexington Insurance Company, et al.

This action arises from an insurance claim Ocotillo submitted to Tudor Insurance and Lexington Insurance Company regarding property loss from hail. Ocotillo filed suit against Defendants in state court. Ocotillo alleged claims for violations of the Texas Insurance Code, violations of the Texas Deceptive Trade Practices Act, breach of contract, and negligence. The carriers removed the state court action to Federal Court. Ocotillo moved to remand.

A defendant may remove a state court action to federal court if he establishes the federal court’s original jurisdiction over the action. It is the defendant’s burden to establish the existence of federal jurisdiction. Thus, to remove a case, a defendant must show that the action either arises under federal law or satisfies the requirements of diversity under 28 U.S.C. § 1441(b). Because removal raises significant federalism concerns, the removal statute is strictly construed and any doubt as to the propriety of removal should be resolved in favor of remand. A district court must remand a case if, at any time before final judgment, it appears that the court lacks subject matter jurisdiction. 28 U.S.C. § 1447(c).

Hail Claim – Declaratory Judgment

March 5, 2015 | Mark S. Humphreys

Burleson lawyers handling hail damage claims will know that insurance companies try to get cases into Federal Court. The US District Court, Northern District of Texas, Dallas Division issued an opinion in a case, illustrative of this tactic. The style of the case is, Tudor Insurance Company, et al. v. Ocotillo Real Estate Investments I, LLC.

This is declaratory judgment action in which Tudor and Lexington Insurance Company seek a declaration that they have no duty to provide coverage to Ocotillo for losses resulting from alleged hail damage to Ocotillo’s property. In its motion to dismiss, Ocotillo argues that because it has filed a state court action that will resolve all issue between the parties, the Court should abstain from considering this case.

Ocotillo filed the State Court Action on August 1, 2014. In the State Court Action, Ocotillo alleges claims against Carriers and additional defendants for violations of the Texas Insurance Code, violations of the Texas Deceptive Trade Practices Act, breach of contract, and negligence. Carriers timely removed the State Court Action. By separate order of this date, the Court denied the motion to remand on the grounds that Ocotillo had improperly joined in-state defendants.

Storm Damage Claims

March 3, 2015 | Mark S. Humphreys

Dallas insurance lawyers handling storm damage claims need to dread a recent opinion from the US District Court, Southern Division Texas, Houston Division. The opinion is styled, Nasti v. State Farm Lloyds, et al.

This is an insurance case arising from alleged storm damage to Nasti’s home which State Farm has filed a motion for summary judgment regarding. After the storm, Nasti was approached by Manley of Mac Roofing, who was offering free roof inspections to storm victims in the neighborhood. Both of Nasti’s neighbors on each side already had roofs replaced because of the storm. Nasti reported his claim to State Farm and requested an inspection with Mr. Manley present. State Farm adjuster Stewart Brown inspected Nasti’s roof and reported: “Reviewed 30yr fiberglass shingles for wind and hail damage with Mac’s Roofing present…. I did find damage that would be consistant w/ wind damage to the back left slope…. Inspected interior gameroom /entry and dining room and found water damage to ceilings.” Brown estimated the covered damage to be $3,107.54, less than the deductible of $6,584.00. Nasti requested a reinspection with a different adjuster. State Farm adjuster Dwight Johnson inspected Nasti’s roof and reported: “I inspected the roof with the contractor. My inspection revealed no evidence of storm related damage to the roof system…. The Shingle is a heavier 40 year shingle.” Despite finding no storm damage, Johnson did not alter Brown’s estimate of $3,107.54 damage. Nasti’s expert adjuster Shannon Kimmel inspected Nasti’s roof and reported:

I have visited Mr. Nasti’s home and inspected the damage to his roof. There is no question that Mr. Nasti’s roof was damaged by the severe wind and hail storm that hit The Woodlands, Texas, in June 2012…. I have adjusted thousands of these types of claims for various insurance companies, including State Farm…. In my opinion and based on my extensive experience as a former State Farm adjuster, inspections by Stewart Brown and Dwight Johnson were inadequate and unreasonable…. Photographs in the claim file clearly prove up covered damages resulting from wind and hail…. Mr. Brown’s and Mr. Johnson’s inspections and Mr. Brown’s damage estimate that was essentially rubber- stamped by Mr. Johnson-despite the fact that his findings contradicted Mr. Brown’s estimate-underestimated and/ or ignored obvious covered damaged [sic] that a reasonable adjuster, acting in good faith, would not have ignored.

Proving Hail Losses The Wrong Way Or Not At All

February 21, 2015 | Mark S. Humphreys

Fort Worth insurance attorneys who handle hail damage claims need to know how “not” to handle the claim. A US Northern District case from the Dallas Division is worth reading to know what courts are looking for in a lawsuit. It is a 2014 opinion styled, Stevenson v. Nationwide.

Stevenson filed a lawsuit against Nationwide. Stevenson’s claims included: (1) breach of contract; (2) violation of Section 542 of the Texas Insurance Code; (3) violation of the Deceptive Trade Practices Act; (4) violation of Section 541 of the Texas Insurance Code; (5) breach of duty of good faith and fair dealing; (6) fraud; and (7) conspiracy to commit fraud.

Stevenson contends that she is the owner of an insurance policy issued by Nationwide. She states that she owns the insured property. She states that on April 3, 2012, strong storms and tornadoes in North Texas caused severe damage to her home. She submitted a claim to Nationwide for damage, water damage, hail damage, windstorm damage, and mold damage to the Property as a result of the storm. She states that she asked Nationwide to cover the cost of repair to the Property pursuant to the Policy and any other available coverages under the Policy. She contends that Nationwide’s adjuster failed to properly adjust the claim made by her. Additionally, she contends that Nationwide has denied at least a portion of the claim without an adequate investigation. She asserts that Nationwide has failed to compensate her adequately under the terms of the Policy.

2 Policies Covering Same Property

February 14, 2015 | Mark S. Humphreys

Arlington insurance attorneys will run across situations where a person, on purpose or by accident, has two insurance policies covering the same property. So what are some of the possible outcomes of this situation? A 2005, Fort Worth Court of Appeals opinion had this issue. The style of the opinion is, Harris v. American Protection Insurance Company. Here is some of the relevant information from that case.

This case arises from two insurance claims for successive casualty losses to the roof of a shopping mall.

On May 5, 1995, a severe hail storm damaged the roof of a vacant building known as Westridge Mall. At the time, the shopping mall was covered by two insurance policies, one issued by American and the other by Aetna Life & Casualty. Each policy effectively covered fifty percent of the loss and named Southwest Portfolio as the insured. On September 6, 1995, roofing contractor Gary Boyd discovered the hail damage during a warranty-related roof inspection. Southwest made a claim for the hail damage under the Aetna policy on October 6, 1995. Because it was unaware of the American policy, Aetna agreed to cover one hundred percent of the loss and settled the claim for $712,612.50. In accordance with the settlement agreement, Aetna paid Southwest $268,445 for the actual cash value of the loss (“ACV”) and retained $444,167.50 as the replacement cost holdback, which would be paid out as repair costs were incurred.

Suing The Adjuster

February 7, 2015 | Mark S. Humphreys

Arlington insurance attorneys can tell you that it is sometimes hard to sue an adjuster. Federal Courts look at these situations really close. This is illustrated in the 2014, US Northern District Court, Dallas Division, case, One Way Investments, Inc. v. Century Surety Company, et al. Here is some information from that case.

One Way sued the insurance company and the adjuster, Mattoni. One Way asserts that its own roofing contractor and public adjusters determined, after conducting a thorough inspection of the exterior and interior, that hail had caused extensive damage requiring urgent repairs and replacement of the roof and building appurtenances, and that Mattoni under-scoped the damages during his investigation. One Way also avers that Century, VeriClaim, and Mattoni misrepresented that the damage to the property was not covered under the Policy, even though the damage was caused by a covered occurrence, thereby violating Section 541.060(a)(1); failed to make an attempt to settle One Way’s claim in a fair manner, although they were aware of their liability under the Policy, thereby violating Section 541.060(a)(2)(A); failed to affirm or deny coverage of One Way’s claim within a reasonable time, thereby violating Section 541.060(a)(4); refused to fully compensate One Way under the Policy, even though Mattoni failed to conduct a reasonable investigation, thereby violating Section 541.060(a)(7); and knowingly or recklessly made false representations as to material facts and/or knowingly concealed all or part of material information from One Way. One Way sued Mattoni under Section 541.151 based on the alleged violations of Section 541.060(a). The case was filed in State Court and the insurance company had the case removed to Federal Court.

Ome Way filed for remand back to the State Court.

Hail Storms In Texas 2014

January 10, 2015 | Mark S. Humphreys

Dallas attorneys who handle hail storm claims need to know where the hail events are happening. The reasons are many. Usually when an insurance company denies a hail claim, a major reason cited is that the damage is pre-exixting. This is a reason for knowing when the storms have occurred and the gathering of records showing the exact locations of the hail and the size of the hail.

The Insurance Council of Texas is a good source for keeping up with where hail events are occurring. A May and June report are cited here.

The first one is titled, Denton Storm Number Rises. Here is what it tells us.

How Not To Handle A Hail Claim

January 4, 2015 | Mark S. Humphreys

Dallas area attorneys handling hail damage claims have a case to review as an example of how NOT to handle a claim. This is a United States Northern District Court case. It is a 2014 opinion and is styled, Stevenson v. Nationwide Property and Casualty Insurance Company.

Beatrrice Stevenson filed suit against Nationwide. Her claims include: (1) breach of contract; (2) violation of Section 542 of the Texas Insurance Code; (3) violation of the Deceptive Trade Practices Act; (4) violation of Section 541 of the Texas Insurance Code; (5) breach of duty of good faith and fair dealing; (6) fraud; and (7) conspiracy to commit fraud. She also states that Nationwide has waived and is estopped from asserting any coverage defenses, conditions, exclusions, or exceptions to coverage not contained in any reservation of rights letters to her. She seeks damages, plus prejudgment interest, attorney’s fees, additional damages, and exemplary damages. The case was removed to Federal Court.

Stevenson submitted a claim to Nationwide for damage, water damage, hail damage, windstorm damage, and mold damage to the Property as a result of the storm. She states that she asked Nationwide to cover the cost of repair to the Property pursuant to the Policy and any other available coverages under the Policy. She contends that the adjuster failed to properly adjust the claim made by her. Additionally, she contends that Nationwide has denied at least a portion of the claim without an adequate investigation. She asserts that Nationwide has failed to compensate her adequately under the terms of the Policy.

Abilene Texas Hailstorm Damage – 2014

January 1, 2015 | Mark S. Humphreys

Attorneys handling Texas hailstorm claims need to keep up with events happening throughout the state related to hailstorms. Insurancenewsnet.com ran an article in June of 2014, that talks about some of the recent hailstorm events in Texas. Abilene, Texas got hit particularly hard. Here is some of the information from that article.

As reports of damage from the recent hail storms continue to pour in, people wait for insurance adjusters to estimate repair costs.

Three Abilene Independent School District elementary schools received roof damage. Repairs will cost the district at least $250,000, the amount of the district’s deductible, said Phil Ashby, communications director. This is a high deductible which essentially means the School District was self-insured up to that amount.