Hail Claims

Hail Claims – Cosmetic Damage

June 10, 2017 | Mark S. Humphreys

Hamilton insurance lawyers need to read this opinion from the Western District, Waco Division, Federal Courts. It is styled, Stephen Hahn v. United Fire and Casualty Company.

Hahn filed this lawsuit against United Fire after United Fire refused to pay a hail damage claim submitted to them by Hahn. United Fire refused based on their assertion that the damage is cosmetic only and does not jeopardize the integrity of the roof and is an exclusion not covered under the policy. United Fire filed a motion for summary judgment in an effort to get the case resolved in their favor.

United Fire’s exclusion says:

Hail Damage – Segregating Covered And Uncovered Damages

June 8, 2017 | Mark S. Humphreys

For Hail Claims layers, the Western District, Waco Division, issued an opinion in April 2017, that needs to be read. It is styled, Stephen Hahn v. United Fire and Casualty Company.

Hahn suffered hail damage to his property after a recent hail storm and made a claim for damages. United Fire denied the claim based on their assertion that the damage was not segregated from the damage occurring in the recent storm and prior damage. They also denied based on the damage only being cosmetic in nature.

Hahn filed suit for breach of contract and insurance code violations and United Fire eventually filed a motion for summary judgment seeking to have the case dismissed.

Homeowners Policies And Hail Claims

May 27, 2017 | Mark S. Humphreys

Parker county insurance lawyers will see lots of homeowners claims resulting from hail damage claims. When this occurs and the insurance company does not want to pay the claim and a lawsuit is filed, the likely result is the insurance company trying to have the case heard in Federal Court. An Eastern District, Sherman Division opinion deals with this situation. The opinion is styled, Lopez v. Allstate Vehicle and Property Insurance Company.

When a hail storm hit the Lopez home, a claim was filed with Allstate. The adjuster, Gary Harbison was assigned to investigate the claim and he concluded there was no damage and any potential damage had occurred prior to the storm. A lawsuit was filed and Harbison was sued with the allegations against him being that he conducted a substandard and improper investigation, that he was scared of losing his job, and he was fraudulent in his report because the Lopez’s public adjuster had found much more damage. Lopez claims damages totaling $30,646.73.

The lawsuit was filed in Denton County Court alleging breach of contract, violations of the Texas DTPA, and violations of the Texas Insurance Code, fraud, negligence, and gross negligence.

Remember – There Is An Obligation To Cooperate With Your Own Insurance Company When Making A Claim

May 16, 2017 | Mark S. Humphreys

Experienced insurance law lawyers in Hamilton, Texas, know the above is true. This obligation is illustrated in a 2017, hail damage claim opinion out of the Southern District, Houston Division. The opinion is styled, Metro Hospitality Partners, Ltd., d/b/a Crowne Plaza Hotel v. Lexington Insurance Company.

When a business sues its property insurer and the type of damage is clearly covered, the usual pattern is that the insurance company has failed to pay anything, has failed to pay anything close to what the insured claimed, or has taken too long to pay. This case is different. Here, the property insurer promptly adjusted the claim the insured presented and paid a large sum within the month after the hailstorm that damaged the insured’s hotel. The insurer identified and paid what it concluded were the remaining amounts owed about two months after that. The insured claimed that more money was owed. The insurer asked for documents and information substantiating the demand for additional payment. The insured refused. The policy required the insured to “cooperate” with the insurer. What we have here, says the insurer, is a failure to cooperate. What we have here, says the insured, is a breach of the insurance contract and of the duty of good faith and fair dealing.

After a hail storm, the insured, Metro, promptly notified its Lexington. Lexington quickly responded, inspected, and identified the amount of covered damage and the amount it owed. The parties disputed whether the hailstorm damage justified an insurer-paid new roof, or whether normal wear and tear made a new roof Metro’s responsibility.

Dallas Hail Claims – Making A Proper Pleading Against An Adjuster On Hail Claims

May 2, 2017 | Mark S. Humphreys

For insurance attorneys handling hail damage claims, the Northern District, Dallas Division, issued an opinion worth reading. The opinion is styled, Ronald E. Cohen, et al v. Seneca Insurance Co., Inc., J.S. Held, Inc., Haag Engineering Co., and R. Kean Jenner.

This is a case of an insurance claim denial after a wind and hail storm in Dallas County. The adjuster, Jenner, was the only non-diverse defendant. The lawsuit for denial of policy benefits was filed in Dallas County Court and removed to Federal Court by the other defendants claiming that Jenner was improperly joined in an effort to defeat diversity jurisdiction. Cohen filed a Motion to Remand based on his assertion that Jenner was not improperly joined.

The sole issue in this case is whether the joinder of Jenner was proper under Texas law. If the court finds a reasonable basis to predict that Plaintiffs can potentially recover on one of the causes of action asserted against Jenner, the court must remand the entire case.

Hail Damage And Lawsuits

April 25, 2017 | Mark S. Humphreys

Hail damage lawsuits can be tough when in Federal Court. Special attention has to be given to the way the lawsuit is drafted. This is illustrated in a 2017, opinion issued by the Northern District, Dallas Division. The case is styled, McKinney Square Properties No. 1 Ltd. v. Seneca Insurance Company, Inc.

McKinney filed a lawsuit against Seneca alleging hail storm damage that occurred about June 9, 2015. McKinney alleges they filed a claim as soon as possible after the storm when a leak was detected. Seneca denied the claim.

McKinney alleges that Seneca refused to provide the names of the individuals who inspected the property, a copy of the engineering report, and Seneca negligently damaged roof tiles during the inspection of the property.

Suing The Adjuster

April 4, 2017 | Mark S. Humphreys

A 2017, opinion from the Northern District, Dallas Division, is an example of how not to sue an adjuster to keep a case out of Federal Court. The opinion is styled, Hutchins Warehouse Limited Partners, v. American Automobile Insurance Company, et al.

Hutchins sued American and their adjuster in State Court after their claim for benefits was not properly paid. The allegations against the adjuster, McMillan, were that he made numerous errors in his estimate, which resulted in American underpaying and partially denying Hutchins’s claims.

28 U.S.C., 1441(a) permits the removal of any civil action brought in a state court of which the district courts of the United States have original jurisdiction. The statute allows a defendant to remove a state court action to federal court only if the action could have originally been filed in federal court.

Fort Worth Homeowners Hail Claims

April 2, 2017 | Mark S. Humphreys

The Fort Worth Court of Appeals issued an opinion in February 2017, that is good reading for insurance lawyers. It essentially points out in a case, what was not done correctly. The opinion is styled, Seim v. Allstate Texas Lloyds.

This is claim against a homeowners policy issued by Allstate to the Seims. It is an appeal from a summary judgment in favor of Allstate. The Allstate policy provided coverage on the Seims home for the period April 27, 2013, through April 27, 2014. On or about August 28, 2013, the Seims notified Allstate of damage that had occurred earlier in August. The property was inspected on or about September 10. The adjuster, Scott, testified in deposition that the Seims’ property had some interior water damage, but the roof did not have any wind or hail damage. Scott further testified that in order for the interior water damage to be covered under the Seims’ policy, “there had to be an opening in the roof caused by wind or hail … and the Seims did not have that. The claim was denied by Allstate and a few months later the Seims sued Allstate for insurance code violations and breach of contract.

In the pleading filed by the Seims, they claimed damage was caused by storms in 2013, April 2007, April 2008, and May 2012. In their lasted amended pleading, references to the 2007, 2008, and 2012, storms was removed.

Llano County Property Owners – When Is A Fence Part Of Your Home

March 25, 2017 | Mark S. Humphreys

The Insurance Journal published an article on an opinion issued by the Texas Supreme Court that will have an impact on all property owners in the State of Texas. The title of the article is, Texas High Court Sides With Policyholder In Ike Damaged Property Case.

When is a fence a “dwelling” structure for insurance coverage purposes and when is it an “other structure?”

The Texas Supreme Court, relying on disputed language in a Liberty Mutual homeowners policy, found that a fence is a covered dwelling structure when it is attached to the home.

Hail Claims In Texas

March 16, 2017 | Mark S. Humphreys

The Houston Chronicle published an article in February on a topic that lawyers who handle hail damage claims need to know about. The title of the article is, Insurers, Plaintiffs Lawyers Square Off In Austin Over Hail Storm Bill.

Lobbyists representing insurance companies are pushing legislation they say will prevent premium increases by weeding out “abusive” lawsuits over damages caused by hail and other storms in what is shaping up as a battle royal with consumers and plaintiffs’ lawyers.

Gov. Greg Abbott raised the stakes when he used his State of the State address earlier this week to proclaim that “hailstorm litigation is the newest form of lawsuit abuse.” He urged the Republican-controlled legislature to send him a bill that he can sign into law to limit those types of lawsuits.