Articles Posted in Home Owners Policies

Insurance claims often do not need an expert to help the case.  When an expert is needed, it is important to know how courts look at experts.  Here is a homeowners case wherein an expert is being used to bolster the case.  This is a 2022 opinion from the Western District of Texas, San Antonio Division.  The opinion is styled, FB & SB Leasing, LLC v. Chubb Lloyds Insurance Company of Texas.

In this first–party insurance dispute involving a property experiencing plumbing problems and foundation issues, Chubb presents two reliability arguments to support excluding the opinion
testimony of Plaintiff FB &SB Leasing’s sole causation expert, Michael B. Couch.  Chubb urges first that Couch’s report provides insufficient information about his methodology.  Second, Chubb argues Couch relied on mistaken or incorrect underlying data when opining that there were multiple leaks at the property.  There’s no dispute that Couch’s testimony, if reliable, would be relevant. Chubb also doesn’t dispute Couch’s qualifications. As argued, and on this record, Chubb’s complaints go to the eventual weight a jury might afford the testimony and are most appropriately addressed at trial via cross-examination or through introduction of competing expert testimony.

As to the first argument, there’s no dispute that Couch inspected the property on multiple occasions and relied on a plumbing report that noted multiple breaks in plumbing lines.  Relying on this underlying data and his ample training and experience, Couch opined on the cause of the damage to the property.  This is sufficient given the parties’ arguments presented here.  The second of Chubb’s arguments relies on a distinction Chubb draws between “leaks” and “breaks” in plumbing, which on this record is an issue better reserved for cross examination at trial.  Both side’s experts relied on the same plumbing report that noted multiple plumbing issues.  Even Defendant’s expert appears to use the terms “break” and “leak” interchangeably in his expert report. Moreover, Chubb didn’t depose Couch, which might have provided more detail and nuance on these issues to further inform a motion to exclude.  Accordingly, on this record and based on the arguments presented by Chubb, the Motion, is Denied Without Prejudice.  Chubb may re-urge its arguments later in the case, via a motion in limine or at trial.

Here, an insurance company refused to pay a claim based on their assertion that the insured customer failed to segregate damages.  The Judge agreed with the insurance company.  The opinion is from the Northern District of Texas, Dallas Division.  It is styled, Svetlin Tchakarov and Popova Rossitza v. Allstate Indemnity Company.

The plaintiffs filed suit to recover damages from Allstate for wind and hair damage to the roof of their property.  Allstate moved for summary judgment based on Allstate’s assertion that Plaintiff’s have not provided evidence that would allow a jury to reasonably apportion the harm from the covered and non-covered causes of loss.

The relevant portion of the policy reads:

The Northern District of Texas, Fort Worth Division, decided a case in 2021 wherein the lawyer for insured did a good job of pleading his case.  The strange thing about this case is that it was filed in 2021, well after the new section of the Insurance Code was in effect, that being section 542A.  In section 542A, suing the adjuster has essentially been made something of the past, with rare exceptions.  However, it is not the issue in this case but the case still serves as a good example on how to name the insurance adjuster in such a way as to keep the case in State Court rather than being removed to Federal Court.

The style of the case is, Paradise Villas HOA, Inc. v. Amguard Insurance Company and Todd Anthony Gilmore.  Paradise is the insured, Amguard is the insurer, and Gilmore is the adjuster.

Paradise suffered alleged hail damage and properly reported the claim to Amguard.  Gilmore, a Texas Citizen, was assigned to adjust the claim and according to Paradise, Gilmore greatly under estimated the value of the claim.  A lawsuit was filed in State Court and Amguard caused the case to be removed to Federal Court alleging that Gilmore was improperly named in an effort to defeat diversity jurisdiction and asserting that the causes of action asserted against Gilmore could not stand.  Paradise filed a motion to remand which is the cause of this opinion.

Here is a case from the Eastern District of Texas wherein the insureds did not show that the damages they received were the result of a covered damage.  The case is styled, Tim Whatley and Sheila Whatley v. Great Lakes Insurance, SE and McClelland & Hine, Inc.

In this case, the Whatleys are suing based on their assertion that they suffered damage to their home as a result of Hurricane Harvey.  The case was in Federal Court and had been referred to a Magistrate Judge, who issued a report granting Summary Judgment in favor of Great Lakes and McClelland.  The Whatley’s sought review of the finding made by the Magistrate Judge.

The Whatleys (Plaintiffs) presented four objections to the Report regarding their breach of contract claim.  First, Plaintiffs object “to the court’s finding and recommendation that there is no genuine issue of material fact to support the damage to ther oof and interior and interior of Plaintiffs’ home was caused by the windstorm conditions of Hurricane Harvey.”  Second, Plaintiffs “object to the court’s finding and recommendation that there are no genuine issues of fact to support the roof and interior home damage was caused by a covered peril.”  Third, Plaintiffs “object to the court’s finding and recommendation that there are no genuine issues of fact supporting causation; that the damage was caused by water through an opening created by the direct force of wind and hail.”  Finally, “Plaintiffs object to the court’s finding and recommendation that expert Lester Saucier’s opinions on causation are speculation.”