Home Owners Policies

Palo Pinto County And Hail Damage Claim

August 2, 2021 | Mark S. Humphreys

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.

Hail Damage Claims

July 31, 2021 | Mark S. Humphreys

Here is an interesting case dealing with hail damage. This is a 2021, case from the San Antonio Court of Appeals. It is styled, Allstate Vehicle And Property Insurance Company v. Peter Reininger. The opinion is an appeal from a jury trial in favor of Reininger.

The opinion is lengthy and discusses several legal issues. However, the facts of the case are pointed out here because the facts are similar to situations many other homeowners face themselves.

Reininger’s home had previously been covered by a policy issued by Liberty Mutual and that policy covered cosmetic hail damage to his metal roof. When Reininger began looking for a new policy in 2015, he contacted Justin Losoya, an Allstate agent. Reininger told Losoya he wanted a policy that was “apples to apples” with his Liberty Mutual policy, and Losoya stated Allstate could provide that. Reininger also asked Losoya, “If I have any bad weather, hail or any type of hail and it damaged my roof, am I covered?” Losoya answered, “Yes, sir, Mr. Reininger, you are. You pay a 1 percent deductible.” Losoya did not mention any exclusions on coverage for the roof, and Reininger did not make any further inquiries about exclusions.

Insurance Claim Denial – Proving The Claim

March 20, 2021 | Mark S. Humphreys

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.”

Texas Winter Weather Claims Denial

February 27, 2021 | Mark S. Humphreys

Texas homeowners have just experienced the worst loss state wide that has ever been experienced. Homeowners will be reeling from the damage and hopefully the insurance companies treat all their customers fairly. Unfortunately, there will be many customers who end up having their claim denied for one reason or another.

Here are some things to think about as it relates to weather related property claim.

After the historic and widespread property loss and damage resulting from the recent Texas freeze, home and business owners will be turning to their insurance provider for help. Some of those insurance claims will be denied unfairly and property owners will turn to Texas Trial Lawyers Association (TTLA) members for assistance in getting their homes and businesses repaired.

Home Owners Insurance Policy And Collapse

August 12, 2020 | Mark S. Humphreys

Do homeowner insurance policies cover a collapse of the home? It sounds like a simple question but as is illustrated in a 2020, opinion from the Southern District of Texas, Houston Division, it is not as simple as it looks.

The opinion is styled, Beatrice Stewart v. Metropolitan Lloyds Insurance Company of Texas. The case needs to be read to get the facts of the case, however, the facts end up being discussed in the relevant parts of the opinion discussed here.

Metropolitan insured Stewarts home. Stewart experienced some structure problems with her home and turned in a claim to Metropolitan. Metropolitan ultimately denied the claim stating there was no coverage under the wording of the policy.

Non-Renewal Of Policy

July 19, 2020 | Mark S. Humphreys

Here is a homeowners claim from the Northern District of Texas, Amarillo Division, that is interesting. The case is styled, Valerie Smith v. State Farm Lloyds.

This is a summary judgment opinion wherein State Farm asserts that it is entitled to summary judgment because it notified Smith two months before a fire destroyed her home that her homeowners policy had not been renewed.

Smith asserts she never received notice that the policy had expired.

Homeowners Claim And Breach Of Contract

May 13, 2020 | Mark S. Humphreys

Home owners claims are a frequent source of litigation. Here is a case from the Northern District of Texas, Fort Worth Division, that has a little different twist to it. The case is styled, Allen Ripley, et al v. State Farm Lloyds.

Ripley’s home was damaged by a hail storm and he was insured by State Farm. A dispute arose about the damages and there was ultimately an appraisal award. State Farm did not pay the full appraisal amount due to their assertion that part of the damages were not covered by the policy. This lawsuit resulted with Ripley alleging breach of contract and various violations of the Texas Insurance Code.

State Farm filed a motion to dismiss for failure to state a claim.

Is Issuing An Insurance Claim Check And Receiving The Check The Same Thing?

March 15, 2020 | Mark S. Humphreys

Insurance lawyers need to know the various ways other insurance lawyers have attempted to pursue an insurance company and the ways that work and the ways that do not or have not worked. Here is a different approach that failed to work.

This is an opinion from the Northern District of Texas, Dallas Division. It is styled, Corinne Pearson v. Allstate Fire and Casualty Insurance Co.

Corinne filed suit in State Court alleging Allstate improperly denied or underpaid a claim after a storm damaged her home. Allstate removed the case to this Federal Court and obtained an abatement pending an appraisal of the damage to her home. In June 2019, the Court was notified that appraisal had been completed and the case was reopened. Allstate immediately filed this motion for summary judgment.

What Are Insurance First Party Policy’s?

March 4, 2020 | Mark S. Humphreys

What is a First Party claim versus a Third Party claim?

A “first party” policy typically involves insurance that provides policy benefits directly to the insured or beneficiary in the event of a loss. The Texas Insurance Code, Section 541.051(2) defines “first party claim” as a claim “by an insured or policyholder under an insurance policy or contract or by a beneficiary named in the policy or contract that must be paid by insurer directly to the insured or beneficiary. These types of policies generally include health insurance, life insurance, disability insurance, auto policy insurance, homeowner’s property insurance, and commercial property insurance.

In contrast, “third party coverage” is generally considered to include all forms of liability insurance. This type of insurance is designed to insure against loss to third parties caused by the insured or another covered person for whom the covered person may be legally responsible.

“Surface And Ground Water Damage” Exclusion

January 11, 2020 | Mark S. Humphreys

Spring is coming soon and exclusions in homeowner policies for “surface and ground water damage” will be an issue an insurance lawyer must be able to discuss with client.

Here is a November 2019, opinion from the Southern District of Texas, Houston Division, that “kinda” addresses this issue. The opinion is styled, Robert Salcetti v. AIG Property Casualty Company.

Salcetti suffered damage to his home after the U.S. Army Corps of Engineers decided to release water from reservoirs and Salcetti alleges that water entered his home causing significant damage.